The Clock is Ticking… Are You Exit Ready?

Most of us think of the exit as a day. The day you sign the papers and hand over the keys. The day the practice you built becomes someone else's responsibility.

It isn't a day. It's a window. And it opens about five years before you think it does.

I've watched this play out hundreds of times now, and the pattern almost never changes. The value of your exit — not just the dollars, but whether you have real options or only the one offer in front of you — is mostly determined in the three-to-five years before you transition.

Not at the closing table. Long before it.

The doctors who get blindsided aren't unlucky. A health scare, a buyer who lowballs them, a DSO offer they have no framework to evaluate, a practice so dependent on them that no one else can run it — these things don't feel like failures of preparation. They feel like bad luck. But they're almost always the same story: the window was open, and nobody told them. So they didn't use it.

And then one day it became too late.

The DSO Fairytale is Collapsing. Where Does That Leave Your Exit?

Right now, the landscape is changing fast. The DSO consolidation that so many doctors quietly assumed would be their easy exit is not the sure thing it was a few years ago. Multiple high profile DSOs are entering receivership. Recaps have repeatedly been postponed.

Few if any are offering enough up front to make a transaction worthwhile. They are offering servitude more than an exit.

Having your future dependent on conditions you don't control is exactly the kind of plan that leaves you with fewer options, not more.

So if the window is open for you — and if you're reading this, it probably still is — here's what to do with it.

The Unseen Groundwork of a Successful Transition

Know your practice numbers cold. 

Not just your production. You almost certainly know that. I mean the number that matters to a buyer: what your practice is actually worth to someone else, and what makes it transferable in the first place. Most owners have never looked at their practice the way a buyer will. The gap between what you think it's worth and what it's worth to the market is where bad sales are born.

Know your Freedom Number. 

This is the one almost nobody has. Your Freedom Number is the income your assets need to produce — independent of you showing up to work — for work to become a choice instead of a requirement. Here's why it matters more than any other number: without it, “enough” is always just a little more than you have. You never stop, because you've never defined the finish line. The Freedom Number is what finally gives you permission to make a move. You cannot choose freedom you haven't measured.

Get honest about need versus want. 

We're trained to maximize — to squeeze every last dollar out of the thing we spent decades building. But ask yourself the uncomfortable question: do you actually need the top-dollar offer, or do you just want it because leaving money on the table feels like losing? Because chasing the last dollar often costs you the very thing the dollar was supposed to buy. Your time is worth more now than it will ever be again. Freedom while you're still young enough to enjoy it is not a consolation prize. For a lot of us, it's the whole point.

Evaluate your options through a Freedom filter, not just a dollar filter. 

Two exits can carry the exact same price tag and produce completely different lives. One hands you your time back. The other ties you to an earnout, a non-compete, and three more years of answering to someone else. The highest offer is rarely the freest one. Once you know your numbers and you know what you actually need, you can finally weigh your choices on the thing that matters — not which one pays the most, but which one gives you the life you've been deferring.

Becoming Exit Ready Gives You Options

None of this requires you to sell. That's the part people miss. Doing this work doesn't push you toward the door. It just means that when you reach it — by choice or by surprise — you walk through on your terms.

You may discover that becoming “exit optional” makes staying in practice viable for longer than you thought. Practice ownership can be fulfilling and meaningful – if you are staying by choice and not due to limited options.

We are preparing an exciting announcement on this theme, stay tuned!