Private equity is buying everything from vet offices to tech conglomerates
Despite the directions the interviewer tried steering this conversation into, this is a really interesting interview.<p>But when it comes to the private equity roll-ups, I think everyone is missing the forest for the trees. If you are a doctor looking to retire and sell your business <i>there is no one else right now who would buy it</i>. The same goes for every category of &quot;mom and pop&quot; business in the US. Even if you could find someone experienced enough and interested in running it - that person could not afford the business.<p>So there is kind of a double problem happening right now. One is simply demographic - experienced business owners are retiring at a much faster rate than they are being replaced. Secondly, there is the capitalization problem. A doctor knows what his practice is worth and wants every cent he can get out of it - but the next generation of doctor is not going to be able to compete with debt financing what a PE cash-buyer can get.<p>In addition, there is a problem specific to medical practices - you can&#x27;t just hand them over to your kid! (unless they also happened to pursue the exact same medical training you did). <i>And in addition to this</i> medical schools (as I have been told) are really underprepared new doctors for running a business.<p>Keep in mind owner-operators already get a huge income and tax incentive over PE firms. It&#x27;s kind of a perfect storm that makes medical clinics such a special target vs plumbers or landscapers or whatever.<p>If you want clinics to stay independent <i>and keep retiring doctors happy</i>, we are going to have to carve out special programs or tax breaks for young doctors to buy up these businesses with debt. And keep in mind, these would be essentially subsidies for millionaires.