What independent practices are worth, according to Andy Colbert

Independent medical practices are facing a difficult strategic choice as consolidation continues to accelerate: remain independent, or look for a partner. That question sits at the center of a Medical Economics podcast conversation with Andy Colbert of Ziegler, who outlines how physicians should think about value, scale and the future of their organizations.

The episode frames the pressure on independent practices as coming from several directions at once. Rising labor costs, lower reimbursement and a heavier administrative burden are making it harder for physicians to keep practices afloat on their own. Those forces are also changing how physician groups think about mergers, private equity, hospital partnerships and the worth of the businesses they have built over many years.

Colbert is a senior managing director at Ziegler, a privately held investment bank that has focused on health care for more than a century. He leads the firm’s physician advisory practice and has advised on more than $6 billion in transactions, according to the episode description. In the conversation, he discusses the scale needed to remain independent, why physicians often misjudge what their practices are worth, and how different deal structures compare.

The episode summary does not provide a full transcript of Colbert’s comments, but it does outline the main topics covered. One of the central themes is the changing scale required for a practice to stay independent. The conversation references a range of roughly 40 to 50 physicians as the threshold now needed to remain on one’s own. That shift reflects how much more difficult it has become for smaller groups to absorb costs, manage operations and compete in a changing market.

Another major topic is valuation. The episode describes how cash flow defines a practice’s worth and notes that physicians may not always see the business through the same lens as a buyer or investor. It also refers to a 30% “scrape,” though the source does not explain the term in detail beyond its mention in the context of valuation. The value of a practice can also change depending on how many years a physician has left in practice, but the source does not give a formula or example.

The conversation appears to stress that owning a practice now requires more than clinical expertise alone. One of the episode’s key points is that physicians have to think like business owners, not just clinicians. The source says Colbert traces the path from a family of physicians to leading Ziegler’s physician advisory practice, but it does not provide additional biographical detail beyond that outline.

Hospital alignment is another area discussed in the episode. The summary says the conversation compares hospital alignment with a private investor and notes some of the possible effects of a hospital deal, including a day-one reimbursement bump and added referrals and volume. It also describes hospital alignment as a defensive move in some situations. However, the source does not report specific financial terms, any named hospitals, or how those arrangements played out in individual cases.

The episode also contrasts platforms and tuck-ins, suggesting that not all transactions are the same. The source does not define these terms in detail, but it indicates that the structure of a deal matters when physicians are comparing options. That same section of the conversation also places private equity in the mix, with Colbert presenting it as a third option between hospital employment and health plans. The source does not provide his full argument, only that he makes a case for private equity as an alternative path.

Artificial intelligence is also part of the discussion. According to the episode rundown, the conversation explores where AI can help practice economics and why it raises the bar for solo groups. The source does not specify which tasks AI may improve or how those tools would be deployed, but it suggests that technology is becoming another factor influencing whether a small practice can compete.

Staffing and overhead are treated as practical issues in the context of a deal. The episode summary says mergers rarely cut headcount, which implies that physicians should not assume a transaction will immediately reduce staffing needs. It also notes the importance of communicating change without alarming employees. The source does not report any specific communication strategy, but it makes clear that workforce concerns are part of the process.

The podcast also covers the role of a management services organization, or MSO. In the episode outline, Colbert discusses how an MSO can help a practice think and act like a real business. The source does not lay out a specific MSO model, but it suggests that this structure can support practices trying to build scale while preserving some degree of independence.

Primary care is another focus. Near the end of the conversation, Colbert offers a message to primary care physicians about building scale and preparing a three-to-five-year strategic plan before someone else initiates a conversation. The source does not quote him directly, but the takeaway is clear: practices should not wait until market pressure forces a decision. Planning ahead may give physicians more options.

The episode is presented as part of a broader set of Medical Economics conversations about physician compensation, productivity, concierge medicine and coverage of GLP-1 drugs under Medicare and Medicaid. While those other topics are not part of this specific discussion, the placement suggests that the podcast is aimed at helping physicians navigate the business side of medicine as well as clinical work.

The source materials also note that the episode includes timestamps and a transcript produced using AI tools. Those notes are administrative rather than editorial, but they indicate that the podcast has been organized into segments covering the major themes of practice valuation, deal structures, AI, staffing and strategic planning.

For physicians weighing whether to stay independent or seek a partner, the episode positions valuation as only one part of the decision. The broader question is whether a practice has enough scale, systems and strategic direction to compete in a more consolidated environment. The source does not suggest one universal answer, but it makes clear that the economics of independence are changing.

In that sense, the conversation with Colbert is less about a single number than about a framework. Physicians are being asked to assess their practices as businesses, understand how buyers may view their cash flow and think carefully about the trade-offs among hospital alignment, private equity and MSO arrangements. The source does not report final recommendations beyond that strategic lens, but it does show why valuation and planning have become central issues for independent groups.

As consolidation accelerates, the episode’s message is that practice owners need to know what they have, what it is worth and how much time they have to shape their next move. The source does not provide a universal answer to whether physicians should sell, merge or stay independent. Instead, it highlights the importance of understanding the business realities before making a decision.