When Buying or Selling a Medical Practice: EBITDA vs SDE Which Metric do Buyers use when assessing the Purchase of a Medical Clinic? The answer is that it depends on the size of the Business and the buyer. First let’s define EBITDA, Earnings before Interest, Taxes, Depreciation, and Amortization. The way to Calculate this is to simply add those items from the financial statements. This method assumes a “Passive” (not working in the business) owner and investor for example.
SDE is the acronym for Sellers Discretionary Earnings, AKA Sellers Discretionary Cash Flow, Adjusted Net and a few other similar sounding names. This Metric includes all of the EBITDA items listed above but also Assumes a Full-Time working owner and includes the Sellers Discretionary Expense “add backs”. Examples might be Travel that is not necessary for the business, a company car, a retirement plan for the owner of the business just to name a few.
An individual Doctor looking to buy a Medical Practice to work in and own will be looking at SDE to calculate how much they will make. An example would be an Internal Medicine Practice with $800k in collections and the Full-Time working Doctor owner is making $350k after all the bills are paid. A buyer might pay 1 to 2.5 times (maybe more) of the SDE to purchase that practice.
A Large Group or Hospital looking to buy this same Practice will be a somewhat passive investor and will include a Doctors Salary of $200k in the expenses. They will also add general and administrative cost and where the SDE was $350k in this example, the EBITDA is now around $100k for the same Business. With the owner Doctor leaving, they will also want the seller to “earn out” of the business for the risk that the patients don’t like the new Doctor they place in the Practice. This means that if the Collections decrease after the sale, the seller receives less money for the business. The large group may pay 2 to 3 times (could be more for a Business that has $1mm+ in EBITDA) the EBITDA but the higher Multiple is on a much smaller Number. 3 Timed EBITDA of $100k in this example equals $300k price where 1.5 times SDE of $350k equals a price of $525k
Keep in mind this is the Same Business, Same Numbers, just a different point of view from different types of buyers. Your Business has a different value to different types of buyers.
The Bottom line is that you need find the best buyer to get the best price for your Business when it is time to sell. If you are thinking about selling your Medical Practice and are not happy with the offers you have received from large group buyers, call Vince LoCricchio BCI at 813 690-0109 (586) 298-1240 for a free confidential consultation about buying or selling a Medical Practice or email Vince@EnterpriseBrokers.com.