PMA Practice Transitions

Each practice transition is more than a transaction, it's the passing of a legacy and the beginning of a new chapter. We're honored to help guide these important transitions and ensure a successful outcome for everyone involved.

I'm pleased to announce the successful transition of Dr. Mike Appel's general dental practice in Akron, Ohio, to Dr. Paul Mikhli.

A sincere thank you to Dr. Mikhli, Dr. Appel, their advisors, and everyone who played a role in making this transition a success. Milestones like these are made possible through collaboration, trust, and a shared commitment to ensuring a seamless transition for the practice, its team, and its patients.

What Dentists Need to Know About Transitions, Insights from Keith Nicholson in Dental Economics

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Key Takeaways:

For many dentists, buying or selling a practice is the most meaningful business transaction of our professional lives. As a dental professional, I’ve purchased a practice, acquired another location during ownership, and sold my business. With each iteration, I learned actionable insights that I apply to support peers embarking on practice transitions.

Practice value is the gestalt of profitability, brand, culture, geographic location, trajectory, and more. As consultants, we work cohesively with clients to highlight the salient features relevant to value.

Adjusted (normalized) operating cash flow is a critical data point for computing value as it underpins the buyer’s access to a practice loan and capacity to make loan payments. However, numerous factors impact value, including the payer mix, hygiene production, equipment condition, local demographics and economics, and more.

The type of sale and the tax allocation of assets influence the final sales price because these features have significant implications for liability and after-tax proceeds. Dental transactions are typically classified as an asset sale, ascribing 70-90% of value to intangible assets.

DSO transactions are ostensibly more complex because the seller’s proceeds are enveloped in much more than the sales price. We use financial modeling to forecast the expected financial implications of keeping your practice vs. selling to a DSO.

In private equity, value creation can be achieved through EBITDA growth, EBITDA multiple expansion, and debt paydown. These channels have important implications for equity stock performance.

As advisers, we lead negotiations, taking a holistic approach and focusing on integrative issues to expand the pie for mutual gain.

Planning and preparation is an important stage during which we provide strategies to boost the future sales price and adhere to the desired exit timetable. The first step is often a Quality of Earnings (QoE) process to examine the level and sustainability of cash flows.

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PMA’s Pinnacle Practice Consulting delivers another success story, proudly representing the buyer in a seamless practice transition.

"I recently purchased an orthodontic practice with the help of PMA. Their team's expertise and guidance were invaluable in navigating the complex process.
What stood out most was their support during due diligence and the closing process. Their experience helped me identify the right questions to ask and ensured that I fully understood the financials, operations, and growth potential of the practice I ultimately purchased. I knew Dr. Keith Nicholson from my orthodontic residency. He shared insights during the acquisition process that meaningfully improved the purchase agreement terms. Their knowledge of the dental industry and attention to detail gave me confidence in my decision. The entire process was seamless, and their team's responsiveness made it easy to get answers and move forward. I highly recommend PMA to a colleague looking to buy a practice - they truly made the process stress-free and their professionalism, industry expertise, and commitment to their clients make them an exceptional partner throughout the entire process".

Dr. Bhumika

PMA Practice Transitions is excited to announce the successful transition of Dr. Angela Gasser’s dental practice in Wadsworth, Ohio. Congratulations, Dr. Gasser, we wish you continued success and all the best in this next chapter!