Roll-ups are always interesting because you'll find people who are either in the camp of, "I better jump in!" to, "I better back far, far away...." Roll-ups either fail or they succeed, there's not much in between. If your roll up is successful, of course, it's an incredible accomplishment!

There are a few major key considerations to take into account with a roll-up.
-Target criteria - You can't just acquire anything under the sun. You need specific criteria for why any business you acquire in a roll-up. Otherwise you'll make poor purchasing decisions that don't mesh well with the other businesses involved.
-Dilution & Exit strategy - Dilution in a roll-up is the kiss of death. You need a strategy for how to deal with that. To ensure you investors can make an appropriate exit.
-Operating model - Will you know what all the levers of power will be in the business to get the results you want? Without a cohesive operating model that binds the companies together you may as well be running an investment vehicle with a bunch of separate businesses.
-Value - What value is added to the companies brought into the roll-up? There needs to be something tangible that will give them an immediate competitive edge. That way when you come asking if they're interested to sell they were ready to say 'yes' yesterday..

If you'd like to talk more in-depth sometime, I'm open to scheduling a call!

Tough tough business. Don't see this too often, but imagine there's opportunity there because of it. Lots of problems inherently with private practice PTs.