Short answer
Private equity ownership of physician practices is concentrated in a handful of specialties. Dermatology and dental are the most mature and most crowded. Gastroenterology, urology, and retina have seen large sales to strategic buyers such as Cardinal Health and Cencora. Anesthesiology and radiology are dominated by a few heavily indebted platforms. Orthopedics is still early and has produced only one true second-bite exit. Reported multiples range from roughly 4 times EBITDA for a small add-on to the mid-teens for a platform, and the tax issues differ with the equipment, ancillaries, and real estate each specialty carries.
Key facts
- Physicians in PE-owned practices
- 6.5% overall in 2024 (AMA), but far higher in the specialties below.
- Dental
- 16.1% of dentists DSO-affiliated in 2024; more than 25% of those within 10 years of school.
- Radiology
- 12% of radiologists in PE-backed practices at the end of 2023, up from 1% in 2013.
- Gastroenterology
- Roughly 1 in 10 gastroenterologists in PE-backed groups.
- Dermatology
- Roughly 10 to 15% of practices, more than 35 platforms, the most mature market.
- Spread between add-on and platform multiples
- Platforms clear roughly 3 to 5 turns of EBITDA above add-ons (FOCUS Investment Banking, 2025).
Choose your specialty
Every specialty page follows the same seven sections: where private equity stands in 2026, what a practice is worth to a platform, the deal terms specialists typically see, tax issues specific to the specialty, reimbursement and regulatory headwinds, who should not sell right now, and what to do next.
Most mature
Dermatology
Roughly 10 to 15 percent of practices under PE and more than 35 platforms. Cosmetic revenue, Mohs, and laser recapture drive the tax picture.
Strategic exits
Ophthalmology
Retina platforms sold to Cencora and McKesson at high multiples while cataract surgeon fees fell 11 percent in 2026.
Highest volume
Dental (DSO)
149 add-on deals in 2025. The DSO employment model and dentist-owned real estate make this its own animal.
Strategic exits
Gastroenterology
About 1 in 10 gastroenterologists in PE groups. ASC ownership sets the multiple, and endoscopy rates fell about 8 percent in 2026.
Still early
Orthopedics
OrthoAlliance's sale to SCA Health is the only true second bite so far. Ancillary income is most of what you sell.
Regulatory overhang
Anesthesiology
Envision's 2023 bankruptcy and the FTC's case against USAP cut multiples two to three turns from their peak.
Active
Urology
Solaris to Cardinal, United Urology to OneOncology to Cencora. Oncology and lithotripsy ancillaries are why strategics pay up.
Concentrated
Radiology
One platform holds about 70 percent of PE-employed radiologists and refinanced $2.3 billion of debt in 2025. Read the waterfall.
What is the same in every specialty
Three things do not change no matter what you practice. The purchase price allocation decides whether a dollar is taxed at 20 percent or 37 percent, and the buyer usually does not care how it is split; see how a practice sale is taxed. The rollover equity is deferred but not tax-free, and it sits behind lenders and preferred investors; see rollover equity. And your pay will drop by the scrape, typically 20 to 30 percent of practice profits, with income repair promised but not guaranteed; see what happens to your salary.
Specialties not covered here
Cardiology had the highest reported multiples of any specialty in 2025 (platforms at roughly 12 to 15 times EBITDA, add-ons 8 to 12) and more than 340 PE acquisitions since 2013, most of them in 2021 through 2023. Women's health, ENT, plastic surgery, nephrology, neurology, and behavioral health all have active platforms. The tax and rollover pages on this site apply to all of them. If you practice in one of these and want a specialty-specific read, ask us; it is often a short conversation.
Questions people ask
Which specialties does private equity buy the most?
Dental, dermatology, ophthalmology, and gastroenterology have the longest history and the most platforms. Cardiology, urology, and orthopedics with surgery centers were the most active in 2025 and 2026. Anesthesiology and radiology are dominated by a few large platforms rather than many small ones.
Does my specialty change the tax treatment of my sale?
The rules are the same, but the mix is different. Specialties with expensive equipment (ophthalmology, dermatology with lasers, dental, gastroenterology with an ASC, radiology) face more depreciation recapture at ordinary rates. Specialties with little equipment (anesthesiology) see the fight play out in the split between goodwill and the non-compete or transition pay.
Are multiples higher in some specialties?
Yes. Investment banks reported cardiology and gastroenterology platforms in the 12 to 18 times EBITDA range in 2025, while single dermatology or urology practices were reported at roughly 4 to 7 times. Ambulatory surgery center ownership adds one to three turns in most specialties. These are reported ranges, not offers.
Is now a good time to sell?
It depends on the specialty. Deal counts fell roughly by half in the first half of 2026, and buyers are pushing more of the price into rollover, earnouts, and notes. Specialties with active strategic buyers (GI, urology, retina) have a real second-bite story. Saturated specialties (dermatology, dental, anesthesia) have fewer buyers and choosier ones. Each page below gives a specialty-specific view.