E#35: Oliver Abrams on MSK, Clinic M&A, Private Equity, Dental Rollups & Patient Retention | The Business of a Clinic

In this episode of The Business of a Clinic, Jared speaks with Oli, Director of M&A at Kinetico Health, about what makes a private healthcare clinic valuable, scalable, and ready for acquisition.Oli shares his journey from dental M&A into MSK, what he learned from the consolidation of the dental market, and why MSK is now entering a new phase of professionalisation, partnership, and group-building.The conversation explores the full M&A process: origination, heads of terms, due diligence, commercial review, legal challenges, partner onboarding, and integration. Jared and Oli discuss what acquirers actually look for in a clinic, why culture is one of the most important signals, how founder reliance affects valuation, and why recurring patient revenue matters more than new patient volume alone.They also go deep on the economics of MSK clinics: insurance vs self-pay, practitioner capacity, margin, overheads, cancellation rebooking, first-visit integrity, and why patient retention is central to organic growth.The episode closes with a comparison between dentistry and MSK: what MSK clinic owners can learn from dental practice owners about preparing for sale, and what dentists can learn from MSK operators about reducing reliance on the principal practitioner.Chapters0:00 Introduction1:00 Oli’s role at Kinetico Health1:45 Finding and onboarding MSK clinics2:30 From law to dental M&A3:40 Why working with clinic owners matters4:25 What happens after heads of terms5:00 Financial and commercial due diligence6:05 The legal process and lease issues7:20 Why M&A should not feel adversarial8:10 How clinic owners can prepare for acquisition9:05 What acquirers look for beneath revenue10:00 Why the clinic owner matters first10:45 Culture, team loyalty, and principal retention11:30 Key person reliance and founder concentration12:20 Succession planning inside the clinic13:15 The “who” behind a valuable clinic14:05 Patient body, recurring revenue, and data quality15:00 Insurance, NHS contracts, and payer mix16:20 Stroke-of-the-pen risk in healthcare revenue17:15 Insurance provider rates and profitability18:00 MSK economics vs aesthetics and dermatology19:10 Margin improvement through revenue growth20:15 Private equity stereotypes and cost-cutting21:15 Revenue growth in MSK clinics22:10 Returning patient mix and clinic performance23:05 When low retention is fixable24:00 Practitioners, treatment plans, and “sales” discomfort25:00 Helping patients commit to the right care journey26:05 The practitioner as guide, not salesperson27:15 Who owns follow-up after the patient leaves?28:25 Practitioner responsibility vs front desk responsibility29:10 Booking the next appointment before exit30:10 Patient leakage and why patients drift31:10 First-visit integrity and cancellation management32:15 Building a pipeline to backfill cancellations33:10 Same-day cancellations vs seven-day cancellations34:05 Cancellation fees, friction, and reputation34:50 Reading culture inside a live clinic36:10 Why Oli moved from dental to MSK37:15 Dental consolidation and market maturity38:20 Emotional investment in clinic partnerships39:30 Why mature M&A markets feel different40:20 Building an organic acquisition pipeline41:15 Why corporates get a bad reputation42:10 Why MSK is an exciting consolidation market43:10 Building a group from a less mature market44:00 Entrepreneur by accident: the clinic owner journey45:00 Helping practitioners get back to patients46:00 What dentistry and MSK can learn from each other47:00 How dental owners prepare for sale48:00 Getting accounts and operations exit-ready49:00 Why sellers should speak to other partners50:05 What dentists can learn from MSK owners51:00 Reducing reliance on the principal practitioner52:05 The next phase of Kinetico Health53:00 Greenfield sites, acquisitions, and group growth54:05 Integration as the foundation for growth55:00 Building systems so clinicians can focus on care55:40 Closing thoughtsThe Business of a Clinic explores how private healthcare clinics can grow by improving patient relationships, patient engagement, clinic operations, retention, follow-up, commercial systems, and the overall patient experience.