Tag
#Ebitda
17 articles
The Dental Practice Data Room: What to Build, How to Structure It, and Why Starting 5 Years Early Changes Your Multiple
Most sellers assemble data rooms in 60 days. Here's the forensic-grade folder structure PE buyers actually expect — and why building it early changes your multiple.
The Merry Go Round Tax: What High Turnover Is Really Costing Your Practice
High turnover is not a staffing problem. It is a tax — paid in lost production, eroded patient trust, training drag, and a QoE audit fingerprint that costs you at the multiple.
The Algorithmic Denial Machine: How Payer AI Is Weaponizing Your Radiographs
Insurance payers are deploying pixel-level AI to deny claims at scale. The same weaponization PE firms use during QoE is coming to every claim you submit.
The Data Room Nobody Builds: What Buyers See That Sellers Never Prepare
A QoE team spends 30 days dismantling the story you spent 30 years building. Sellers who pre-audit their data room dictate the terms of their exit.
The Silent Margin Collapse: Clinical Judgment as Enterprise Value Destruction
A single D4910-to-D1110 downgrade costs $70. Repeated daily across 3 locations, it erases $504,000 in enterprise value at a 6x multiple.
The Practice That Should Have Sold: What Dentists Get Wrong About Selling
A practice with strong collections sat on the market for 30 months because the operational narrative went cold. The three-year mistake explained.
The Due Diligence Ambush: How PE Weaponizes Your Data to Hijack Your Exit
Private Equity QoE teams extract raw PMS data to systematically dismantle your EBITDA. A $3M group lost $13.8M in enterprise value to unsanitized data.
Eyes Wide Open: What I Wish Every Dentist Knew Before Signing a DSO Contract
DSO contracts are built to maximize platform EBITDA, not doctor compensation. Realization rate traps, capitation true-ups, and non-competes explained.
EBITDA Laundering: The Clinical Blind Spot in Dental M&A
The EBITDA Laundering blind spot in dental M&A: how compliant-looking revenue masks clinical fraud that survives standard due diligence.
The Asset Allocation Error: Why You Over-Invest in Tech and Under-Invest in Trust
I audit practices that have $200,000 worth of clinical technology sitting in a facility that looks like a 1990s DMV. They have the CBCT. They have the PrimeScan. They have the lasers.
The "Cash Flow" Mirage: Why Profitable Practices Go Broke in Year 1
You are looking at a prospectus for a $1.5M practice. The Broker points to the bottom line: "Look at this! $280,000 in Free Cash Flow. After debt service, you take home $180k. It's a turnkey investmen.
The Operational Gap: Why Most Dentists Are Underpaying Themselves for 30 Years Or More
My brother James published his newsletter last week: "The EBITDA Illusion: Why DSOs Buy You at 5x and Trade at 14x." He's breaking down how private equity plays the arbitrage game—buying practices at .
The EBITDA Illusion: Why DSOs Buy You at 5x and Trade at 14x (And How to Keep the Difference)
Why dental DSOs trade at 14x while acquirers pay 5x — understand the Multiple Arbitrage mechanism that transfers wealth from practices to PE.
The Hygiene Asset: Why Your Recall System Is Your Practice's 401(k)
The Hygiene Asset: Why Your Recall System Is Your Practice's 401(k) In my last piece, we dissected "The Expert's Trap," exploring the journey from practitioner to true business owner. That discussi.
Income Rich, Asset Poor: The High-Production Valuation Trap
Income Rich, Asset Poor: The High-Production Valuation Trap You are the most profitable producer in your practice. Your clinical skills are unmatched, your schedule is perpetually booked, and you p.
The Million-Dollar Mistake: Why Waiting Until You're Ready to Sell Could Cost You Your Legacy
The Million-Dollar Mistake: Why Waiting Until You're Ready to Sell Could Cost You Your Legacy For decades, you have been a pillar of your community, a trusted caregiver for generations, and the lea.
Analyzing Your Dental Practice's P&L: Setting the Course for 25% EBITDA
In previous articles, we've explored how leveraging data can unlock significant growth in your dental practice. Now, let's delve into a crucial step: conducting a financial analysis to assess where yo.