SBA financing for healthcare practices that require licensed professional

February 05, 2026

by an intermediary from The University of Chicago - Booth School of Business in Chicago, IL, USA

Most healthcare practices have to be owned and managed by a licensed professional (doctor, LCSW, Dentist, etc.). PE groups buy them and form a MSO (Managed Service Organization). The actual practice continues to be owned and operated by a licensed professional (current owner or a new one who is paid a salary). Buyer's MSO takes over all admin functions, and the practice pays a management fee. Does SBA finance such deals? How?

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Reply by a lender
from Cornell University in Los Angeles, CA, USA

Agree with Joseph, this is spot on. The PG friction is real and catches people off guard. One additional insight: the reason lenders want that licensed professional to personally guarantee isn't just about legal structure; it's because that person IS the revenue engine. If the licensed professional leaves, the practice can't operate. The license is the business. The practical workaround: find an existing employee in the practice who already holds the same license and get them to sign a multi-year employment agreement with retention bonuses. Or recruit a new licensed professional from outside and lock them into a similar arrangement. Either way, you're showing the lender operational continuity that doesn't depend solely on the seller, which is what actually gets them comfortable on the PG and the credit. We have a lot experience financing various healthcare practices via the SBA. If you ever need help reviewing a deal, I am happy to help. We work with all the major SBA lenders. The bank pay us after your loan closes, so this is a 100% free service for you. You can email me directly at redacted or schedule a meeting with me: https://cal.com/francodeguzman/30min. Look forward to chatting!

Reply by a professional
from University of Notre Dame in New York, NY, USA

Most SBA lenders do not get comfortable underwriting an MSO/PC structure as two truly separable borrowers. They generally look through the structure, treat the MSO and the clinic as a single operating enterprise for credit purposes, and underwrite based on consolidated cash flow and control. As a result, if the selling physician must remain the clinic owner under state law, many banks will require that physician to personally guarantee the SBA loan for the full term, even though economics are largely flowing through the MSO. Where it can work differently is if clinic ownership can be transferred at closing to a non-selling physician who meets SBA eligibility and control requirements - often not realistic for smaller practices. It can work … but it’s very bank-by-bank and often comes with PG friction that surprises sellers (and buyers) who are new to healthcare MSOs.

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