Brandon Pierron

This is quite small for an ortho practice. I've seen single ortho Physician practices wound down with around $2m+ revenue / 600k+ SDE. All the value is in the providers. Equipment purchased in these wind down transactions ($10-$15k) + maybe takeover of the existing lease. This is more done so as a favor for patient continuity of care than any financial gain.

Attention SMB/medical friends — What is a small/SMB orthopedic practice worth that generates $200K/year of SDE (i.e. EBITDA $0)? Revenue $500-750K.

If you are looking for a church to attend tomorrow and want help finding a good one, shoot me a DM, and I’ll be happy to help.

My advice to entrepreneurs starting out… Even though it may be tempting to offer products/services below market rate, to get a foot in the door, I’d try to avoid it as much as possible. It can turn into a cycle of brand dilution, difficulties with hiring/retention, and overall challenges with growing the business. There’s a time for this at the start but some are never able to move past this. (Especially true if you are in the top decile in what you do)

@patrickdichter @SMBTelecomGuy

Ring Central or Zoom phones folks? Our VOIP and texting provider has become so unreliable. We need to do texting 2FA easily, be able to send pictures via text, clear phone calls, and have easy set up for new staff.

Interesting, I’ve noticed similar across businesses with a material presence in the Philippines — a workforce much larger than what would be typical for a US-based team, close to negating any direct monetary benefit obtained from offshore initiatives. Not to mention the increased risk for cyber attacks. Remote teams based in middle-America are beginning to look more attractive.

Everyone's betting on Ozempic to fix healthcare costs But... my data shows 15%+ increases this year Starting to wonder if GLP-1s can even move the needle

@mitchellcmorris New grads are having serious problems securing jobs Middle class is being squeezed with inflated real estate, rising healthcare costs, and low wage growth. Overconsumption could be one factor (of many) imo Overall economy (hyperscalers / upper class) is doing well…

An economist I listened to last Thursday says that the economy isn't slowing, and that it is in great shape. He summarized that it is normalizing, back to average, after a 5 year stimulus consumption binge. He then went on to say that it's overconsumption that is getting folks out "over their skis". What do you think?

@_agarner Yes, specifically for development

@BrandonCPierron you seeing the same?

maybe anecdotal but i get way more frustrated with gpt5 than I was with 4/4o

@MikeBotkin_ Killer grit

Lot of chatter today about multiples and EBITDA, etc. The OG's on here know the original acquisition story (I was basically posting play-by-play), but majority of the people on here only know my landscaping acquisition journey from when we finally caught momentum and really started humming. Figured it would be fun to share this.... The first business I bought, was a residential landscaping company. It was doing $800k in sales. Not EBITDA...sales. It was doing $125k in 'SDE'. It had 10 employees (owner son was one of them) and 4 box trucks (3 were shit, not that I knew that). I was buying a job. I knew that going in. My thought was, if I bombed, I guess I'd be a landscaper and make ~$60-70k a year. If I really bombed, I'd sell the assets and go get a job. But, if I didn't bomb... ...I HAD to know. There was zero percent chance that I was going to be able to keep grinding away for somebody else (corp life) and never know for sure, if I could do it. What is "it"? No idea. Some days, it was be my own boss. Some days, it was unlock riches. Some days, it was to provide future jobs for family in generations to come. etc. My desire to know...could also be described as irrational confidence. I didn't even know how to turn on a lawn mower, let alone use one. I am not kidding btw! Anyway, back to the landscaping company. The longest tenured and most senior level employee - who the owner told me would be THE MAN and help me get through the rough early days - quit midway through my "hi, I'm Mike" speech. Seriously. Midway through, just bounced. Fun times. Day 2, the owners son quit. Day 3, truck #2 breaks down midday and needs towed Day 4, truck #3 doesn't even start. Week 2, I had to drain my family savings (not much), and ask my lone investor for a LOC that I would PG (not worth much) just to survive and make payroll and improve capex. I drove 80 minutes every single morning to the shop, leaving my house at 4:30am. I was not getting home until 6:30pm at night, and then praying nobody called me or my wife didn't see the stress on my face so it wouldn't ruin dinner. By 8pm my newborn was sleeping and I'd go right to the computer. Reading every article I could find. Browsing lowes/home depot nursery pages to learn plants and then googling them. Watching every youtube video ever made on all things from how to change oil in a lawn mower to how to edge to tips on pricing. My days were 100% dictated by who showed up, what mood they were in, and what fire happened each hour of the day. I had 3 sets of clothes with me at all times. 2 uniforms and 1 polo. I had to learn landscaping unit economics. We were bleeding cash. Praying that checks were in the mail box, so I could make payroll. Using all my personal credit cards. (tip: Ask the owner if he pays guys in cash on the side) The best way to learn that (unit economics)? Well, I'm sure there are smarter ways but, I'm kind of a dummy (see all the above), so I did it the only way I knew. I road in every single truck for weeks straight. With a yellow notepad, tracking EVERYTHING. Fuel usage, distance, time on site, time to get places, how long this route took us, what if we switched and went down this street instead? would it save us 5 minutes? What if instead of mowing first we did all the stick work first, would that help by 3 minutes? etc. Constant A/B testing and trial and error. Every.Single.Thing. about the business had to change. I wasn't going out like this. From how we executed jobs, to how we lined the trucks up, to how we parked the trucks at a clients house, to what crew member sat where in the truck (if the edger is on the right rack, and the guy who edges sits in the left backseat, he has to walk around to get the edger. He needs to sit in the right backseat.)...you get the idea. I fired 70% of the original clients. Things started clicking. Our employees bought in (the ones who stayed), our equipment got better (thanks Chelsea [my wife saving acct]), we were becoming more efficient. I increasing pricing....3x within 6 months. I also changed the invoice date from say...June 30th (for the month of June service) to June 1st (for the month of June service), and increased cash conversion cycle. We were making it work. I changed the business from 100% residential to 100% commercial. Landed some clients we probably should not have even been talking to. But, I had irrational confidence. Fast forward, we then went and acquired 6 commercial landscaping companies and had locations in Florida and Georgia. We became one of the premier landscaping companies in the Southeast, servicing A+ clients like Disney, World Marriott hotels, etc. I remember sending pictures to my wife of our first $10k week, $100k week, and $1m week. We exited to a strategic in late 2023. Moral of the story is this. I could be cutting your grass making $60k a year. :) Just kidding. (but not). IF you BELIEVE...don't worry about multiples, etc. Just get in the game. Oh, and never listen or take advice from somebody who doesn't have to live with the consequences.

Does the private equity HVAC/Plumbing business strategy apply to hospitals and medical practices? Buy up all the private practices, then cut costs Will patient care be better or worse?

Looking for two businesses that need finance help. Recent client experienced a $6M+ increase in EBITDA since the beginning of our work together. This couldn't have happened without a basic financial and reporting foundation in place.

Create a world of your choosing with a simple prompt. The Metaverse is upon you. Whether you like it or not.

Why many AI initiatives fail: A core part of businesses moving from lower middle-market to enterprise is a solid data foundation, something that you can mesh with agentic AI capabilities This doesn't happen overnight. Deploy AI before you're ready, and it will be useless

@BoringBiz_ Ifykyk

Watching this on repeat

@mitchellcmorris If ‘can’t afford’ is the status quo, there’s likely unwillingness to invest in the business. So much opportunity for the company itself, but often a red flag for vendors. Can be challenging to work with this persona from my limited experience with them. Wish that wasn’t the case

When someone says their Co makes $7m a year, but they can't afford $5k a month. Is that a red flag or opportunity? Why👇?

@InvestingDoc Decline but reach out to the exec and see if they are interested in selling the practice (then they can see how you run things)

The significant other of a C-suite exec at our competitor just asked if I could be their primary care doctor. Not sure if I should be honored... or start charging consulting fees...or they trying to get an inside scoop on what makes us who we are. Would you see them or decline to accept them as a patient?

@InvestingDoc @GoDaddy We can get it up again quickly if it’s still giving you problems

Im done with @GoDaddy my websites were getting more traffic so I paid several thousand dollars to increase my bandwidth and servers and it's been 13 hours...my websites are still down since the "upgrade" what an absolute joke. I've called in 15 times and just told to wait longer. Insane. Who y'all using for website hosting. I'm done with GoDaddy. Just awful.