The healthcare sector, especially medicine and pharmacy, is one of the most complex and heavily regulated industries in the U.S. market. For private equity firms looking to invest in this space, it’s not enough to run the numbers, review the diligence binder, and walk away with a thesis. The real work begins after the term sheet is signed.
At Workshop Strategy, I work directly with private equity groups as an advisor, board member, and former healthcare CEO and founder who successfully exited to private equity. I sat on both sides of the table. I know what looks good on paper, and I know what works in reality.
Private equity firms often engage me to evaluate whether a target is worth pursuing, not just from a transactional standpoint, but from an operational and strategic one. It's about more than EBITDA and P&Ls. It’s about people, scalability, compliance posture, and sustainable growth. My role is to answer critical questions:
Recently, I advised a PE group on a pharmacy that looked phenomenal on paper, showing strong revenue, solid EBITDA, and a seemingly dominant market position. But as I dug in, it became clear the story didn’t hold. Management faltered under pressure. They lacked depth in regulatory knowledge. Growth was acquisition-dependent, not organic. The fundamentals weren’t sound, just dressed up to look that way.
That firm took my advice and walked away. Months later, that same company is now facing serious insurance and compliance issues. The warning signs were there, but only someone who has operated in the space would know where to look.
Here’s a tough truth many overlook: healthcare is not a software business. Scaling doesn’t come with the same margins. As revenue grows, so do operating costs and compliance risks. Reimbursement is government-controlled. Growth isn’t linear. Slapping in a generic “growth CEO” to run a pharmacy business does-not-work. You need nuanced execution, domain expertise, and real operator judgment.
This is where most deals go sideways, not during diligence, but during execution.
Too often, good companies are passed over, or worse, bad ones get picked up, simply because the decision-makers lack sector-specific context. An entrepreneur-operator who has lived in the trenches brings a lens that pure financial diligence cannot replicate. I know what scalability looks like. I know what hidden risk looks like. And I know how to evaluate whether a team can truly deliver on a growth thesis.
Private equity doesn’t buy for dividends. It buys for multiple expansion. If you can’t confidently draw a line from Day 1 to a 2 to 3 times return based on realistic operating improvements, you shouldn’t write the check.
I partner with private equity to unlock real value in healthcare transactions, particularly in pharmacy and medical services. Whether as part of diligence, post-close operational strategy, or long-term advisory/operator roles, I help ensure that the companies you buy are not just well-priced, but well-positioned for exit at the multiples projected
If you’re a private equity firm exploring opportunities in healthcare, feel free to reach out.
"There is no rulebook. There’s only experience"
Sam Maddula, Pharm D.
CEO & Founder, Workshop Strategy