How to Spot a DSO That’ll Ruin Your Legacy

Dear Reader,

You didn’t build your practice overnight.

You built it through:

• Late nights and early mornings
• Missed family dinners and weekends on call
• Hiring and firing
• Sleepless nights over payroll, patients, and problems no one else could solve

So when it comes time to sell? You’re not just handing over a business. You’re handing over your life’s work.

And the fastest way to destroy everything you’ve built… is to sign with the wrong DSO. Because not all buyers are equal. And not all deals are designed to honor what you’ve built. Some are wolves in scrubs. All smiles up front — until the ink dries.

The Horror Stories No One Tells You Up Front

We’ve seen it too many times:

• A doctor sells to the wrong group, and within six months… their staff starts quitting
• Long-time patients notice the difference — and leave
• Systems get gutted, schedules get slammed, production demands double
• And the doctor? He’s stuck for the next three years, working harder than ever… for less control and less money

And here’s the kicker: That doctor didn’t get a bad offer. He got a bad partner.

Because he didn’t know the signs. Didn’t know what questions to ask. Didn’t know how to see past the surface. And by the time he realized it… His name was still on the wall — but the soul of the practice was gone.

5 Red Flags That Should Make You Run

If you’re talking to DSOs, watch for these:

1. No Clarity on Culture Fit
   If they talk numbers but never ask about your team, patients, or values — they don’t care. And they won’t.
   
   
2. Pressure to Sign Fast
   A real partner wants a fit, not a flip. Urgency tactics are for used car lots — not multimillion-dollar deals.
   
   
3. No Role for You Post-Sale (Or One That’s Vague)
   If they can’t clearly define your role, hours, authority, and exit plan… they’re keeping options open — and you at their mercy.
   
   
4. Sketchy or Opaque Financial Terms
   If you can’t get clear answers on valuation methodology, working capital adjustments, or earn-outs — stop.
   
   
5. You Can’t Talk to Other Sellers
   If they won’t let you speak to doctors who’ve sold to them… they’re hiding something. Period.

Your Legacy Deserves More Than a Payday

This isn’t just about money. It’s about how you leave. It’s about what you leave behind. It’s about whether your name still means something in your community when you’re gone.

We’ve helped doctors walk away from flashy deals that looked great on paper — and find partners who respected their people, protected their patients, and paid them well. Because in the end, the best deal isn’t always the highest dollar. It’s the one that lets you sleep at night.

Let’s Make Sure You Don’t Regret Who You Pick

Before you sign anything, let us help you:

• Review the offer — with your values in mind
• Vet the DSO’s track record with other sellers
• Identify risk areas buried in the LOI
• Structure your role post-sale so you stay in control

You only get one shot at this. Make sure it’s the deal that honors what you’ve built — not one that tears it apart.

To your unstoppable success,

Your Team at Everything DSO