7 Questions to Ask Before Buying a New Podiatry Practice

2026-08-21

Before buying a podiatry practice, ask these 7 key questions about finances, patients, staff, and more. Get practical advice and realistic cost ranges for 2026.

Buying an existing podiatry practice can be a faster path to ownership than starting from scratch, but it comes with hidden risks. Before you sign anything, you need to dig into the practice’s financial health, patient base, staff, and operations. Here are 7 questions to ask, with concrete steps you can take this week.

1. Why is the seller leaving, and what is the real reason for the sale?

The seller’s stated reason (retirement, relocation, health) may not tell the whole story. Ask for the real reason, and verify it. For example, if the seller says they are retiring, check if the practice’s revenue has been declining for the past 3 years. If so, the decline may be due to competition, payer mix changes, or a poor reputation, not just the seller’s age.

This week: Request the last 3 years of tax returns (business and personal) and profit and loss statements. Look for trends in revenue and expenses. If revenue is flat or down, ask for an explanation.

2. What is the patient mix, and how many are active?

A practice may have a large patient file, but many may be inactive. Ask for the number of active patients (seen in the last 18 months) and the payer mix (Medicare, Medicaid, private insurance, cash). Medicare typically pays well for podiatry, but if the practice relies heavily on Medicaid, reimbursement may be lower. Also, ask about the age of the patient base: an older base may be loyal but may also shrink over time.

This week: Ask for a report of active patients by payer and by age. If the seller cannot provide it, that is a red flag.

3. What is the real EBITDA, and are there any one-time expenses?

EBITDA (earnings before interest, taxes, depreciation, and amortization) is a key indicator of profitability. But the seller may have adjusted EBITDA to look better. Ask for a detailed breakdown of expenses, and identify any that are discretionary (e.g., a car allowance, family members on payroll) or one-time (e.g., new equipment). Also, check if the seller is paying themselves a market salary; if not, the EBITDA may be overstated.

This week: Create a simple spreadsheet listing all expenses from the P&L, and flag any that seem unusual. Compare the seller’s salary to industry benchmarks (a podiatrist owner typically earns $200,000-$300,000 per year).

4. What is the condition of the equipment and the lease?

Podiatry practices rely on specialized equipment like X-ray machines, ultrasound, and surgical tools. Ask for a list of all equipment, its age, and maintenance records. Also, review the lease: how many years are left, what is the rent, and are there any renewal options? If the lease is expiring soon, you may face a rent increase or have to relocate.

This week: Hire an equipment appraiser (cost: $500-$1,500) to assess the value and condition. Also, have a real estate attorney review the lease (cost: $500-$1,000).

5. How many staff are there, and will they stay?

Staff can make or break a practice. Ask for an org chart and the tenure of each employee. Key staff like the office manager, biller, and lead podiatry assistant are critical. If they leave after the sale, you may struggle. Also, ask about their salaries and benefits, and compare to market rates.

This week: Request a list of all employees with job titles, salaries, and start dates. Plan to meet with the top 3 staff members before closing, and offer retention bonuses (e.g., $2,000-$5,000) if they stay for 6 months.

6. What is the payer mix and reimbursement trend?

Podiatry reimbursement varies by payer. Medicare pays well, but private insurers may negotiate lower rates. Ask for the top 10 payers and the percentage of revenue from each. Also, check if the practice has any pending audits or disputes with insurers. A practice with a high denial rate or frequent audits is risky.

This week: Ask for a report of denials by payer for the last 12 months. If the denial rate is above 5%, investigate the reasons.

7. What is the asking price, and how does it compare to industry multiples?

Podiatry practices typically sell for 0.5 to 1.0 times annual gross revenue, or 3 to 5 times EBITDA. For example, a practice with $500,000 in annual revenue might sell for $250,000 to $500,000. But the multiple depends on location, growth potential, and patient loyalty. Get a professional business valuation (cost: $2,000-$5,000) to ensure you are not overpaying.

This week: Hire a certified business appraiser who has experience with medical practices. Ask for a valuation report that includes a comparison to recent sales in your state.

FAQ

Can I use an SBA loan to buy a podiatry practice?

Yes, the SBA 7(a) loan program is common for practice acquisitions. You typically need a 10% down payment, and the loan term can be up to 10 years. Interest rates are competitive, often prime plus 2.5% to 3%. Expect closing costs of 2% to 5% of the loan amount.

How long does the due diligence process take?

Typically 30 to 60 days. This includes reviewing financials, legal documents, and operations. Do not rush; a thorough due diligence can save you from costly mistakes.

That is a red flag. If the seller refuses to provide tax returns or P&L statements, walk away. You cannot make an informed decision without them.

Should I hire a broker?

A broker can help you find practices and negotiate, but they charge a fee (usually 5% to 10% of the purchase price). If you are experienced, you may not need one, but for a first-time buyer, a broker or an attorney with M&A experience is wise.

The bottom line

Buying a podiatry practice is a significant investment, and asking the right questions can protect you from financial loss. Focus on the practice’s financial health, patient base, staff, and lease. Use the 7 questions above as a checklist, and do your due diligence thoroughly. With careful evaluation, you can find a practice that provides a solid income and growth potential for years to come.