How should a physician go about getting buy-in from partners?

It cannot be stressed enough how important it is to have candid and open communication with all parties. Deals have blown up at the 11th hour or in the red zone (to use a football term) because of trust, when it could have been prevented with better buy-in and consistent OVERcommunication. Some of the pros to selling your surgery center (a huge part of getting partner buy-ins):  Convert future income into today’s dollars with advantageous tax rate-pay capital gains rates today rather than income rates over time. Take money off the table and diversify your investments. Reduce your risk exposure and debt-no one has a crystal ball to see what the future holds, all business ownership carries risk. Better management, contracts, pricing, improved physician recruitment, efficiencies. In some cases you get your life back, meaning someone else is responsible for the IT problems, personal problems, replacing that nurse of office staff, etc. and you can concentrate on practicing medicine. Some of the cons of selling your surgery center are: You are no long the only decision maker; now you have a corporate partner. Have to pay management fees, and in some cases pay even if you are not making a profit. You have to share the future performance of the center. You might have chosen the wrong partner and they may not benefit you long term. You need to speak with the partners and discuss the pros and cons of selling your ambulatory surgery center and keep them informed throughout the process in order to keep that buy-in. This needs to be spoken about early on and not held until later in the process or it can kill the deal. Buyers want partners who are serious about the transaction, can make decisions and know what they want and do not want. Do not wait until you are in the negotiation stage to educate and get the buy-in of your physicians. You do not want them learning about this piecemeal though half-true rumors, which leads to assumptions and...

What are some typical deal killers and how should an ASC address them early on?

Here are some things that kill deals: Time – taking too long (addressed by being very prepared when selling your surgery center) Not knowing what you want (unable to make a decision) Unrealistic expectations Not knowing the market Arguing over positions rather than working to find a way to get the deal done Not having your physician partners bought in Not having open communication (kills the trust factor) Not disclosing potential snags early on or trying to hide issues – buyers will find out all the problems during the due diligence process and then the seed of doubt could creep in Coming to an agreement on deals terms then wanting to change them later For example, one client seller got information from their lawyer that the prevailing multiple for surgery centers was 5-7 times. The problem was that the lawyer understood that it was 5-7 times of EBITDA for 50% of the company. Think about that: 5-7 x of 100% of EBITDA for 50%, which in reality would have made it 10-14 times EBITDA. We had an early LOI come in that we thought would be solid with some negotiating, but because it was not 10-14x, the main selling doc dismissed it as a bad offer and did not want to discuss it. We spent the next 4 months collecting other offers and speaking with other buyers just to allow the market to educate the client. Luckily we knew that the first LOI was solid and continued to engage the buyer to keep them engaged and wanting the deal because we ended up selling to that buyer. Know the market because not knowing kills...