Should I sell my practice to private equity?

PE transactions in healthcare are not retirement events; they are partnerships. The price is usually split between cash at close and rollover equity in the buyer's platform, and Foley & Lardner notes that in larger deals the rollover can make up to 40 percent of the value of the recapitalized practice. Sellers also sign employment agreements and restrictive covenants that keep them practicing after closing. The right reasons to sell to PE: you want partial liquidity, you want capital and operational infrastructure to grow, you are willing to give up final decision authority on hiring and capital allocation, and you expect to keep practicing for years after closing. The wrong reasons: you want to fully retire (your employment agreement will keep you working), you want full autonomy (PE platforms standardize operations), or you are tired and want out (post-close transition is harder than current operations). The financial outcome depends heavily on rollover equity performance, which is unknowable at close. At the second sale, Nixon Peabody's healthcare deal lawyers point out, a physician's result can depend less on the headline price than on terms signed years earlier: where the rollover sits in the payout waterfall and whether it has to roll again. Treat the second exit as the main payday and the first close as the de-risking event.