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In today’s healthcare market, few vantage points offer as much depth as standing at the intersection of entrepreneurship and private equity. My work spans both sides of this ecosystem, partnering with independent founders building high-growth companies, while also advising private equity firms on diligence, valuation, and strategic acquisitions. This dual role gives me a rare bird’s-eye view of how healthcare businesses are built, scaled, valued, and ultimately exited.
Healthcare does not operate in isolation. At the core of my work is collaboration with economists, attorneys, accounting firms, healthcare systems, and other industry verticals. These tangential yet crucial perspectives inform every conversation. By engaging directly with the Big Four, investment bankers, health system executives, and respected advisors, I gain real-time intelligence across sectors that influence healthcare outcomes, whether regulatory, financial, or operational.
This integration allows me to see both the micro-level intricacies of founder-led innovation and the macro-level trends driving capital markets.
Independent healthcare founders represent the cutting edge of innovation. They are creating companies with clinical differentiation, superior patient outcomes, and scalable platforms that have genuine growth potential. Working alongside these founders provides an intricate understanding of their challenges: refining the thesis, driving customer experience, maintaining clinical excellence, and preparing for the eventuality of scale or exit.
In a market where consolidation has left fewer strategic buyers, founders must build with resilience and adaptability. The best approach today is not rushing toward an exit, but rather perfecting the fundamentals, building companies that can withstand volatility and emerge stronger when conditions stabilize.
On the private equity side, conditions are markedly different from just a few years ago. There is plenty of dry powder, but the deal environment has slowed. Funds are extending hold periods, often well beyond the traditional five-year cycle, as exits have become less frequent and more complex. This creates tension: limited partners are waiting longer for returns, while funds are forced to manage and maximize their existing portfolios rather than aggressively pursue new acquisitions.
Market volatility, unpredictable interest rates, tariff uncertainty, and a shifting regulatory environment have compounded the challenge. Valuations often lack logic, with assets sometimes overpaid for, undervalued, or overlooked entirely. The result is a cautious environment where introductions and movement abound, but closings remain selective.
The current healthcare investment landscape reflects larger macroeconomic dynamics. Economists, bankers, and attorneys alike highlight:
• Uncertainty in capital markets: Are equity markets overvalued? Where will rates settle?
• Political and regulatory volatility: Policy shifts and inconsistent regulation create hesitation.
• Valuation mismatches: Assets priced without grounding in fundamentals lead to inefficiencies.
• Exit constraints: With fewer strategic buyers available due to consolidation, private equity firms face limited options for exits.
These forces converge to create a market where both founders and investors must play the long game.
For entrepreneurs, this moment is not a setback but an opportunity. With private equity cautious and exits delayed, the best course is to double down on strengthening the company’s foundation:
• Refining the value proposition
• Driving measurable customer and patient outcomes
• Enhancing operational performance
• Creating a culture that sustains long-term growth
When the markets stabilize, those who have used this period to build with discipline will stand out as the most compelling opportunities for investment and acquisition.
Operating at the nexus of founders and private equity provides unmatched insight. I see the ingenuity of healthcare entrepreneurs firsthand while also understanding the capital markets that fuel their growth. This dual perspective allows me to forecast where opportunity lies and guide both founders and investors through an environment marked by uncertainty but also enormous potential.
Healthcare remained one of the most resilient and dynamic sectors. Will it stay strong amongst intense crosswinds? Even amid market turbulence, the combination of innovation, capital, and clinical necessity ensures that growth will continue. Or is that a baked in assumption from the past? The key is navigating the current pause with clarity, patience, and an unwavering focus on value creation.
"There is no rulebook. There’s only experience"
Sam Maddula, Pharm D.
CEO & Founder, Workshop Strategy
