Podcast Episode 48 – Private Equity: Lucrative Business Opportunity or the Doom of Modern Medicine? – Mark Rieboldt (The Coker Group)

private equity with mark rieboldt of the coker group

Episode 48 – A lot of physicians I’ve talked to have had some bad experiences with private equity.  Maybe they got a big payout but they lost so much autonomy and had their workload increased so much that they ended up retiring or leaving the practice because they just couldn’t stand the working conditions.  But, I’ve talked with other docs that said the private equity deal they did was fantastic.  They got a big payout, they’ve grown their business faster than they thought possible, and the equity company is a great partner that just wants them to be able to practice great medicine on the doctors’ terms.  I’m grateful to have Mark Rieboldt of The Coker Group on the podcast today to talk about private equity deals.

Not every private equity deal is bad. If you do your due diligence, a private equity deal could end up being a great opportunity for your business.  I would encourage you to not reject every PE deal out of hand, but take each opportunity on a case by case basis.  Listen to the podcast episode today to learn all about private equity and decide if it’s a good move for your business.

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Meet Mark Rieboldt

Mark Rieboldt and the coker group on private equity

Mark Reiboldt is a senior vice president and director of strategy at Coker Group, where he specializes in financial advisory and transaction services for hospitals, health systems, and other healthcare organizations. These transactions include mergers and acquisitions, divestitures, equity purchases, physician alignment deals, and joint ventures. His advisory services often entail acquisition/investment due diligence, valuation services, transaction management, buy-side representation, strategic alternatives processes, and post-merger integration.

Mr. Reiboldt regularly presents at numerous national and regional conferences on a variety of topics, such as healthcare financial transactions, valuation trends, capital markets issues, and healthcare public policy. He has also contributed as an author on articles and books for a variety of publications covering a wide range of topics related to his area of focus, and his pieces have been featured in numerous industry and mainstream media publications.

 Check out some of the great content from Mark Rieboldt and The Coker Group!

Connect with Mark Rieboldt and The Coker Group

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Show times

  • 00:00 – Introduction to the episode
  • 01:06 – Subscribe to the podcast, and please leave a review!  
  • 01:26 – Join the Business and Personal Finances for Physicians and Dentists Facebook Group.
  • 01:50 – Need your contract reviewed?  Call Resolve!
  • 02:36 – Introduction to Mark Rieboldt.
  • 03:14 – Introduction to Mark Rieboldt and The Coker Group.  The Coke Group wants to be partners with physicians.  
  • 04:32 – If you go with a private equity group, find a group of people with the heart of a teacher.  That’s what the Coker Group strives to be.
  • 04:59 – Mark Rieboldt comments on the trend towards more and more physician practices being an employee model, rather than physician owned.
  • 06:59 – The Coker Group has observed a shift towards hospital affiliation for the last 10 years.
  • 08:31 – What are the options for physicians looking to start their own practice?  Mark Rieboldt breaks down the “hospital-acquired practice” model.
  • 11:48 – What is a Professional Services Arrangement?  The Coker Group calls this “employment lite.”
  • 14:53 – Mark Rieboldt breaks down the typical private equity deal.  What are the advantages for the parties involved? 
  • 16:33 – Private equity is nothing new.  It has been around for decades, and The Coker Group has been involved along the way. 
  • 17:41 – A good private equity deal will be good for physicians, patients, and the private equity company.
  • 18:53 – Mark Rieboldt talks about the importance of recognizing the non-financial aspects of any private equity deal, in addition to the financial aspects.  
  • 20:37 – Are you going to lose autonomy if you do a private equity deal?  Depends on the deal.  You also need to think about how they’ll do training, the electronic medical records, and whether they’ll allow you to continue to practice the way that you want.
  • 23:49 – Start with the non-financial aspects of the deal first before consideration of the financial upside of a private equity deal.
  • 24:27 – Mark Rieboldt shares how the financial benefits of a typical private equity deal may make the deal worth considering. 
  • 27:03 – Whether you’re doing a deal with The Coker Group or not, consider what you get with the “first bite of the apple.”
  • 28:03 – How do you value a clinical practice to determine how much you can expect to be paid?  Mark Rieboldt says, you first need to consider whether it’s a hospital acquisition or not.  
  • 32:01 – When you take your up-front payout, it reduces your compensation going forward, but you’ll build your practice and increase that revenue back to baseline over time.
  • 36:14 – If you keep building your business, you’ll eventually get a “second bite of the apple.”  You’ll get another big payout and reset your compensation, but you’ll keep building your business and growing your revenue.
  • 39:13 – The Coker Group has had many experiences where they are working with a clinical practice and they determine that it’s not in the physicians’ best interest to sell to a private equity group.
  • 41:58 – 70-80% of private equity deals eventually fall through. Sometimes the deal just isn’t good.  Sometimes there are major red flags.  Have the tough conversations to figure out what the non-financial aspects are. 
  • 44:03 – Make sure to exercise in-depth due diligence when evaluating  a private equity deal.
  • 47:08 – Connect with Mark Rieboldt and the Coker Group to learn more about private equity.
  • 49:44 – Summary of the episode.
  • 50:32 – This week’s free resource is a guide called “The Scope of Practice Reading List.”
  • 51:23 – Signing off!


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