In a healthcare M&A transition, most practices don’t sell to private equity, yet private equity often plays a role behind the healthcare organizations (i.e., DSOs or MSOs) that practice owners partner with. Confused? Let’s break it down. 

7 Pillars Founding Partner Brett Pierce joins Brian to break down private equity’s role in healthcare, common misconceptions, and what practice owners should understand before entering a strategic partnership with a DSO or MSO. 

Topics Discussed:  

➡️ What is Private Equity and How Does it Fit in the Healthcare Space (3:30) 

➡️ The History of Private Equity (7:35) 

➡️ How Common is Private Equity in Our Everyday Lives (12:40) 

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🎙How Valuations Actually Work  

🎙Navigating a Business Transition  

🎙The Right Time to Sell Your Business with Dentist Advisors  

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Selling a practice is rarely top of mind for younger owners, who are typically focused on establishing their careers and growing their business. But what if building a successful practice early gives you more options, not fewer? 

In this episode of The Advisor’s Table, Brian and Michael sit down with Dr. Fishbein to explore how he built a successful orthodontic practice, what drove its growth, and why he chose to pursue a DSO partnership earlier in his career than most owners. 

Topics Discussed:  

➡️ Experiencing Incredible Growth in a Short Period of Time (3:15) 

➡️ Choosing to Partner with a DSO (6:20)  

➡️ Fishbein Fundamentals (13:47) 

Additional Resources:  

Fishbein Fundamentals  

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🎙Building the Right Advisory Team Before a Transition  

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🎙Dental Marketing That Truly Fuels Growth with HIP Creative 

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For many CEOs, a successful transition isn't just about finding the right partner. It's about leading through uncertainty, balancing the expectations of doctors, investors, and employees, and making decisions that position the organization for long-term success.  

In this conversation, we explore the leadership side of a DSO transition through the perspective of a CEO who's recently been there. 

Brian is joined by Founding Partner of 7 Pillars, Brett Pierce, and former CEO of Viridian Dental Partners, Alix Laurain to discuss the realities of scaling an organization, preparing for a transition, and the leadership lessons learned along the way.  

Topics Discussed:  

➡️ Viridian Dental Partners Recent Partnership with Innovate 32 (3:00) 

➡️ Challenges of Leading an Emerging DSO (10:00)  

➡️ Creating Alignment with Associates and Key Leaders Throughout the Transition Process (14:25) 

➡️ Navigating Difficult Conversations (24:50) 

➡️ How to Lead People Through One of the Most Complex Milestones in the Life of a Business (27:20)  

Additional Resources:  

7 Pillars Success Story 

Episodes You May Like:  

🎙Inside Dental Leadership Lab Dallas: What It Takes to Build a Scalable Emerging DSO 

🎙Healthcare M&A Market: Q2 2026 Update  

🎙Navigating a Business Transition: The 7 Pillars That Drive Smart Decisions  

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The biggest obstacles to practice growth aren't always external. In many practices, they're hidden in the everyday inefficiencies that slow down teams, create friction for patients, and leave opportunities on the table. In this episode of The Advisor’s Table, we sit down with Aimee Fletcher, Director of Strategic Partnerships of Spear Education to talk through what truly defines efficient dental practices for both the team and the patient. This episode provides practical insights for dental practice owners who are looking to increase production and patient care. 

Additional Resources 

Spear Education

7 Pillars Advisory Services 

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Some of the most valuable conversations in dentistry don't happen from a stage. They take place around a table. 7 Pillars brought together practice leaders, advisors, and industry experts for a day of collaborative learning and honest conversations around growth, leadership, and long-term planning. Brian sits down with HR for Health’s COO, Ralf Tomandl, to highlight key takeaways from this event. 

Additional Resources: 
Dental Leadership Summit  

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Today's market rewards preparation more than timing. In this quarterly bonus episode, Michael and Brian explore the latest healthcare M&A trends, from private equity's response to prolonged higher interest rates to the continued evolution of DSO deal structures. They also discuss why having the right advisory team is more important than ever in a slower, more selective deal environment. 

Additional Resources 

Snax Media

Building the Right Advisory Team Before a Business Transition 

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When your practice is your largest asset and reflects decades of dedication, deciding when to transition can feel just as emotional as it is financial. Brian and Michael are joined by Managing Partner and Senior Advisor Matt Mulcock of Dentist Advisors to explore a question many owners wrestle with: Is there ever a truly “perfect” time to sell your practice? This episode helps practice owners understand their financial readiness as well as preparing emotionally. 

Additional Resources:  

Dentist Advisors  

Matt Mulcock 

Tune in the previous episodes of The Advisor’s Table HERE. 

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Many doctors spend years building a successful practice but enter a transaction without fully understanding the decisions that can impact their long-term outcome. Brian and Michael sit down with Cain Watters & Associates, David Forbess and Zane Harris, to explore topics including cash versus rollover equity, tax planning, and the importance of aligning your transition with long-term personal and financial goals. They also discuss how post-sale regret often develops, and the proactive steps owners can take to better position themselves before entering the market. Throughout the episode, the focus remains on helping practice owners understand the decisions that can meaningfully impact both the transaction itself and life after the deal closes.

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“Wealth creation starts well before the transaction. If everything is tied to one asset, your timing gets dictated by market conditions, buyers’ interest, or personal circumstances rather than by choice.” 

In this episode of The Advisor’s Table, Michael sits down with Wealth Advisor, Daniel Corello, from Bernstein to explore how business owners should think about investing before a sale, balancing wealth inside and outside of their primary business, and preparing financially years ahead of a transition. Whether you are years away from a transition or actively considering one today, this episode offers insight into why building personal wealth outside the business can be just as important as maximizing enterprise value inside of it.

Additional Resources 

Bernstein 

Learn More from 7 Pillars 

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Few business owners take the time to plan for the tax impact after a deal closes. In this episode of The Advisor’s Table, Brian and Michael sit down with Senior Wealth & Tax Advisor, Carson Henderson, from Earned to understand tax-loss harvesting. This conversation explores how tax-loss harvesting strategies can help business owners navigate the impact of a significant capital gain and why planning well in advance matters. Carson shares real-world examples of both a private equity transaction and a doctor-to-doctor sale, highlighting how proactive tax strategies can significantly influence financial outcomes after a deal closes.

Additional Resources:

Earned 

Carson Henderson 

Learn More from 7 Pillars

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Contact 7 Pillars at [email protected] or on our website at 7pillarsadvisory.com/contact.