For The Record

Episode 97: The Evolving Landscape of Private Equity with Elizabeth Macready


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In this episode of For The Record, we sit down with Elizabeth Macready, Director of Special Markets at Tusk Practice Sales, to discuss the evolving landscape of private equity investment and practice sales in the medical aesthetics industry. With over 15 years of experience in healthcare M&A, particularly in the dental sector, Elizabeth brings valuable insights and years of personal experience on how medical aesthetics practices can prepare for and navigate potential acquisitions.


We kick it off with Elizabeth outlining the current state of Medical Aesthetics M&A which is not surprising but a reminder that this industry is growing rapidly with very little signs of slowing. We also talk through how to objectively look at your practice and understand its potential market value in an M&A transaction. She shares the key metrics to consider and an overview of the entire deal process:

• EBITDA (Earnings Before Interest, Taxes, Depreciation, and Amortization) is the crucial metric for valuation

• Practice revenue of $3 million+ typically positions a practice well for competitive bidding

• Multipliers and deal structures vary, but the underlying EBITDA calculation is critical

• Buyers may manipulate EBITDA calculations to offset higher multiple offers

While it may seem scary to some, there are a host of major benefits that come along with an exit! We discuss what it can mean for you as an owner, for your team, and for your patients’ experience long-term when you move forward with an acquisition:

• Increased buying power for products and supplies

• Access to better vendor relationships and negotiations

• Enhanced ability to attract and retain talent through career growth opportunities

• Operational support and resources for scaling

• Potential for "second bite of the apple" through future liquidity events

As you listen to Elizabeth talk about the ins and outs of an M&A deal, it’s abundantly clear that you have to have a middleman, a broker, to help navigate the process for you and get you the highest price for your practice. At Tusk, Elizabeth is a trusted guide helping Med Spa owners connect to the right sellers that align to the mission, vision and values of the practice, structure a deal that is favorable to both parties as this is not an event but a long term partnership where everyone needs to win, and in many cases, act as a confidante and counselor throughout the many emotional up and downs that come with this process.

Elizabeth recommends a few key things as you begin down the M&A path and start thinking about your next steps. We cover her hit list which includes starting early which may be well before you intent to sell; build a strong team that provides exceptional patient outcomes and experiences as this is where you create your value; find the right team of advisors to help you with financial decisions along the way, and always keep a close eye on your numbers!

We wrap it up with a look into the future of M&A and Elizabeth's predictions for the next 5 years:

• Continued consolidation across medical aesthetics

• Integration with other healthcare verticals (dermatology, plastic surgery)

• Increasing importance of scale for competitive advantage

• Evolution toward multi-specialty practices and comprehensive care models

Elizabeth’s team at Tusk Practice Sales offer various resources for practice owners considering their exit options, including educational content, podcasts, and one-on-one consultations. They emphasize the importance of proper timing, preparation, and partnership alignment in achieving optimal outcomes for practice sales.

If you are eager to get started and connect with Elizabeth:

Reach out via Tusk’s website: https://tuskpracticesales.com/ & checkout all their free resources!

Connect with Elizabeth on LinkedIn: https://www.linkedin.com/in/elizabeth-macready-b38b9a248/

Reach Out via email at [email protected]

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For The RecordBy Tiphany Hall, PhD

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