Buying a Podiatry Practice

Loan options

• SBA 7(a) Standard Loan$5,000,000 · 10-year repayment term for practice acquisitions; variable rate tied to WSJ Prime plus 2.75%–3.75% depending on loan size and borrower profile; fully amortizing with no balloon payment

  Acquiring an established podiatry practice with goodwill, patient records, equipment, and a physician employment or transition agreement; ideal for buyers financing $1M–$5M in total transaction value

• SBA 7(a) Small Loan

  Smaller podiatry practice acquisitions or add-on purchases of a single-provider satellite office with limited tangible assets and lower goodwill value

• SBA 504 Loan

  Acquisitions that include the purchase of the practice facility or real estate alongside the operating business; commonly used when a podiatrist is buying both the practice and the building it operates from

Eligibility

• The podiatry practice must have at least 3 years of operating history with documented tax returns and financial statements showing consistent collections, ideally in the $1M–$5M annual range
• The acquiring entity — whether an individual podiatrist, search fund operator, or physician-entrepreneur — must inject a minimum of 10–15% equity at closing, sourced from personal funds, a seller note on full standby, or a combination of both
• The buyer must demonstrate sufficient management experience or clinical qualifications to operate a podiatry practice; licensed podiatrists purchasing their first practice are viewed favorably, while non-physician buyers must show a credible operational plan and identify a licensed medical director
• The practice must operate as a for-profit entity and meet SBA small business size standards, which for physician offices and specialty medical practices typically means annual receipts under $10 million

Step by step

1. Define Your Acquisition Criteria and Assemble Your Advisory TeamWeeks 1–4

   Before approaching lenders, clarify your target profile: a podiatry practice with $1M–$5M in annual collections, positive EBITDA margins of 15–30%, an associate provider, and a payer mix with Medicare under 60%.

2. Identify the Practice and Execute a Letter of IntentWeeks 4–10

   Source podiatry practices through healthcare brokers, M&A intermediaries, or direct outreach to solo practitioners in your target geography.

3. Select an SBA-Preferred Lender with Healthcare Acquisition ExperienceWeeks 8–14

   Not all SBA lenders are equipped to underwrite medical practice acquisitions. Target SBA Preferred Lenders (PLPs) or Certified Lenders (CLPs) with documented experience financing podiatry or specialty medical practice acquisitions.

4. Conduct Healthcare-Specific Due DiligenceWeeks 10–18

   Engage your attorney and CPA to conduct thorough due diligence covering: payer mix analysis and reimbursement rate trends; billing and coding compliance review including accounts receivable aging and claim denial rates; physician employment agreements and non-compete enforceability; state licensure, DEA registrations, and credentialing transferability; malpractice history; and patient retention and referral source concentration.

5. Submit the SBA Loan Application and Finalize Deal StructureWeeks 14–22

   With due diligence complete, submit your formal SBA 7(a) loan application including: the completed SBA Form 1919, personal financial statements, business plan with post-acquisition financial projections, purchase agreement, practice appraisal or business valuation, and all due diligence documentation.

Other financing

• SBA 7(a) Loan

  The most common financing vehicle for podiatry practice acquisitions. Covers goodwill, equipment, and working capital with up to 90% LTV, requiring 10–15% buyer equity injection and strong personal credit.

  • + Goodwill financing accepted, which is critical since podiatry practice value is largely intangible patient relationships
  • − SBA lenders will scrutinize Medicare concentration above 60%, potentially limiting loan approval for high-Medicare practices
  • − Lengthy approval timeline of 60–90 days can complicate deal timing when sellers have competing offers
• Seller Financing / Seller Note6%–8% fixed, interest-only or deferred during physician transition period

  The selling podiatrist carries 5–20% of the purchase price as a subordinated note, often paired with an employment or transition agreement. Signals seller confidence and bridges lender equity gaps.

  • + Aligns seller incentives with a smooth patient and staff transition, reducing physician departure risk
  • + SBA lenders typically allow seller notes on standby, improving total deal structure flexibility
  • − Default on seller note can damage physician relationship during the critical post-acquisition transition period
  • − Note terms must be carefully documented to avoid Stark Law or anti-kickback issues in healthcare transactions

Lender tips

• Target SBA Preferred Lenders with a dedicated healthcare vertical: Banks like Live Oak Bank, Celtic Bank, and Byline Bank have established healthcare practice acquisition lending programs and underwriters familiar with podiatry-specific revenue cycle dynamics, physician employment structures, and Medicare payer mix risk.
• Present a clean, normalized financial package upfront: Prepare a detailed addback schedule that clearly documents owner compensation, personal vehicle expenses, family payroll, and any one-time costs to arrive at true EBITDA.
• Show evidence of operational continuity beyond the selling physician: Lenders want to see that the practice can generate revenue after the seller's departure.
• Address compliance proactively in your lender package: Include a summary of your pre-acquisition due diligence findings, confirmation that no active Medicare audits or overpayment demands exist, and a copy of the billing compliance audit.

• Asset Purchase with Seller EarnoutEarnout typically represents 15–25% of total purchase price, paid over 12–24 months based on collections retention targets

  The buyer purchases the practice's assets — including patient records, equipment, lease, and goodwill — rather than the legal entity.

  • + Protects buyer from revenue drop-off if the selling physician's patient relationships don't transfer fully to the new owner
  • + Allows buyer to avoid assuming legacy liabilities such as undisclosed billing audit exposure or malpractice claims
  • − Earnout disputes are common — defining 'collections' versus 'revenue' and attributing patient attrition to seller versus buyer actions can cause significant friction
  • − Sellers may resist earnout structures that leave a large portion of proceeds at risk, especially if they plan to retire or reduce clinical hours immediately post-sale
• SBA 7(a) Financed Asset Purchase

  The buyer secures an SBA 7(a) loan — up to $5 million — to finance the majority of the purchase price, with a required buyer equity injection of 10–15% and an optional seller note of 5–10% on full standby during the SBA loan term.

  • + Provides the seller with maximum cash at close, which is particularly attractive for retiring podiatrists who need liquidity to fund post-practice life
  • + Enables individual buyers — including associate podiatrists with limited personal capital — to acquire established practices with relatively modest equity injection
  • − SBA underwriting scrutiny is high for healthcare practices — expect detailed review of payer mix concentration, provider credentialing, and accounts receivable aging
  • − Seller note must remain on full standby for the duration of the SBA loan, meaning the seller receives no payments on that portion for up to 10 years unless the SBA loan is retired early
• Partial Equity RecapitalizationSeller retains 20–49% equity; buyer platform acquires 51–80%; deal financed through PE equity with no SBA debt typical at this level

  Rather than a full sale, the practice owner sells a majority stake — typically 51–80% — to a private equity-backed specialty practice management group or DSO platform, retaining 20–49% ownership.

  • + Seller receives immediate liquidity while retaining meaningful upside in the platform's growth — particularly valuable if the practice is early in a regional roll-up strategy
  • + Removes administrative burden from the selling physician, who can focus on clinical care while the platform handles billing, HR, and compliance infrastructure
  • − Seller gives up control of practice operations, culture, and clinical decision-making — a significant adjustment for a DPM who has run an independent practice for 15–30 years
  • − Retained equity is illiquid until the platform's next transaction, exposing the seller to platform-level execution risk and potential dilution from future capital raises

Negotiation tips

• Push for a precise definition of 'practice collections' in any earnout clause — specify whether the metric is gross charges billed, net collections received, or adjusted collections net of write-offs, since ambiguity here is the most common source of earnout disputes in podiatry deals
• Negotiate the selling physician's post-close employment agreement terms simultaneously with purchase price — the length of the transition commitment, clinical hours, and compensation structure directly affect what earnout risk is reasonable to accept or offer
• If the practice has Medicare as a primary payer, require the seller to represent and warrant clean billing history and no open RAC audits or Medicare overpayment demands as a condition of close, not just a due diligence item
• For SBA-financed deals, request a seller carry of at least 5–10% structured as a seller note — SBA lenders view seller participation as a confidence signal and it often accelerates approval timelines

Financial Quality & Payer Mix Analysis

• Request 3 years of tax returns, P&Ls, and collection reports reconciled to bank statements.critical

  Owner compensation addbacks are common; clean reconciliation reveals true EBITDA available to a new owner.

• Analyze payer mix by percentage of collections: Medicare, Medicaid, commercial, and self-pay.critical

  Medicare concentration above 60% limits reimbursement upside and increases policy change exposure.

• Pull accounts receivable aging report segmented by payer and days outstanding.important

  Aged AR over 120 days signals collection problems that reduce net purchase consideration.

• Identify all owner personal expenses and one-time charges run through the practice.important

  Normalizing EBITDA requires removing non-recurring and personal costs to price the deal accurately.

Physician Retention & Employment Agreements

• Review the selling physician's employment or ownership agreement, non-compete, and any existing restrictive covenants.critical

  Unenforceable or absent non-competes allow the departing physician to open a competing practice nearby.

• Quantify what percentage of collections are directly attributable to the selling physician versus associates.critical

  100% physician revenue concentration means the business may not survive a clean owner exit.

• Evaluate associate podiatrist agreements, compensation structures, and remaining contract terms.important

  Associates who depart post-close can cause immediate revenue decline and patient disruption.

• Confirm proposed earnout or transition terms align with patient retention metrics and revenue milestones.important

  Earnouts tied to collections protect buyers if the seller's departure causes patient attrition.

Billing, Coding & Revenue Cycle Compliance

• Audit CPT code utilization patterns for the top 10 billed codes against Medicare national benchmarks.critical

  Outlier coding rates for routine foot care or diabetic nail debridement trigger CMS audits and overpayment demands.

• Request documentation of any past RAC audits, Medicare overpayment notices, or payer recoupments.critical

  Unresolved overpayment demands or pending audits become buyer liability in an asset purchase.

• Review claim denial rates by payer and assess the practice's denial management and appeals process.important

  High denial rates reduce net collections and signal documentation or credentialing failures.

• Confirm all providers have current Medicare and Medicaid enrollment numbers and credentialing is up to date.important

  Lapsed credentialing creates billing gaps that can halt cash flow during transition.

Healthcare Regulatory & Legal Compliance

• Verify all state podiatric licenses, DEA registrations, and facility permits are current and transferable.critical

  Unlicensed or lapsed registrations can shut down operations on day one post-close.

• Assess the deal structure for compliance with your state's corporate practice of medicine doctrine.critical

  Many states prohibit non-physicians from owning or controlling a medical practice without a compliant management agreement.

• Review all referral arrangements, co-management agreements, and any ancillary service relationships for Stark Law compliance.important

  Improper physician self-referral arrangements expose both seller and buyer to False Claims Act penalties.

• Review HIPAA policies, Business Associate Agreements, and any prior breach notification history.standard

  Undisclosed data breaches or missing BAAs transfer liability to the buyer and can trigger HHS investigations.

Podiatry Practice-specific checks

• Verify all orthotics and durable medical equipment billing complies with Medicare DMEPOS supplier standards and that the practice holds required supplier numbers.
• Confirm diabetic foot care and wound care protocols are documented and deliverable by clinical staff independent of the selling physician to protect recurring revenue post-transition.
• Review the EHR system's age, vendor support status, and interoperability — outdated systems in podiatry practices can require $30,000–$80,000 in replacement costs post-close.
• Assess surgical case volume and facility relationships, including ambulatory surgery center agreements, which significantly impact revenue mix and EBITDA in surgical podiatry practices.
• Evaluate malpractice claims history and tail coverage obligations — confirm whether the seller's policy is claims-made or occurrence-based and who bears tail premium responsibility at closing.

Red flags

• Selling physician generates more than 85% of total collections with no associate podiatrist and refuses post-closing employment or earnout.
• Medicare and Medicaid combined payer mix exceeds 70% of collections, capping reimbursement upside and maximizing policy change exposure.
• Active or undisclosed Medicare RAC audit, CMS overpayment demand, or pending malpractice litigation not reflected in the purchase price.
• Non-physician buyer pursuing direct practice ownership in a corporate practice of medicine restricted state without a compliant management services organization structure.
• Billing patterns for diabetic nail debridement or routine foot care codes more than double the Medicare national utilization average with no documentation protocol.

What the LOI covers

• Parties and Practice Identification

  Identifies the buyer entity, the seller (typically the physician-owner individually and/or their professional corporation or LLC), and the specific practice assets or entity being acquired.

• Purchase Price and Valuation Basis

  Establishes the proposed total consideration, the EBITDA multiple applied, and how the seller's discretionary earnings or adjusted EBITDA was calculated.

• Due Diligence Scope and Access

  Outlines the categories of information the buyer requires access to during the diligence period, including financial records, payer contracts, credentialing files, billing data, and compliance documentation.

• Representations and Warranties Preview

  Identifies the key representations the seller will be expected to make in the final purchase agreement, alerting the seller to areas where they must disclose known issues or face post-closing indemnification liability.

Terms to negotiate

• EBITDA Addback for Selling Physician Compensation

  In podiatry practices, the selling physician's compensation is typically addback to calculate adjusted EBITDA, but the replacement compensation rate assumed in the valuation has a major impact on the final multiple.

• Earnout Measurement Period and Revenue Baseline

  Earnouts in podiatry acquisitions are commonly structured around post-closing collections retention, but the measurement methodology must be negotiated carefully.

• Payer Contract Assignability and Re-Credentialing Risk Allocation

  Commercial payer contracts for podiatry practices vary significantly in their assignability provisions.

• Non-Compete Scope, Duration, and Geographic Radius

  Non-compete agreements for selling podiatrists must balance legitimate buyer protection with the physician's ability to practice their licensed specialty.

Target profile

• Established practice with minimum 3 years of operating history, stable or growing appointment volume, and at least one associate podiatrist or mid-level provider reducing sole-physician revenue concentration
• Payer mix with Medicare below 60% of total collections and meaningful commercial insurance revenue, with documented contracts that are assignable or re-credentialable post-acquisition
• Clean billing and coding history with low claim denial rates, no outstanding Medicare overpayment demands, and an EHR system compatible with centralized revenue cycle management
• Located in a suburban or urban market with favorable demographics including high diabetes prevalence, aging population density, and proximity to primary care and endocrinology referral networks

Platform and add-on criteria

• Minimum $1.5M in Annual CollectionsPlatform

  Platform practices should generate sufficient revenue to absorb centralized management costs while demonstrating a proven, scalable clinical model with positive EBITDA margins of 20% or better.

• At Least One Associate Podiatrist On StaffPlatform

  Revenue must not be 100% dependent on the selling physician. An existing associate reduces transition risk and provides a foundation for clinical capacity expansion post-acquisition.

• Diversified Payer Mix Under 60% MedicarePlatform

  A healthy commercial insurance base limits reimbursement rate risk and supports stronger revenue per visit. Platforms with wound care or surgical volume alongside routine diabetic foot care score highest.

• Multi-Year Referral Relationships at the Practice LevelPlatform

  Referral networks tied to PCPs, endocrinologists, and orthopedic surgeons must be documentable as practice-level assets, not solely dependent on the departing owner-physician's personal relationships.

Acquisition sequence

1. Establish the Platform with a Anchor Practice AcquisitionEntity structure, physician employment agreement, SBA financing execution, and shared services infrastructure buildout

   Identify and acquire a single well-managed podiatry practice generating $1.5M–$3M in collections as the platform anchor.

2. Conduct Deep Due Diligence on Healthcare-Specific Compliance RisksPayer mix sustainability, billing and coding compliance audit, CPOM legal structure, and AR aging analysis

   Before closing any acquisition, execute a healthcare-specific due diligence workstream that goes beyond standard financial review.

3. Build the Shared Services Center and Centralize Revenue Cycle ManagementRCM centralization, coding standardization, margin expansion, and operational KPI infrastructure

   After the anchor acquisition, immediately begin consolidating administrative functions across the platform.

4. Optimize Clinical Service Lines and Ancillary Revenue StreamsAncillary revenue expansion, orthotics program scaling, wound care clinic development, and payer contract renegotiation

   Once geographic density is established, conduct a systematic service line audit across all platform locations to identify revenue expansion opportunities.

Value creation levers

• Revenue Cycle Centralization and Coding Compliance Optimization

  Most independent podiatry practices leave 8–15% of collectible revenue on the table through under-coding, high claim denial rates, and slow follow-up on rejected claims.

• Associate Podiatrist Recruitment and Key-Person Risk Reduction

  Practices where 80–100% of revenue flows through the selling physician are the most common risk factor in podiatry acquisitions — and eliminating that concentration is the most important value creation project for any platform.

• Payer Contract Renegotiation at Platform Scale

  Individual podiatry practices negotiate insurance contracts from a position of weakness.

• Orthotics and Ancillary Service Revenue Expansion

  Custom foot orthotics represent a high-margin, cash-pay-friendly revenue stream that many acquired practices have never systematically developed.

Day one

• Notify Medicare Administrative Contractor of ownership change and initiate provider enrollment updates to prevent billing interruptions and reimbursement holds.
• Introduce yourself to all clinical and front desk staff, confirm employment terms, and distribute updated offer letters or retention bonuses to key personnel.
• Verify the selling physician's transition employment agreement is fully executed, schedule their first 90-day patient handoff calendar, and confirm coverage obligations.
• Conduct a full walkthrough of the practice management and EHR system with the office manager to identify access credentials, billing queues, and outstanding claim issues.
• Confirm the practice facility lease assignment is recorded, utilities are transferred to the new entity, and business liability and malpractice insurance are active under new ownership.

Phase 1: Stabilize Operations and Revenue Cycle (Days 1–30)

• Submit CMS 855B or 855I enrollment changes and file reassignment paperwork for all treating providers under the new practice entity immediately.
• Audit the accounts receivable aging report for claims over 60 days, identify denial patterns, and assign a billing lead to pursue open balances systematically.
• Schedule one-on-one meetings with each staff member to assess morale, clarify their role under new ownership, and identify any immediate retention risks.

Phase 2: Physician Transition and Referral Network Transfer (Days 31–90)

• Host a referral partner lunch or send personalized transition letters co-signed by the selling and acquiring physician to warm-transfer relationship credibility.
• Implement a structured patient recall system for diabetic and wound care patients, ensuring no high-value chronic care patients fall through scheduling gaps.
• Review all CPT coding practices against current Medicare LCD guidelines for routine foot care and diabetic shoe billing to identify compliance or optimization opportunities.

Phase 3: Growth Infrastructure and Performance Optimization (Days 91–365)

• Negotiate commercial payer contract fee schedule increases at renewal, benchmarking against published MGMA podiatry reimbursement data for your state.
• Recruit or promote an associate podiatrist if the practice relies on a single clinical provider, reducing key-man risk and expanding patient capacity.
• Implement a patient satisfaction and recall program targeting the top 20% of revenue-generating patients to protect high-value chronic care relationships long term.

Pitfalls

• Payer Enrollment Gaps Freeze Cash Flow

  Failing to file Medicare and commercial payer enrollment changes immediately post-close can cause 30–90 day reimbursement holds, creating a cash flow crisis that surprises unprepared buyers.

• Seller Exits Too Quickly, Patients Follow

  When the selling physician reduces hours faster than planned, loyal patients cancel or transfer. Enforce the transition employment agreement timeline and monitor patient appointment retention weekly.

• Billing Compliance Issues Surface Post-Close

  Routine foot care and diabetic shoe billing under Medicare is heavily audited. Inherited upcoding patterns or missing documentation can trigger retroactive overpayment demands with significant financial exposure.

• Underestimating Physician Revenue Concentration Riskcritical

  When the selling podiatrist generates 90%+ of collections personally, the business leaves with them. Buyers frequently overpay for goodwill that dissolves the moment the seller reduces clinical hours.

• Ignoring Medicare and Medicaid Concentration Riskcritical

  A payer mix exceeding 70% government payors creates dangerous reimbursement exposure. Medicare routine foot care and diabetic billing codes face recurring CMS rate reductions that directly compress practice EBITDA.

• Skipping a Billing and Coding Compliance Auditcritical

  Upcoded E&M visits, improper orthotics billing, and undocumented diabetic care claims are common in podiatry. Buyers inherit Medicare overpayment liability and OIG audit exposure if compliance isn't verified pre-close.

• Failing to Address Corporate Practice of Medicine Lawscritical

  Non-physician buyers and DSO platforms often overlook state-specific CPOM restrictions. Some states prohibit lay entities from owning or directing podiatry practices, invalidating deal structures post-close.

• Overlooking Referral Source Transferabilitymajor

  Podiatry referrals from PCPs, endocrinologists, and orthopedic surgeons are often personal relationships with the selling physician. Buyers assuming practice-level referral networks exist without verification face immediate revenue decline.

• SBA

  Underestimating physician-dependency risk: Buyers often fail to account for how much revenue is personally tied to the selling podiatrist's relationships.

Warning signs

• Seller cannot produce three years of clean financials with documented physician compensation separate from practice overhead
• No associate podiatrist or mid-level provider currently generating any independent patient revenue at time of sale
• Medicare or Medicaid accounts for more than 70% of trailing twelve-month total collections
• Open billing audits, unresolved insurance disputes, or any history of Medicare overpayment demand letters
• Practice lease is month-to-month or expires within 12 months with no documented renewal or assignment rights

Phase 1: Financial Cleanup and Documentation (18–24 Months Before Sale)

• Document all physician compensation addbacks clearlyhigh

  Identify and separately document all owner-physician compensation above a fair-market replacement salary, personal vehicle expenses, personal insurance premiums, retirement contributions, and any discretionary spending run through the practice.

• Separate personal expenses commingled with practice financialshigh

  Work with your accountant to reclassify or remove personal expenditures from practice books for at least the two most recent full fiscal years.

Phase 2: Billing Compliance and Revenue Cycle Audit (15–20 Months Before Sale)

• Conduct an internal billing and coding compliance audithigh

  Engage a healthcare billing compliance consultant or attorney to audit a statistically significant sample of claims — particularly for high-volume podiatric codes including routine foot care (CPT 11055–11057), diabetic foot exams (G0247), orthotics (L3000 series), and surgical procedures.

• Resolve any outstanding insurance disputes, claim denials, or audit findingshigh

  Clear the decks on any pending payer audits, Medicare Advantage claim disputes, or Medicaid recoupment demands. Buyers performing due diligence will request a representation from you that no material billing investigations are pending.

• Review and document denial rates and clean claim rates by payermedium

  Pull 12 months of claims data to calculate your clean claim rate (percentage of claims paid on first submission) and denial rate by payer. Industry benchmark for a well-run podiatry practice is a clean claim rate above 90%.

Phase 3: Clinical Operations and Staff Infrastructure (12–18 Months Before Sale)

• Recruit or formalize the role of an associate podiatrist or mid-level providerhigh

  If you are the sole provider, the single highest-impact action you can take is hiring or formalizing an associate podiatrist (DPM) or a physician assistant with podiatric training who generates revenue independently.

• Create a comprehensive operational manualhigh

  Document clinical protocols for your highest-volume service lines — diabetic foot care, wound care, orthotics fitting and billing, nail procedures, and pre/post-operative surgical protocols.

• Develop a diabetic foot care and wound care program documentation packagehigh

  Podiatry practices with established, documented chronic care programs — including Medicare Annual Wellness Visit integration, diabetic shoe programs (HCPCS A5500 series), and wound care protocols — command premium valuations because these programs generate predictable, recurring revenue.

Phase 4: Legal, Licensing, and Compliance Readiness (10–15 Months Before Sale)

• Ensure all provider credentialing, DEA registrations, and state licenses are currenthigh

  Confirm that your DPM license, DEA registration, Medicare and Medicaid provider numbers, and all commercial payer credentialing are active, in good standing, and not facing any pending disciplinary action.

• Engage a healthcare M&A attorney to assess your state's corporate practice of medicine lawshigh

  Many states — including California, Texas, and New York — restrict non-physician ownership of medical practices through corporate practice of medicine (CPOM) doctrines.

• Review all employee agreements, non-solicitation clauses, and confirm key staff retention planshigh

  Audit existing employment agreements for your associate podiatrist, office manager, billing staff, and clinical support staff.

Quick wins before a sale

• Pull your most recent 12 months of collections data and calculate your exact Medicare, Medicaid, and commercial payer mix percentages — this single number will shape every valuation conversation you have with buyers and brokers, and knowing it in advance lets you address concentration risk proactively.
• Order your National Practitioner Data Bank self-query report and confirm your DPM license, DEA registration, and Medicare provider enrollment are all active and in good standing — licensing gaps discovered during buyer due diligence are among the most common deal-delay triggers in podiatry practice sales.
• Ask your CPA to prepare a preliminary seller's discretionary earnings (SDE) or EBITDA addback schedule using last year's tax return — documenting your physician compensation above fair-market replacement salary, personal expenses, and one-time costs will likely reveal that your practice is worth significantly more than your net income suggests.
• Review your office lease today and determine your remaining term, renewal options, and whether the lease requires landlord consent for an assignment — if you have fewer than 3 years remaining with no options, begin landlord negotiations immediately since SBA lenders typically require 10 years of total remaining lease term to finance a medical practice acquisition.

Questions to ask a broker

• How many podiatry or specialty physician practice transactions have you closed in the last three years?

  Podiatry deals require payer mix expertise and Stark Law knowledge; general business brokers often misvalue or misstructure medical practice sales.

• How do you handle physician retention risk and earnout structuring when the selling doctor is the primary revenue generator?

  Buyer financing and deal value depend heavily on whether the seller-physician commits to a credible post-close transition and employment agreement.

• What is your approach to marketing a podiatry practice while maintaining HIPAA compliance and staff confidentiality?

  Premature disclosure of a pending sale can trigger staff departures and patient attrition, directly eroding practice value before closing.

Broker red flags

• Broker cannot explain Medicare reimbursement concentration risk or has never analyzed a podiatry payer mix during due diligence preparation.
• Broker proposes listing price based solely on revenue multiples without adjusting for owner compensation addbacks, personal expenses, or billing compliance exposure.
• Broker has no documented process for confidential marketing and cannot explain how they protect patient data and staff relationships during deal marketing.