Fertility Practice M&A Multiples: 2026
Selling a Medical Practice: The Complete Guide
October 13, 2026
A practical look at valuation, buyers, and the sale process for physician owners.
Estimated Read Time: 8 minutes
Selling a medical practice can be one of the biggest financial decisions of a physician’s career. Most owners only sell a practice once, so it makes sense to start preparing well before a buyer makes an offer.
Understanding how buyers value a practice and what to expect during negotiations puts you in a better position to make the right decisions.
In this article, you will learn:
- What drives valuation in a medical practice sale
- Who typically buys physician practices today
- How a sell-side transaction unfolds from start to close
- What to prepare before going to market
What Drives Valuation in a Medical Practice Sale
Buyers typically value a medical practice using an adjusted EBITDA multiple. The multiple varies by specialty, with cosmetic-heavy dermatology practices often commanding higher multiples than primary care groups. Geography also matters, since less competitive markets may attract fewer buyers. Most practices in specialties where private equity is an active buyer will trade in the 6x to 10x EBITDA range.
Multiple factors can where a practice falls within the multiple range. For example, an affiliated ASC that is also for sale as part of the package can raise value, while heavy revenue concentration in a single owner can lower it. Larger, more profitable practices in desirable locations often attract more buyer interest and higher valuations. Buyers also consider specific factors like payer mix and growth potential.
Who Buys Physician Practices Today
Private equity now drives most physician practice transactions, though health systems are becoming larger buyers. Many owners first hear from a private equity buyer through direct outreach, before they hire an advisor.
| Buyer Type | Typical Target | What They Look For |
| Private Equity Platform Investment (First investment in a specialty) | Larger, multi-provider groups with sophisticated operations and existing leadership | Established governance; room to expand into new locations and acquire other practices |
| Add-On Acquisition | Practices of any size that present a strong growth opportunity for the buyer | Steady or growing EBITDA; a geographic fit or expansion point for the existing platform’s operations |
Platform buyers may pay higher multiples because they are buying a larger, established practice. However, they may involve more rollover equity and non-clinical seller involvement after closing. Add-on buyers can often move faster to acquire practices that are a good fit with the systems they already have. For a given practice, the list of interested buyers will depend largely on practice size, location, and specialty.
How a Sell-Side Transaction Unfolds
A physician practice sale typically moves through five stages, with each one affecting the final deal. The process usually starts when an owner hires an advisor and moves faster when the practice has organized financial records.
| Phase | What Happens |
| Valuation and positioning | Your advisor reviews the financials and practice operations to determine where the practice fits within current market ranges. Marketing materials are created to tell a compelling story to buyers along with the information they need to understand the opportunity. |
| Buyer outreach | Your advisor contacts potential buyers and works to create interest in the practice. Interested parties sign NDAs and have the opportunity to review information and speak with your advisory team. |
| Bidding and Negotiation | Buyers submit offers per a structured timeline, often in multiple rounds of bidding and negotiation. You will work with your advisory team to choose and negotiate a final offer, which is memorialized in a “Letter of Intent”, which forms the outline of your deal. |
| Diligence | The buyer reviews financial records, provider contracts, and other practice details before finalizing the deal. |
| Legal Documents and Closing | Many legal agreements are involved in medical practice transactions. Your legal team reviews, negotiates, and finalizes these agreements, and the transaction closes. |
Preparing a Practice Before Going to Market
Planning ahead will smooth the road and can help increase valuation. Here are some common items that owners should consider before going to market, ideally in consultation with an experienced M&A advisor.
| Preparation Area | Why It Matters |
| Financial Normalization | Removing personal expenses and non-recurring items gives buyers a clearer EBITDA figure |
| Compliance Documentation | Current licenses, credentialing, and related items avoids diligence surprises later |
| Reduced Owner Dependency | Diversifying clinical production decreases “key man” risk and can improve your valuation by lowering your practice’s risk profile |
| Growth Narrative | A plan to add providers or add services can increase value. |
Further Reading
- Dental Practice Valuation for 2026
- Physician Practice M&A Multiples: 2026 Data
- Plastic Surgery Practice Valuation (2026 Benchmarks)
What Could Your Practice Be Worth?
Selling a medical practice starts with knowing where you stand. FOCUS regularly works with healthcare owners on practice sales and recapitalizations. Talk with our healthcare team about your practice, your goals, and what a transaction could look like. You can also get a clearer sense of your practice’s market position before making any decisions.
Connect with FOCUSFrequently Asked Questions
Typically, yes. In most private equity deals, the selling physician stays on for an employment period and continues seeing patients as before the deal.
Usually, no. Most deals combine cash at closing with rollover equity in the buyer’s platform. Rollover equity lets the seller keep an ownership stake and benefit if the buyer successfully grows and sells after the deal (often known as the “second bite”).
No. Smaller practices can still attract buyers as add-on acquisitions. Generally, practices with at least $10M of revenue are best suited for private equity deals. The size of your practice mainly affects which buyers may be interested and how they structure an offer.
Specialty can have a major effect on buyer interest and valuation. Procedural specialties often attract higher multiples, while primary care practices can still draw strong interest from the right buyers. Some specialties have seen very limited private equity interest to date and are better candidates for physician-to-physician transactions or deals with a health system or larger practice.
A typical sale takes six months from preparation through closing. Some deals move faster, while others take longer when diligence uncovers issues, the legal process moves slowly, or the buyer needs additional time to complete its review.
Written by
Eric Yetter
Managing Director
Eric Yetter is an investment banker focused on healthcare provider services. Eric has completed a variety of healthcare transactions, many with private equity firms and PE-backed companies. His past clients include leading physician and dental groups, behavioral health companies, healthcare facilities, and institutional healthcare investors.
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Written by
Managing Director
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