Selling Your Healthcare Business: The Long, Emotional Journey

Volume 12, Issue 7, April 8, 2025

By: David Purinton, MBA, CM&AA

Selling your healthcare business, especially when you're the founder or long-time owner, is one of the most emotionally complex and taxing journeys you'll ever take. The sale is not just a financial transaction. It's the culmination of years, and sometimes even decades, of work. The lengthy process of selling your company brings a whirlwind of feelings, expectations, excitement, and challenges that can — and often will — impact every step of the transaction process.

In our extensive history and experience working with healthcare business owners, there's a recurring psychological pattern we've seen play out time and again. And it's this pattern — this rollercoaster of emotions — that can make or break a deal.

You Believe Your Healthcare Company is the Best

By the time you decide to sell your business, you've likely built something you believe is exceptional. With all the long hours you've put into the company, you know it inside and out. You may know the inner workings of your business better than those of your home. You've spent countless hours working to optimize operations, assembling a talented supporting team, building a strong customer base and referral network, and establishing a brand and reputation that customers and partners have come to trust and value.

When you look at your company, you see an asset that you strongly believe should command top dollar.

That belief is important. It's that confidence which has helped you find success with your business and will drive your desire to find a buyer that truly understands and appreciates the value of what you've worked to build.

But that belief is also the foundation for a deep emotional attachment that can complicate matters as you move through the transaction experience.

The Initial Surge of Seller's Motivation

When you first make the decision to bring your company to market, it's like flipping a switch. After what was likely extensive contemplation, you make the call, and the sales journey begins. Once that happens, the adrenaline will likely kick into overdrive, and you operate with intense focus and energy, which is exciting and one of the reasons many CEOs become addicted to healthcare mergers and acquisitions (M&A). You engage an M&A advisor, gather documents, clean up financials, and undergo a healthcare business valuation. You work with the advisor to assemble your detailed confidential information memorandum (CIM).

The first discussions with potential buyers fill you with excitement and nervousness. You rehearse talking points and then overanalyze your delivery afterward. You try to read between the lines of every question asked of you and your advisor and every follow-up email you receive.

This first surge of motivation that comes with bringing a company to market can make the beginning of the transaction process feel like a sprint.

And that's potentially a big trap.

The Transaction Process Slows, But You're Still Running

After the first few weeks or even few months of research, preparation, outreach to buyers, and calls, the deal process inevitably slows down. Gaps between communications grow. Buyers go dark temporarily as they work through their own — and extensive — diligence processes. A process that once seemed urgent now begins to feel sluggish, which naturally makes you uncomfortable and a little bit skeptical about the future.

At this stage, your motivation begins to shift. You're still committed to the transaction, but you're no longer sprinting. It's more like you're jogging or walking. Some days, there's no movement at all.

Despite all the work that's gone into the transaction, the finish line is still a ways away.

Under LOI: An Emotional Letdown

When your company finally goes under a letter of intent (LOI), it justifiably feels like a huge milestone. But emotionally, this is where a seller's psychology can really start to change.

You feel like you're in the home stretch, but in reality, you're about halfway there.

Due diligence accelerates. The quality of earnings (QoE) evaluation starts. Legal teams get involved or further engaged. The buyer starts asking more prodding questions that can feel personal at times. Some questions may have you believing that the buyer is undervaluing or misunderstanding your business. Conversations get tougher, and the excitement you had for selling your company crashes.

Then comes the fatigue.

Fatigue as a Common Deal Killer

By the time you're in the final stretch, which includes steps like negotiating the purchase agreement, resolving working capital targets, answering diligence questions for what feels like the tenth time, it's only natural to feel exhausted. After all, you've also been trying to run your company while knowing the end of your ownership is on the horizon. The team members you involved in the transaction are tired, and the rest of your staff may sense something big is happening behind the scenes. Your advisors are juggling a hundred things. And emotionally, you're drained, and you may even doubt whether you should have started this process in the first place.

This is the part of the transaction experience that is often unknown, surprising, and disappointing.

What we sometimes see in our seller partners at this stage is a kind of emotional paralysis. Owners slow down. They stop responding to emails as quickly. They delay document requests. They take longer to make decisions. They express skepticism in the buyer.

These actions typically don't stem from a lack of desire to close the deal. More often, it's simply that they've run out of gas.

And that, in the words of Kenny Loggins, is the "danger zone." Healthcare transactions don't usually die because of a single issue. They die from a loss of momentum. Buyers get nervous. Timelines slip. People — including the buyer's team — start second-guessing. Before you know it, the whole deal unravels and it's largely back to square one.

The Healthcare M&A Marathon Mindset

The key to succeeding — and surviving — in the prolonged sale process is understanding that a healthcare business transaction is almost never a sprint. It's more like a marathon. For some deals, it could even feel like an ultramarathon. From the get-go, you need to try to pace yourself — both emotionally and mentally. It's okay to feel everything talked about in this column: pride, anxiety, excitement, doubt, concern, and even grief. But what matters is showing up consistently, focused on the tasks at hand, and ready to do what's needed and asked of you.

The good news is that this is not a journey you should do alone. Build a team you trust and be transparent with them. Ask questions, speak up when you're struggling, and don't be afraid to let others carry the load when you need a mental or physical break — or when your still-operating business requires your complete attention. Above all else, make sure you're working with an experienced healthcare M&A advisor — someone you trust and with whom you feel comfortable picking up the phone and talking through the process, including the emotional side of it.

Throughout it all, stay focused on the end goal. Remind yourself why you started this process in the first place. And most importantly, save some fuel for the finish line — because that's when you'll need it most.

David Purinton, MBA, CM&AA

After working in M+A advisory and corporate financial consulting, I was fortunate to co-found Spero Recovery, a provider of drug and alcohol recovery services with over 100 beds in its continuum of residential, outpatient, and sober living care. As its CFO I led the company to significant revenue and margin growth while ensuring it adhered to the strictest principles of integrity and client care. After selling Spero I remained in leadership with the buyer as its CFO and quickly realized accretion and integration. Of the myriad lessons not learned while earning my MBA with Distinction in Finance from a Tier 1 university, the most profound was the importance of investing in my staff and clients. I learned that the numbers on a spreadsheet represent humans, families, and dreams, which was a radically different paradigm from investment banking.

At VERTESS I am a Managing Director providing M+A and consulting services to the Behavioral Health, Substance Use Disorder treatment, and other verticals, where I bring a foundation of financial expertise with the value-add of humanness and care for the business owners I am honored to represent.

We can help you with more information on this and related topics. Contact us today!

Email David Purinton or Call: (720) 626-2500.