Buying Physician Practice Businesses

September 10, 2025

by a searcher in San Francisco, CA, USA

I am looking at deals that are physician practices and this is an area I would like to know more so I'm hoping to get feedback from the community here. 1. What is the current market multiple range for $2M+ EBITDA businesses? Does this multiple range vary across different practice areas (Podiatry, pediatrics, OBGYN, plastic surgery, or any others)? 2. Is there significant multiple expansion for businesses with $10M+ EBITDA? 3. Besides the obvious like low customer concentration, what factors make a good business? Some that I noticed so far - multiple physicians, less reliance on state medicaid. 4. What are your thoughts about practices with only one physician (who is sort of the face of the business)? Is it worth pursuing these with an earnout type deal structure?

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Reply by a searcher
from Columbia University in New York, NY, USA

Great question and would love to hear where you land. Agree with your reasoning, For $2M+ EBITDA physician practices, I’m generally seeing ~4×–8× EBITDA, with variation by specialty as you mentione (elective/private pay areas like plastics often higher; Medicaid-heavy specialties lower). Multiples usually expand meaningfully at $10M+ EBITDA because scale lowers risk and attracts more PE/strategics. I'm guessing you'd want to pursue this as a roll up. Beyond low customer concentration, look at: multiple physicians, diversified payer mix (less Medicaid), clean RCM, and standardized ops that scale. Solo-doc practices are tougher — high key-person risk. They can be pursued with earnouts + transition/employment agreements, but usually at a discount vs. group practices. Would love to hear how others have approached / have been creative around key-person risks.

Reply by a searcher
from Rockhurst University in Danville, CA, USA

As a physician currently operating multiple behavioral health practices in different states and actively searching for additional ones, here are some things I can add to the excellent advise give by others: I would advise not looking at medical practices as a singular group of businesses. There can be tremendous inherent variability in practices solely due to the specialty, including but not limited to: - Scalability - Regulatory headwinds/tailwinds - Amenability to telehealth - Reliance on hospital privileges and alignment - Margins - Use of midlevel providers and the scope of practice a state allows for them - Shortage/abundance of physicians trained in that specialty in an area - Patient-physician relationship in the context of that specialty You’ll be better off understanding the nuances of various specialties, limiting your buy box to 2-3 specialties that align with your goals and narrowing down your search. If you are not a physician yourself, you will need to understand CPOM laws and regulations and think about an MSO-friendly PC model, or stick to states that allow non-physicians to buy medical practices. Avoid medicaid and Medicare as much as you can and stick to commercial payers. Gain a strong understanding of the revenue cycle management. Avoid solo-physician practices. You will not be able to keep all patients after the one physician that they’ve had a relationship with departs, so revenue will take a hit. Also, relying on one physician until you’ve scaled enough to bring on additional ones will expose you to too much key-personnel risk, particularly if you’re not a physician who can jump in and see patients in a pinch at that practice. Good luck with your search. If you would like to discuss anything specific, please feel free to reach out to me via a DM or email: redacted I’m also on LinkedIn (linkedin.com/in/ashergill).

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