Yes — and the earlier the better. Once a transaction process starts, options narrow quickly. PE groups move fast because speed benefits them, and their advisors are experienced at creating urgency. We provide independent advisory on what the offer actually means for you: the post-close employment terms, the long-term financial model, the clinical autonomy implications, and whether alternatives exist that you may not have been shown. The initial conversation is free and completely confidential.

No. Our sweet spot is independent practices with 3 or more providers — precisely because these practices are large enough to have real operational complexity, but typically don't have a dedicated strategic or administrative leadership layer. That's the gap we fill. We have worked with practices of 2 physicians and groups of 40. The common thread is independence and the desire to protect it.

A confidential conversation with no agenda other than understanding your situation. We work regularly with brokers and practice transition advisors — they refer clients to us when those clients need independent advisory that sits outside the transaction itself. We'll give you a straightforward assessment, explain what we can do, and let you decide whether and how to move forward. There's no obligation and no cost to the initial conversation. We respect the relationships that brought you here.

It depends on what you need. We have supported practices with billing and revenue cycle infrastructure, payroll setup and management, HR frameworks and staffing protocols, vendor selection and management, and the full administrative layer that consumes physician time. Some practices engage us for a specific operational project. Others retain us on an ongoing basis as a fractional operational partner. We scope every engagement to match the actual need — not a standard package.

Most healthcare consultants advise from the outside. AxisMD was built by people who ran these organizations from the inside — managing physician compensation, running operations, and sitting in rooms where acquisition strategies were designed. We don't bring frameworks borrowed from other industries. We bring 30 years of direct operational experience in physician organizations, applied exclusively on behalf of independent practices and the physicians who lead them. We have no relationships with health systems, PE groups, or payers.