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Agreed.

Had a family member receive an LOI at 10x EBITDA so they decided to sell (not sure where they closed).

They mentioned that if a doctor would have purchased the practice, it would be 1x or 2x at best.

Related: they would have been interested to scale up, but didn't know how and were afraid of the complexity of trying to manage a 3rd location.

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Another thing to keep in mind is that it was a completely different regulatory environment when most of these private practices started. 50 years ago you could run a cash business with yourself, a receptionist, and a nurse. Incumbent practices could keep up with the times and add billing staff, but you would have to be insane to start a new practice today.

I'm all for healthcare reforms, but it's a pity that we didn't pursue a simple voucher or cash-based system over our insanely complex system.

Right.

Seems like there’s opportunity to be the backend operating system to scale these practices.

That’s what PE is supposed to be anyway, but they don’t run it like an owner-operator would.

The human body is an insanely complex system, hence the resulting complex system to discern fraud and waste. Really only a doctor or very educated person can evaluate another doctor’s determination.

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