Hi team: Curious if anyone with healthcare acquisition experience is knowledgeable about the corporate practice of medicine (CPOM) doctrine which prohibits non-licensees (non-doctors, psychologists, etc) from owning equity in the professional entity.

My question is: If you create an MSO structure in which the business and professional decision making are separated, and the practice founder (assuming they are a licensed professional) remains owner of the professional entity, does this create any kind of risk whereby the founder can has a lot of power to potentially against investor interest?

What does institutional PE usually do? Do they replace the founder with a licensee under their control/ on their team? And if so, does that licensee assume risk?