Orthopedic surgeons spend months obsessing over valuations, deal terms, and tax strategies—then face a harder question once the wire hits: what now? This article walks through the identity gap no one warns you about, how to design a purposeful “second act,” and the financial guardrails that can protect your practice-sale proceeds from lifestyle creep and impulsive decisions. If you are planning to sell to private equity or another buyer, this is the work to do before the deal closes.

Most orthopedic surgeons look at tax returns and assume that number is what their practice is worth. In reality, buyers use normalized EBITDA—adjusted for owner pay, personal expenses, and one-time costs—to decide what they’ll actually pay. This article shows how to estimate normalized EBITDA and use it to negotiate from a position of strength.

When you sell your orthopedic practice, the IRS cares how much of the price is the business—and how much is you. This article explains personal vs. enterprise goodwill, why early documentation matters, and how thoughtful planning can translate into six‑figure tax savings at exit.

Private equity offers orthopedic surgeons big multiples and polished pitch decks—but the real story lives in the fine print. This article walks through how rollover equity, compensation resets, EBITDA ‘engineering,’ and PE hold periods actually work in many orthopedic deals. It then shows, with a simple $4M practice sale example, how planning around personal goodwill and deal structure can change a surgeon’s federal tax bill by hundreds of thousands of dollars. If you’re an orthopedic surgeon being courted by private equity, this is the pre‑dinner framework to read before you say yes—or no.