Before you answer an acquisition offer, decide what the buyer is actually buying.
Someone wants to buy your practice.
You feel flattered, and right behind the flattery comes something harder to name.
That second feeling deserves more of your attention than the first.
The question that settled one owner’s offer
This shows up in call after call. One owner got a practice acquisition offer and spent a full coaching call circling it without landing anywhere.
She walked into the next conversation foggy and walked out about ten minutes later with a decision.
Her coach had asked one question: “Do you think they want you, or do they want your business?”
She answered right away. “They want me.”
She wanted someone to buy what she had built, and the offer in front of her read as someone buying her.
She sent a short email declining. The buyer wrote back graciously and thanked her for considering it.
Offers like this are arriving more often
Private equity firms are drawn to physical therapy and behavioral health because both fields are growing and fragmented, with many small providers available to buy, according to the Philadelphia Inquirer.
In the Philadelphia region, a 2024 count by the Private Equity Stakeholder Project, an advocacy group that tracks the industry, found more private-equity-owned sites in physical therapy than in any other specialty, with behavioral health second.
If you run a physical therapy, occupational therapy, speech, or mental health practice, an offer like this may reach you sooner than you expect.
A buyer prices the practice without you
Every buyer runs the same test, whether they say so or not. They estimate what the practice would earn if you were not in it.
A valuation professor at NYU Stern teaches that when a private business depends on a key person, usually the owner-operator, the buyer has to account for that person leaving, and the simplest method is to value the business on the income it would produce without them.
The same lecture notes that an owner who agrees to stay on for a period gets a higher value. That explains why so many offers arrive with a role for you attached.
A role for you can be a fair part of a good deal. It also tells you how much of the value the buyer believes is you.
Founder handovers fail more often than other leadership changes, according to a 2026 Harvard Business Review analysis. A buyer who asks you to stay is managing that risk.
3 questions to ask before answering a practice acquisition offer
Three honest answers will tell you more than the first draft of any term sheet.
Ask what they would be buying
Put the coach’s question to the buyer directly. If you stepped out the day after closing, what would they expect the practice to do?
Listen for how much of their plan depends on you.
Test what runs without you
Pick a two-week stretch and picture yourself gone. List everything that would stall.
That list is the part of the practice a buyer would ask you to stay for, and the part worth fixing first.
Decide your answer before the deadline
Offers come with timelines, and pressure makes flattery louder.
Write down what you want from a sale before you hear the next number. If the answer is no, a short, warm email is enough.
Answer the question before the offer arrives
Ask yourself the coach’s question today. If a buyer made an offer next month, would they want you or would they want the business?
If the honest answer is you, you have found the work. It is the same work as getting out of the day-to-day, and it raises the value of the practice whether you ever sell.
Freedom By Design
Freedom By Design is available on Apple Podcasts, Spotify, and YouTube featuring conversations with practice owners and independent thinkers who are building businesses, and lives, on their own terms.
If something in this piece resonated, the show goes even deeper into the mindset shifts behind it.
————————————————————-
Are you ready for a coach? Join the hundreds of physical therapy owners who are building the practice of their dreams with the support, guidance and direction of a Practice Freedom U Coach. Take the first step towards creating a business that sets you free by scheduling a Discovery Call
