Sample Workup

What a full psychiatry transition analysis looks like.

An anonymized, fictional Doc2Doc Transition Workup. Aggregate business facts only. No PHI. The shape of the document mirrors what a real practice receives: planning range, transferability scoring, continuity risks, evidence requests, advisor prep, and 30 / 90 / 365-day priorities, with confidence calls attached.

Transition Workup preview · fictional

Hart Psychiatry Associates

Fictional solo outpatient psychiatry practice. Philadelphia, Pennsylvania. 22 years operating. No PHI included.

State-specific rules, regulatory requirements, and payer norms vary. This sample illustrates the structure and content of a Doc2Doc Transition Workup; the specific legal references, retention periods, and procedures applicable to your state will differ.

Recommendation Prepare for Sale
ConfidenceHigh
Timeline9–18 months
Active panel430
Monthly visits390

Executive summary

Hart Psychiatry Associates has the demand profile, earnings base, and owner-support runway to justify a prepared-sale path. The practice should not begin buyer outreach casually; it should first organize financial normalization, payer-transfer assumptions, and patient-continuity planning into a controlled business-only diligence package. The path read is high confidence; the range will tighten once payer assignability and credentialing timelines are documented.

Valuation bridge

Annual collections (TTM)$875,000
Operating expenses$375,000
Implied pre-adjustment earnings$500,000
Less: owner replacement compensation($310,000)
Adjusted owner discretionary earnings$190,000
Quality-adjusted planning range$1.1M – $1.6M

Triangulated from a revenue multiple, an adjusted owner-earnings view, and a panel-continuity check. Indicative planning range only.

Why the range moves

  • Strong demand: waitlist, monthly visits, and active panel depth support the upper end.
  • Owner transition support: 6–12 month overlap improves buyer confidence and tightens the range.
  • Evidence gap: payer assignability still needs documentation. This is the single largest swing factor.
  • Continuity risk: manageable, but must be planned before outreach to avoid buyer discount.

Transferability scoring

Six independent layers. Strength in one does not rescue weakness in another.

Strong

Practice-level demand

Waitlist consistently 8–12 weeks; new-patient inquiries exceed owner capacity.

Strong

Staff and workflow portability

Two retained staff, written front-desk and billing workflows, EHR templates documented.

Moderate

Practice goodwill vs. owner

Practice has independent name recognition, but ~35% of referrals route to the owner personally.

Moderate

Referral durability

Five PCP groups, two therapist networks, one EAP. No single source above 25%, two are personal.

Needs work

Payer / credentialing portability

3 of 5 payer contracts have change-of-ownership language documented; 2 appear to require successor re-credentialing, with timing to be confirmed by counsel and payer representatives.

Strong

Patient-continuity risk

~18% of panel on Schedule II prescriptions; PDMP review documented per refill. Handoff feasible with overlap.

Evidence requests

The specific items that would tighten the planning range and shorten advisor diligence.

01

Payer contracts, fee schedules, credentialing notes, and explicit assignability or change-of-ownership language. Confidence impact: high.

02

Telehealth state / modality map and emergency-response workflow summary, including current PA-only vs. multi-state posture. Confidence impact: medium.

03

Trailing 24–36 month P&L with owner-comp normalization to a market replacement rate. Confidence impact: high.

04

Aggregate panel description: visit-frequency bands, controlled-substance prescribing share, psychotherapy intensity, broad acuity distribution. Confidence impact: medium.

05

Lease term, renewal options, personal guarantee, and malpractice tail availability. Confidence impact: medium.

Continuity flags

  • Schedule II prescribing concentrated in ~18% of panel. Successor prescribing authority, state licensure, DEA registration, and PDMP workflow need to be confirmed before transfer.
  • Two PCP referral relationships are personal; warm-introduction protocol needed before notice goes out.
  • One payer contract requires 90 days of advance notice for change of ownership. Sequencing matters.
  • Disability and FMLA paperwork dependencies for a small subset of patients require a documented handoff plan.

30 / 90 / 365-day priorities

30 days

Confirm goals, normalize financials, map active panel in aggregate, and identify advisor questions before any buyer conversations. Stop making informal commitments.

90 days

Build a business-only diligence room, pressure-test payer assignability with counsel, define owner-overlap terms, and confirm malpractice tail.

365 days

Run a controlled successor or buyer process with continuity planning, counsel review, staged disclosure, and a documented introduction protocol.

Path comparison: prepared sale vs. planned wind-down

If Hart Psychiatry Associates were wound down rather than sold, there would be no transaction proceeds. The economics during a wind-down period would be practice income while the panel is transferred, referrals are closed, and operations are wound down. The primary obligations would be patient notice, individualized handoff planning for higher-acuity and controlled-substance patients, records custodianship, malpractice tail, payer-contract terminations with appropriate notice windows, and lease/vendor unwind.

For this fictional practice, a prepared sale is the better economic outcome because demand, adjusted earnings, staff workflow, and owner-overlap availability are strong enough to support a careful buyer or successor process. A planned wind-down becomes the better path if the owner's timeline compresses, if payer portability proves weaker than expected, or if a qualified buyer cannot be identified within a clinically appropriate window.

Advisor prep

Healthcare counsel should review patient notice, records custodianship, confidentiality, BAA sequencing, controlled-substance continuity questions, and transaction structure before any identifiable information is shared. A healthcare CPA should normalize owner compensation against a market replacement rate and isolate non-recurring expenses before valuation conversations become formal. Successor or buyer conversations should be staged: clinical fit and overlap first, financial detail after counsel and CPA have confirmed structure.

Confidence note

This Workup is delivered at high confidence on the path read and at medium confidence on the planning range. Closing the payer-assignability evidence gap (Evidence Request 01) is the single highest-leverage item to upgrade the range to high confidence. Doc2Doc treats every published or shared range as indicative planning guidance, not a formal appraisal, broker opinion of value, or fairness opinion.

Evidence receivedConfidence effectLikely range effect
Signed payer-contract excerpts confirming change-of-ownership or re-credentialing process.Moves payer portability from needs-work to documented.Tightens the range by reducing revenue-continuity uncertainty.
24-36 month monthly P&L with owner compensation normalized.Moves economics from owner-reported to measured.Reduces debate around adjusted owner earnings.
Aggregate panel map by visit cadence, prescribing complexity, and psychotherapy intensity.Moves continuity risk from directional to actionable.Improves successor-fit analysis and handoff planning.
Written owner-overlap commitment and referral-source introduction plan.Moves owner support from stated intent to executable transition asset.Supports the upper half of the range if buyer/successor fit is strong.

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