Who the buyer is matters as much as the multiple. Corporate acquisition teams are replaced by integration and operations management after settlement, and sellers who committed to a three to five-year earnout work under people they never met during the deal. Single-party engagement removes price discovery and leverage over post-sale terms. Run a process with multiple buyers.
For a complementary view of the same decision, weighing legacy goals against financial optimisation across the main buyer types, see Chris Mitchell's article Choosing the right buyer for your GP practice: legacy vs financial optimisation.
The multiple gets most of the attention when GP practice owners think about selling. But there is a second variable that receives far less scrutiny before the deal closes and receives a great deal of attention once the settlement is concluded: who the buyer is, and what working life looks like once the original deal conditions expire.
The corporate acquisition pattern
Corporate buyers in the GP sector are active and well-resourced. Most practice owners will receive unsolicited approaches before they have actively considered a sale, often from a polished business development representative with good interpersonal skills and a well-rehearsed pitch. The approach feels like validation, and the early conversations are pleasant. That is by design and is standard acquisition practice.
In most deals, the person who first contacts the practice owner and builds rapport is rarely the one handling integration. By closing, they have moved on, replaced by governance, policies, an operations model, and management culture that the seller had limited visibility into during the courtship phase.
This is not a criticism of any specific buyer; it is structural. Acquisition and integration teams serve distinct functions. Deal closers are chosen for commercial skills and relationship management, while those running acquired practices are selected for operational consistency across a network. Their priorities differ, and working under post-acquisition management can sharply contrast with being courted during the deal.
For a GP practice owner who remains in the practice as a contractor for three to five years after the sale, this gap matters. A below-market multiple is a known cost at the time of signing. An incompatible management culture is a daily cost that compounds over years.
The single-party trap
A practice owner who engages with a single unsolicited approach without running a parallel process effectively allows the buyer to set both the price and the terms. The buyer has done this before. They have a process. The seller, in most cases, has not sold a practice before and is learning the mechanics while negotiating with someone who does this professionally.
Without competitive tension, there is no price discovery. Without multiple parties at the table, there is no leverage over post-settlement terms, including those that determine how the practice is managed after the sale. Earn-out structures, clinical autonomy provisions, staffing protections and governance arrangements are all negotiable, but only when the buyer knows they are not the only option.
A single-party process that runs for six to nine months, during which the practice owner has been answering detailed questions and has mentally committed to an exit, produces a seller with a diminished negotiating position at exactly the moment the detailed terms are being finalised. The buyer's team knows this. It is not accidental.
I know this firsthand, the comment that still rings in my ears to this day is: 'Mark, your business is only worth what we are offering because we are the only ones at the table.' By then, I was so exhausted and mentally moved on that I did not have the energy to restart the process. That is exactly the dynamic a single-party engagement creates.
Post-sale working conditions
In the GP context, the post-sale working environment is not peripheral. Practice owners who sell to a corporate or group buyer will, in most cases, continue to work in the practice. Their patients remain their patients. Their staff remains vital to their performance. The clinical environment they work in every day is now governed by policies and management decisions made by people whose primary accountability is to the buyer's network, not to the individual practice.
Whether that environment is tolerable depends on the buyer's operating culture and how closely it matches the values the practice was built on. Two practice owners selling to the same buyer can have entirely different experiences of the same management structure. Personality plays a part, but so do the contract and the buyer's post-acquisition governance across the other practices they already own.
Assessing a buyer's management culture before signing requires deliberate work: speaking to GPs in practices that the buyer has already acquired, examining the governance provisions in the contract before commercial pressure to close has built up, and understanding what operational autonomy looks like in practice rather than in the pitch deck.
If possible, try to talk to a GP owner who didn't sell to them and, of course, find out why.
Running a process
A practice owner who wants a sound outcome across both price and post-sale working conditions needs to run a process, not respond to one. That means engaging advisers before engaging with any buyer, defining what a good outcome looks like across financial and non-financial dimensions, identifying a pool of potential buyers rather than a single party, and maintaining competitive tension through to final terms.
If you are signing on for a three-year earnout (or more), it is worth lowering the pace and investing the time to understand who you will be working for.
In the GP sector, this is less common than it should be. The practice owners who do it are better placed than those who do not, both in terms of price and in terms of what their working life looks like after settlement.