Are you talking about physicians? What is your target populstion?

I'm referring to medicals centers / GP's. Target population? do you mean amount of employees?

I mean age profile, disease burden, medical vs surgical, etc. That defines md profile and equipment requirements

Yes, but unless you're a licensed practitioner in that field you'll need a unique acquisition and management structure to avoid corporate practice of medicine restrictions (depending on jurisdiction).

Very interesting. Would that single structure allow for multiple specialties and ancillary services as well?

I have experience acquiring practices in specialties, not GPs, but there are several unique transaction points to think about. First, as noted above, in certain states in the USA you would have to partner with a licensed physician to acquire a physician's practice. This is due to corporate practice of medicine laws in the US. It is possible and is being executed by many larger PE groups right now (currently working at one of these portfolio companies). Another nuance is that in many of the states in the US, non-compete agreements for physicians are unenforceable. This is particularly tricky if you are acquiring a medical practice and hoping that the primary physician (and former owner) will remain on-board. Theoretically, they could collect their payment and set up a new practice just down the street.

These are just the first two nuances that come to mind when acquiring a physician's practice. Feel free to message me if you would like to talk more about this.

In states where non-competes are unenforceable for healthcare practitioners (NM comes to mind), there are generally exceptions for agreements involving equity in a healthcare practice (IE, you can bind a selling physician to a non-compete that would otherwise be unenforceable against an employee physician).

Also looking at the DSO model in the dental world if anyone has any experience there. Thanks!

Hi Brent and others, feel free to reach out - we are very active in the DSO space and healthcare generally - [redacted]

I do a significant amount of work in the DSO space - upwards of 30 transactions this year as well as various regulatory issues.