Most owners list on earnings lower than the group can produce

If you've started thinking seriously about what your group is worth and what an exit actually looks like, the thing that almost never gets talked about is that most owners go to market with earnings that are lower than they should be and never realize it. Not because the practice isn't profitable, but because there's revenue sitting uncaptured across the locations that's been quietly suppressing the number your entire valuation is based on.

Dental groups typically sell at somewhere between 5x and 8x EBITDA depending on size and structure and buyer type. So if you're leaving $300K uncaptured annually, you're not just losing $300K a year in revenue, you're getting valued on earnings that are $300K lower than they should be and that gap gets multiplied across the entire deal. At a 6x multiple, that's $1.8M less on your sale price. At 8x, it's $2.4M. That's not a rounding error, that's a life-changing difference in what you walk away with, and it came from revenue that was always yours to capture.

The owners who end up in the strongest position going into a sale are the ones who found those gaps 12 to 18 months early, recovered the revenue, and walked into the process with earnings that actually reflect what the practice is capable of producing. That does two things at once: the number your valuation is based on goes up because you've been capturing revenue you weren't capturing before, and the operations behind that number are documented and standardized and clearly sustainable which gives the buyer confidence that the improvement isn't temporary. Both of those move the multiple in the seller's favor and together they compound into a difference that can be seven figures depending on the size of the group.

Most owners who've spent 15 to 20+ years building a group have naturally focused on clinical work and patient relationships and adding locations and managing staff. But the operational fine-tuning that makes a practice truly sellable at a premium doesn't naturally happen in that environment because the incentives are completely different when you're building versus when you're preparing to exit. It's a fundamentally different project and the shift from growing the practice to making it optimally valuable to a buyer is one that benefits from someone looking at the operations with a very specific lens.

What you genuinely don't want is to sell and then watch the buyer capture $300K in revenue from your own patient base in their first year using systems you could have literally built yourself 18 months earlier. That revenue was always yours to recover, and every dollar of it would have flowed into the earnings your deal was priced on.