Tag
#Ebitda
25 articles
The Moving Target: How Dental Practice Earnouts Are Measured and Controlled
An earnout is not a number — it is a measurement system administered by the buyer for 3-5 years. The five clauses that decide whether yours pays $2.1M or $0.
The Blind Claim: The Three Hidden Failure Points Where Your Enterprise Value Is Actually Decided
Buy-side diligence rebuilds your EBITDA from your PMS data. The three failure points where enterprise value is decided — and how sellers defend each one.
The Boutique Fallacy: Why Size Sets Your Dental Practice Value
Two dental practices, same profit, can sell millions apart. Why size — not margin — decides whether you get an SDE multiple or an institutional DSO/EBITDA exit.
The Consultant's Mirage: Why Standard Advice Fails a Dental QoE Audit
The standard dental consultant advice — boost production, cut overhead — is exactly what gets your EBITDA slaughtered in a buyer's Quality of Earnings audit.
What Is My Dental Practice Worth? Why the Answer Depends Entirely on Who's Buying
The value of your dental practice depends entirely on who is buying. Here is how individual buyers and institutional buyers calculate it — and why those are two different numbers.
The KPIs That Kill Your Multiple: Which Dental Practice Metrics Institutional Buyers Actually Score
Not all dental KPIs matter at exit. Here are the metrics PE-backed buyers weight most, the thresholds that move multiples, and the vanity metrics they ignore entirely.
Governance Debt: The Compounding Liability Silently Eroding Your Practice's Enterprise Value
Governance debt — compliance gaps, undocumented SOPs, key-person risk — compounds silently and surfaces during due diligence. Here's how to quantify and eliminate it before a buyer's algorithm does.
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
$200,000 of clinical technology in a facility that looks like a 1990s DMV. Patients can't judge your prep, so they judge the lighting and the smell. Sensory arbitrage and the halo effect.
The "Cash Flow" Mirage: Why Profitable Practices Go Broke in Year 1
The prospectus shows $280,000 in free cash flow. Year one brings market-rate wages, 10–15% attrition, debt service, and deferred equipment — a ~$330,000 swing. The Double Crush, itemized.
The Operational Gap: Why Most Dentists Are Underpaying Themselves for 30 Years Or More
The average dentist earns $218K and should earn $300K+. The 35/25 Rule — 35% of personal production as compensation, 25% practice EBITDA — and why you can't cut your way there.
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)
Hygiene is the only revenue in a dental practice that runs without the owner's hands. Hygiene share of production, the 30% perio benchmark, 90% reappointment, and the 3-minute exam.
Income Rich, Asset Poor: The High-Production Valuation Trap
An $800,000 owner income is a replacement cost, not profit: the buyer deducts 30–35% of your production to pay your successor. Owner-dependent at 5–8x versus platform-ready at 9–11x.
The Million-Dollar Mistake: Why Waiting Until You're Ready to Sell Could Cost You Your Legacy
Dentists who sell when they feel ready sell two to five years too late. $200,000 of added EBITDA at 6–7x is $1.2–1.4M of price left on the table, plus a smaller buyer pool.
The Data-Driven Practice Advantage: Predictable Revenue, Minimized Risk, and EBITDA That Survives the Buyer's QoE
The data-driven practice advantage is not dashboards or software — it is predictable revenue, quantified risk, and an EBITDA figure that survives the buyer's Quality of Earnings audit without adjustment.
Analyzing Your Dental Practice's P&L: Setting the Course for 25% EBITDA
How to categorize a dental practice P&L, the expense percentages behind a 25% EBITDA margin, and the income goal math — including why owner compensation must be reset to market rate first.