When Does It Make Sense to Sell Your Practice or Bring in a Partner?

Most physicians wait too long to sell or bring in a partner—and they pay for it in money, control, and burnout.

You’re probably here because your practice is at a crossroads. You’re tired, growth has stalled, or the numbers suddenly stopped making sense. Let’s be blunt: staying solo forever is not a badge of honor. Sometimes it’s smart. Sometimes it’s just denial with overhead.

This is the decision you’re really making:

• Keep full control and full risk
• Share control and share risk
• Or cash out (partially or fully) and let someone else take the wheel

Here’s how to know which one fits you, right now.

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The Three Real Options on the Table

You do not have fifty options. You have three.

1. Keep the practice solo and independent
2. Bring in a partner (or partners)
3. Sell to a group, health system, or private equity (partial or full sale)

Everything else—IC hires, locums, per-diem help—is just tactical staffing, not a structural decision.

Let’s define terms so we’re not talking past each other.

Option 1: Stay Solo

You own 100% of the practice. You make all decisions. All profits and all risk are yours.
This works best when:

• Your overhead is lean
• Your payer mix is stable
• You’re okay being the primary workhorse

The upside: control and flexibility. The downside: you’re the bottleneck.

Option 2: Bring in a Partner

Bringing in a partner usually means:

• Selling them equity over time (buy-in)
• Sharing major decisions
• Sharing profits and call
• Often increasing total capacity (more patients, more services)

This is not the same as hiring an associate. An associate leaves. A partner stays, votes, and shares your future.

Option 3: Sell the Practice

“Selling” could mean:

• Selling 100% to a hospital, large group, or private equity platform
• Selling a majority (e.g., 60–80%) and rolling the rest into equity
• Selling to an internal buyer (associate or junior partner) via buy-in

Here you’re basically trading control and future growth for security and a payout.

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When Bringing in a Partner Makes Sense

Let’s start with partnerships, because that’s often the better first move than selling.

1. You’re Turning Away Business (Or Working Unsustainably)

If you’re:

• Booking out 3+ months for new patients
• Working >55–60 hours weekly consistently
• Seeing daily add-ons that you can’t reasonably fit
• Watching referrers send patients elsewhere because you’re “too backed up”

…you probably have more demand than one physician can safely handle. That’s a signal for either:

• Hiring more staff and midlevels, or
• Bringing in a partner-level physician to share the load and grow capacity

Here’s how the trade-off usually looks:

Factor	Stay Solo	Add Partner
Control	100%	Shared on major decisions
Personal income	Higher per RVU, lower ceiling	Slightly lower per RVU, higher total
Lifestyle	More call, more hours	Shared call, more time off
Growth potential	Limited by you	Higher, with more clinical capacity
Succession	None	Built-in transition

If you’re constantly saying, “I’ll just push a little harder this year,” and you’ve said that three years in a row, you’re stalling. That’s when partnership talks become rational, not premature.

2. You Want an Exit Plan That’s Not “Close the Doors”

Bringing in a partner early is the single most underrated succession strategy.

The worst scenario I see:
65-year-old solo doc, no partner, no buyer, staff in their 50s, charts and goodwill that vanish the moment they stop working. The practice value basically drops to furniture and equipment.

If you want to retire or slow down in 5–10 years, the best time to start grooming a future buyer/partner is now, not 2 years before you want out. A partner who:

• Buys in at year 1–3
• Grows with the practice
• Then buys additional shares over time

…gives you a gradual liquidity path and a smoother handoff to patients and staff.

3. You Need Strategic Skill, Not Just an Extra Pair of Hands

Sometimes you don’t just need “another doc.” You need someone who:

• Brings in a new procedure line (e.g., interventional pain, endoscopy, Mohs)
• Expands coverage (e.g., inpatient consults, outreach clinics)
• Has strong business/leadership interest to complement your clinical focus

If your practice is stuck at a plateau—good, not great—adding a partner with complementary skills can flip the ceiling.

Revenue Growth After Adding a Partner

Category	Solo Revenue ($M)	With Partner ($M)
Year -1	1.2	1.2
Year 0	1.25	1.25
Year 1	1.28	1.6
Year 2	1.3	1.9
Year 3	1.32	2.1

Is that exact curve guaranteed? Of course not. But the pattern is common: plateau as solo, steeper curve with the right partner.

4. Your Lifestyle Priorities Changed

You’re allowed to decide you want:

• More time with kids
• Dedicated nonclinical days
• Pure outpatient and less call

If those life changes are non-negotiable, you either shrink the practice or share the workload. A partner makes it possible to maintain revenue and patient access while you step back slightly.

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When Selling Your Practice Makes Sense

Now let’s talk about selling. There are times when this is exactly the right move—and times when it’s a panic button.

1. You’re Within 5–10 Years of Retirement and Have No Internal Buyer

If you’re mid-50s or older and:

• No partner
• No associate likely to buy in
• No family successor
• And you don’t want to rebuild with a junior doc from scratch

…an external sale becomes rational. Especially if your practice has:

• Strong referral patterns
• Solid payer contracts
• Good location and brand in the community

Selling here is about capturing the economic value you built—patient list, brand, contracts—instead of watching it evaporate when you walk away.

2. You Hate the Business Side (And It’s Getting Worse)

Some physicians truly despise:

• Negotiating with payers
• Fighting denials
• Managing staff HR issues
• Wrestling with EMR, compliance, audits

If the admin side is draining enough that you’re thinking “I’ll just be an employee again,” then selling to a hospital, large group, or PE-backed platform may buy you:

• A guaranteed base salary
• RVU or productivity bonus
• Benefits, malpractice coverage
• Administrative infrastructure you don’t have to run

That’s not “giving up.” That’s prioritizing your sanity. Just know you’re trading away control and some upside.

3. You Need Capital You Can’t or Won’t Borrow

Sometimes you hit a growth wall that needs real money:

• New building or major expansion
• Expensive equipment (imaging, surgery center, lab)
• Multi-site rollout

If the debt burden to do that solo makes you queasy—or the bank won’t back you at the level needed—selling a stake in the practice can be a financing strategy.

This is what private equity platforms love: consolidate, inject capital, grow aggressively, recap later. That can work well for some, badly for others. The key is understanding exactly what you’re giving up and what the post-sale comp looks like.

Compensation Structure Before vs After Sale

Category	Value
Base Salary	220000
Bonus/Profit Share	150000
Benefits Value	40000

(Example for illustration only: post-sale comp usually shifts toward more base, less pure profit.)

4. Reimbursement or Local Market Is Turning Against You

There are markets where staying independent is getting borderline impossible:

• Rapid hospital or system consolidation
• Payers preferring large groups or ACOs
• Significant reimbursement cuts in your specialty
• Losing key contracts you cannot realistically replace

When the macro environment is sliding, selling before your numbers deteriorate too far is often smarter than hanging on until the practice is clearly distressed. Buyers pay for future cash flow; if that future looks worse every year, the offer drops.

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Red Flags: When You Should Not Rush to Sell or Add a Partner

Just because you feel tired or annoyed does not automatically mean “sell.” Some situations need operational fixes, not structural ones.

1. You Don’t Actually Know Your Numbers

I’ve seen physicians panic because “we’re not making money,” and then their P&L shows:

• Owner comp is fine
• Overhead is temporarily inflated (EMR switch, staffing transition)
• AR is messy but collectible

Before making a big move, you should be able to answer clearly:

• What’s my 3-year trend in collections?
• What’s my overhead % and where is it bloated?
• What is my true owner compensation after add-backs (car, CME, etc.)?
• How much is goodwill realistically worth in my market?

If you cannot answer that, you’re flying blind. Bring in a healthcare CPA or consultant before signing anything.

2. You Haven’t Tried Fixing the Obvious Problems

Examples:

• Your schedule is chaos → fix scheduling rules, staff training, and templates
• You’re buried in admin → hire a real practice manager, not just “the front desk lead”
• Denials are insane → get revenue cycle help, audit billing

Too many physicians skip these fixes and jump to “I’ll just sell to the hospital.” You’ll carry the same inefficiencies into the new system, just with less control and a more complicated org chart.

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How to Decide: A Simple Framework

You want a decision process, not hand-waving. Use this four-part filter.

Practice Transition Decision Flow

Step	Description
Step 1	Current Situation
Step 2	Consider Partner
Step 3	Consider External Sale
Step 4	Optimize Operations First
Step 5	Reassess in 6-12 Months
Step 6	Burnout or Capacity Issue
Step 7	Want to Stay an Owner
Step 8	Market or Financial Pressure

Ask yourself, honestly:

1. Do I still want to be an owner?
   If the answer is no, selling (full or partial) is on the table.

2. Is the main problem personal capacity or structural decline?

   • Capacity (too busy, need help) → partner or associates
   • Structural (reimbursement collapse, loss of contracts) → possible sale

3. What’s my 5–10 year plan?

   • If you want out in <10 years and have no internal buyer, start planning: partner or sale.
   • If you want to build a regional group, bring in partners early and often.

4. What’s non-negotiable for me?
   Control? Income floor? Time with family? Procedures you must keep doing? Use those to filter offers and structures.

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Practical Next Steps (Not Theory)

If you’re seriously considering a partner:

• Get 3 years of clean financials ready
• Outline a clear buy-in structure (valuation method, timeline, vesting)
• Decide what decisions require unanimous vs majority vote
• Talk to a healthcare attorney before you promise anything

If you’re seriously considering a sale:

• Clean up your AR and contracts; buyers pay more for less mess
• Benchmark your specialty’s transaction norms (multiples, structures)
• Talk to other physicians who’ve sold—to hospitals and to PE
• Get your own advisor. Do not rely solely on the buyer’s narrative.

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FAQs: When Does It Make Sense to Sell or Bring in a Partner?

1. What’s the ideal size or revenue level before bringing in a partner?
   There’s no magic number, but a common pattern: once your personal schedule is full, you’re booking new patients out 2–3 months, and you’re consistently turning away work or working unsustainably, you’re “big enough” to justify another owner. Financially, many practices start partner conversations when collections are in the $1–2M range with stable demand and room to grow. The real question is capacity and demand, not an arbitrary revenue line.

2. How is a partner buy-in usually structured?
   Typically as a purchase of equity over time, based on a valuation that includes tangible assets plus some goodwill. Many groups use a formula tied to a multiple of earnings or collections. Example: new partner buys in over 3–5 years using pre-tax dollars from their compensation, gradually earning voting rights and profit share. You want clear terms for buy-in, governance, and buy-out in the shareholder/operating agreement.

3. Is selling to private equity always a bad idea?
   No. It’s over-hyped and over-feared. PE can make sense if: your specialty is targeted (derm, ophtho, GI, anesthesia, etc.), you have solid EBITDA, you want liquidity now, and you’re okay becoming an employee with productivity expectations. It’s a bad idea if you don’t understand the comp model post-close, assume the multiple will always be high, or believe the marketing pitch without reading the actual contract with your own lawyer and advisor.

4. What if my practice isn’t very profitable—can I still sell?
   You can, but the value will be low and buyers will be selective. If your practice is barely breaking even or your owner comp is marginal, an external buyer may only pay for assets (furniture, equipment) and possibly a small amount for charts/goodwill. In that situation, it often makes more sense to fix operations and profitability for 1–3 years, then reassess selling once the numbers look better.

5. How long does it take to bring in a partner or close a sale?
   Longer than you think. Internal partnership tracks are usually at least 1–3 years from an associate’s start date to actual partnership, partly to test fit. An external sale to a hospital or PE often takes 6–12 months from first serious conversation to closing, between due diligence, contract negotiations, and regulatory issues. If you want to retire “next year,” you’re already late.

6. What’s the biggest mistake physicians make in these decisions?
   Two, actually. First, waiting too long—assuming they can flip a switch at 60 and magically find a great buyer or partner. Second, not getting independent advice and relying solely on the buyer’s pitch or a colleague’s anecdote. You need your own numbers, your own goals, and your own experts (CPA, attorney, maybe a transaction advisor) to avoid signing yourself into a deal you’ll resent in two years.

7. How do I protect my culture and patient care when selling or adding partners?
   You put it in writing and in structure, not just vibes. For partners: define clinical standards, scheduling norms, call expectations, and non-competes clearly. For a sale: negotiate autonomy in clinical decision-making, staffing levels, and scheduling where possible. Talk to other docs in the buyer’s system or platform about what actually changed for them. If culture and patient care really matter to you, they need to be central negotiation items, not afterthoughts.

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Key takeaways:

1. Bring in a partner when you have more demand than you can safely handle and still want to be an owner.
2. Sell when you no longer want the risk and responsibility of ownership or need a real exit/retirement plan.
3. Do not make either move without understanding your numbers, your 5–10 year plan, and the exact trade-offs in control, income, and lifestyle.