Most doctors believe the value of their practice is fixed. They think a broker gives them a number, and that number represents their fate. In reality, strategic positioning can completely rewrite the outcome. I’ve seen practices increase their sale price by millions simply by approaching the process the right way.

One recent deal stands out as a textbook example of what happens when a high-performing practice is strategically positioned for the DSO market. The doctor didn’t just get a good deal. He tripled their practice value.

The doctor owned a thriving, multi-doctor general practice in a growing suburban market.

The practice collected just over four million annually with strong patient flow and a loyal team. On the surface, it looked like a great practice. But like many owners, this doctor had never been through a DSO sale and turned to a traditional broker for an initial valuation.

The broker applied a standard percentage-of-collections formula and came back with a valuation of roughly three million dollars. The doctor was ready to accept that figure. They had worked hard for decades, and three million sounded fair.

What they didn’t realize was that this approach undervalued their practice by millions. The broker’s number was based on outdated formulas that worked when dentists sold to other dentists, not when sophisticated DSOs and private equity buyers were involved. This practice had all the fundamentals DSOs look for, but none of that was being reflected in the valuation.

Before moving forward with the broker, the doctor sought a second opinion.

That’s when my team stepped in. Instead of using collection-based formulas, we performed a full strategic DSO valuation. We analyzed profitability, hygiene performance, staffing stability, growth capacity, and operational systems.

The practice was producing one point two million in EBITDA. That alone placed it in a highly desirable tier. But there was more. The operational systems were clean, the hygiene program was strong, the staff had exceptional retention, and there were two unused operatories ready for expansion. In other words, this was exactly the kind of practice DSOs pay premium multiples for.

We spent three months tightening financial reporting, documenting systems, and preparing marketing materials that told the right story. This was no longer a practice being sold through a one-size-fits-all broker process. It was a strategically positioned asset going to market in a competitive DSO environment.

Once the preparation phase was complete, we quietly brought the practice to market.

We identified a targeted list of DSOs that were the right strategic fit. Non-disclosure agreements were signed, a data room was prepared, and buyers began their initial reviews.

Within a few weeks, multiple DSOs expressed interest. Because the practice had been properly positioned, we were able to create a competitive environment where buyers had to sharpen their pencils to win the deal.

The initial offers started around five million. But as negotiations progressed, and buyers recognized the operational strength and growth potential, the numbers began to climb. DSOs understood that this was not just a profitable practice—it was a platform for growth in a desirable market.

Ultimately, three DSOs submitted serious Letters of Intent. One buyer in particular saw the strategic potential and made an aggressive offer to secure the deal.

The final offer came in at just under nine million dollars.

That’s three times the original broker valuation. The deal included a strong cash-at-close component with favorable earn-out terms and an equity rollover that positioned the doctor to benefit from future growth.

Nothing about the practice’s collections changed during this process. What changed was the strategy. By shifting from a generic broker valuation to a DSO-focused positioning strategy, the doctor unlocked millions of dollars in hidden value.

The deal closed smoothly, and the doctor now has financial security well beyond what they expected when they started the process. More importantly, they partnered with a DSO that fit their culture, ensuring a smooth transition for their team and patients.

This deal illustrates several critical truths that many practice owners overlook:

• Brokers often undervalue high-performing practices because they rely on outdated formulas that don’t reflect what DSOs actually pay for.
  
  
• Strategic preparation matters. Tight systems, strong hygiene, clean financials, and a clear growth story are what drive premium offers.
  
  
• Competition drives price. By marketing the practice to multiple qualified DSOs, we created leverage that pushed offers higher.
  
  
• The right buyer matters. Beyond the numbers, cultural and strategic fit plays a crucial role in post-sale success.

These are not abstract ideas. They are the real levers that separate ordinary outcomes from extraordinary ones.

If your practice is generating more than one million dollars in revenue, you owe it to yourself to understand what it’s truly worth in the current market. My team and I offer a comprehensive appraisal and positioning report, valued at $2,743, at no cost to qualified practice owners.

This report reveals where your practice stands in the eyes of DSOs and where targeted improvements can unlock hidden value. The difference between a routine sale and a record-breaking deal often comes down to strategy.

This doctor proved what’s possible. You can too.

To your unstoppable success,
Your Team at Everything DSO