Questions physicians ask us

Straight answers about how we work, what we cost, and what to expect. Don't see your question? Ask us on a free consultation.

What does "physician-side" mean?

We only represent physicians and practice owners. We take no fees from private equity firms, health systems, payers, recruiters, or buyers, so our advice isn't shaped by anyone on the other side of the table.

How much does AxisMD cost?

It depends on the work. Contract reviews start at $2,500, the Practice Scan is $999, and the Full Operational Audit is $2,500. Larger engagements can be a defined project, a monthly retainer, performance-based, or equity participation. You get a quote after a free consultation, before any work begins.

What happens on the free consultation?

It's a confidential 30-minute call with Mark, Sara, or both. We learn your situation and goals. If we're a fit, you get a quote and a plan. If we're not, we'll tell you.

Is what I share confidential?

Yes. We never share your information with employers, recruiters, buyers, or health systems.

Do you work outside Texas?

Yes. We're based in Houston and Dallas and work with physicians and practices across the US.

Are you a law firm?

No. We advise on business, financial, and operational terms. For legal review, you can work with one of our partner healthcare attorneys or your own. Legal review is priced separately and can be bundled with any package.

When should I get my contract reviewed?

Before you sign anything, including a letter of intent. Terms are easiest to change before you've agreed in principle.

How fast can you review my contract?

Standard reviews take 5 business days. Urgent reviews can be done in as little as 24 hours.

Will negotiating hurt my relationship with my new employer?

Done well, no. Employers expect physicians to negotiate. You lead the conversation and we stay in the background, so it stays professional.

Do you negotiate for me?

No. We prepare you to negotiate: a written plan, the data behind each ask, and mock negotiations where we play the employer.

What is a fair wRVU rate for my specialty?

It depends on specialty, region, and practice setting. We benchmark your offer against national compensation and productivity data such as MGMA, AMGA, and SullivanCotter.

Can I negotiate my noncompete?

Often, yes. Radius, duration, and buyout terms are common points of negotiation, and some states now limit physician noncompetes.

Do you work with residents and advanced practice providers?

Yes. We have a $2,500 first-contract package for residents and fellows, and we review employment agreements for NPs and PAs.

What's the difference between the Practice Scan and the Full Operational Audit?

The $999 Practice Scan is a fast, high-level scorecard of your biggest gaps. The $2,500 Full Operational Audit is a complete data review with benchmarks and a prioritized action plan. The Scan fee is credited toward the full audit.

What data do you need from us?

For a Practice Scan, a short questionnaire and one or two standard reports. For a full audit, we send a defined data request list up front.

What is fractional executive leadership?

Part-time COO- or CFO-level leadership for your practice, without the cost of a full-time executive.

Do we need outside capital to grow?

Not always. Many growth moves can be funded from operations or bank financing. We model each option so you can see what you'd give up, if anything.

What's the difference between an MSO and private equity?

An MSO provides business services for a fee while physicians keep ownership of the clinical practice. A private equity deal usually means selling a majority stake in the business in exchange for cash and equity.

When should we bring you into a deal?

As early as possible, ideally before you sign a letter of intent. After the LOI, most of your leverage is gone.

Will you tell us not to do the deal?

If that's what the numbers say, yes. We don't take fees from buyers, so our only interest is the right outcome for you.

What do you look at in a private equity offer?

Valuation and EBITDA add-backs, rollover equity, earnouts, management fees, your compensation after close, noncompetes, and governance rights.

You built an independent practice. We help you keep it that way.