What does it really take to buy and scale a dental practice today? In this episode, M&A advisor Ryan Iwamoto shares hard-won insights from inside the trenches of healthcare deals—from emotional seller exits to broken billing systems and PE-backed rollup chaos.
You’ll hear jaw-dropping stories: a 70-year-old dentist clearing $1M/year with no succession plan, a practice where no one showed up to work… and deals derailed by faxes and family drama.
Whether you’re a first-time buyer, a seasoned investor, or an operator looking to grow through acquisition, this conversation is your tactical blueprint for smart, scalable healthcare acquisitions.
We dive into:
✅ What makes or breaks a dental deal
✅ How to approach aging baby boomer sellers
✅ The private equity roll-up problem
✅ Real red flags during due diligence
✅ Why seller emotions kill more deals than numbers
✅ Building broker relationships that unlock deal flow
If you’re serious about acquiring in healthcare, hit play.
Timestamps:
00:00 Intro – Why healthcare is a buyer’s market
04:10 Buying from emotional sellers vs. strategic sellers
07:30 The deal that died over $0 (emotion logic)
13:15 The practice with 8 patients—and no employees
15:00 “My wife does the billing—if she shows up”
18:00 A dentist making $1M/year at age 70
20:10 Why baby boomer sellers stall M&A deals
22:00 Private equity overpaid—roll-ups are cracking
25:30 Why fax machines still kill deals
28:40 Red flags most buyers overlook
31:20 Structuring a deal without scaring the seller
34:00 How Ryan builds relationships to get off-market deals
37:00 Dental acquisitions vs. medical vs. veterinary
39:50 Actionable advice for first-time healthcare buyers
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