They have advisors. Now, so do you.
Independent evaluation of private equity offers, MSO structures, mergers, and practice sales. We model the economics and review the terms before you sign.
Every path has a tradeoff. See all of them first.
Most physicians hear about one option at a time, from the person selling it. We put them side by side.
Stay independent
You keep: full ownership and control.
You carry: every operating and capital decision.
Join or build an MSO
You keep: clinical ownership, with shared business services.
You give up: a management fee and some operating control.
Partner with private equity
You get: cash at close and rollover equity.
You give up: future earnings and long-term control.
Merge or sell
You get: scale, or a clear exit.
You give up: your practice's independence.
The terms that decide what the deal is worth
Private equity offers
Valuation and EBITDA add-backs, rollover equity, earnouts, management fees, and your compensation after close.
MSO structures
Evaluate an MSO agreement and its fees, or design and set up a physician-owned MSO.
Mergers and affiliations
Combining with another group, joining a health system, or forming a clinically integrated network.
Practice sales and succession
Preparing the practice for sale, finding the right buyer, or transferring ownership to younger partners.
Letters of intent
What to push on before you sign an LOI, while you still have leverage.
Life after close
Employment terms, noncompetes, and governance rights that shape your day-to-day for years.
From first offer to signed deal
- 01
Understand your goals
Your timeline, what you want to keep, and what a good outcome looks like.
- 02
Model the economics
What you take home under each option, today and over the next five to ten years.
- 03
Review the terms
Every business term flagged and prioritized, coordinated with your healthcare attorney.
- 04
Negotiate and close
A clear list of asks and support through counteroffers, diligence, and closing.
Engagements can be structured as a defined project, a monthly retainer, performance-based fees, or equity participation. Quoted after your free consultation. AxisMD is not a law firm; we work alongside your attorney or one of our partner healthcare attorneys.
We've sat across the table on both sides of these deals.
From our founders' prior executive roles.
Questions physicians ask us
When should we bring you in?
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'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.
Do we still need a lawyer?
Yes. We handle the business and financial terms and work alongside your healthcare attorney or one of our partners.