--- title: "Private Equity Practice Sales by Specialty: Dermatology to Radiology" description: "How private equity deals differ across dermatology, ophthalmology, dental, gastroenterology, orthopedics, anesthesiology, urology, and radiology: penetration, reported multiples, and tax issues." h1: "Private equity practice sales, specialty by specialty" lede: "The same eight questions, answered for each of the specialties private equity has rolled up most heavily. Pick yours, then compare." eyebrow: "Specialties" group: specialties order: 1 nav_label: "All specialties" breadcrumb: "Specialties" type: WebPage updated: 2026-09-07 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: - term: "Physicians in PE-owned practices" detail: "6.5% overall in 2024 (AMA), but far higher in the specialties below." - term: "Dental" detail: "16.1% of dentists DSO-affiliated in 2024; more than 25% of those within 10 years of school." - term: "Radiology" detail: "12% of radiologists in PE-backed practices at the end of 2023, up from 1% in 2013." - term: "Gastroenterology" detail: "Roughly 1 in 10 gastroenterologists in PE-backed groups." - term: "Dermatology" detail: "Roughly 10 to 15% of practices, more than 35 platforms, the most mature market." - term: "Spread between add-on and platform multiples" detail: "Platforms clear roughly 3 to 5 turns of EBITDA above add-ons (FOCUS Investment Banking, 2025)." faq: - q: "Which specialties does private equity buy the most?" a: "

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.

" - q: "Does my specialty change the tax treatment of my sale?" a: "

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.

" - q: "Are multiples higher in some specialties?" a: "

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.

" - q: "Is now a good time to sell?" a: "

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.

" llms_summary: "Hub page linking to eight specialty guides on private equity practice sales: dermatology (most mature, 35+ platforms), ophthalmology (strategic retina exits, 2026 cataract fee cut), dental DSOs (16.1% of dentists affiliated), gastroenterology (GI Alliance sold to Cardinal Health), orthopedics (only one true second-bite exit), anesthesiology (Envision bankruptcy, FTC v. USAP), urology (Solaris Health to Cardinal for $1.9B), and radiology (12% of radiologists PE-employed, Radiology Partners debt). Each specialty page follows the same seven-section outline covering market state, reported multiples, typical deal terms, specialty-specific tax issues, reimbursement headwinds, who should not sell, and next steps." ---

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.

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.