Does selling to a DSO ever cross your mind? It's tempting, and I understand why. Most doctors who start thinking about it aren't chasing a dream. They're tired. The practice isn't running the way they want, they're buried in admin work they never trained for, and then someone offers them a big chunk of money. That sounds pretty great.

Here's what I want you to understand: they're offering you that money because they already know your practice is a cash cow. They're not being generous. They're buying a machine that will keep feeding them for years, and they've done the math to make sure it works out in their favor, not yours.

Let me give you a real example. I sat down with a doctor collecting about $2.9 million. He was producing $1.5 million himself, working three days a week, and his associate, paid at 45% of collections, was covering the overhead. That $1.5 million was basically all net profit to him. Then a corporation offered him $4 million for the practice, with a million of it held back for five years. Sounds incredible, right?

Once he ran the numbers, it wasn't. After taxes, that $4 million became about $2 million in his pocket. Once the corporation owned the practice, he'd be working at 40% of collections instead of keeping it all, taking home $600,000 a year instead of $1.5 million. Multiply that $900,000 difference by four years, and the "big payout" was already a wash. After that, the corporation just kept the difference, year after year. Over the next 20 years, he was on track to hand over $20 million he would have kept had he stayed independent.






































That's just the numbers. But it's not only about the numbers. Once you sell, you lose control of who you hire, who you let go, your 401k, your write-offs, all of it. You're working for someone else now, even though you're the one who built the practice. I've seen doctors sell, regret it within a few years, and go start another practice from scratch just to get their independence back.

So before you ever take a DSO meeting, ask yourself this: is my practice actually running well, or am I trying to sell my way out of a problem I could fix? If your practice isn't performing the way it should, no corporation is going to pay you real money for it anyway. You'll sell for less and still end up working for the man. But if you build it right, double your collections, run it like the well-oiled machine it can be, you become your own DSO. Money comes in, you have complete control, and you can work as much or as little as you choose.

I've been doing this 57 years. I've watched hundreds of doctors face this decision. The ones who stayed independent and built real systems are the ones enjoying their lives today, with plenty of time for family, for travel, for the things that actually matter. The ones who sold are, more often than not, working just as hard for a fraction of the reward, wondering why they gave away something that valuable.

Own it. Run it well. And you'll never have to ask yourself whether selling was worth it. 

• A DSO's offer is priced on your practice's future earnings, not as a gift to you 

•  A well-run independent practice can out-earn a DSO sale within four to five years, and keep paying out for decades after 

•  Selling costs you control over hiring, finances, and ownership benefits, even while you keep doing the work