Highly Profitable Family Medicine Practice, Raleigh NC

$810K

Revenue

$515K

SDE

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Full Editorial Writeup

This is a solo-provider adult family medicine and internal medicine practice in Raleigh, North Carolina, one of the fastest-growing metros in the country. The practice posted $810,269 in 2025 gross revenue with $514,607 in adjusted SDE, a remarkable 64% owner-earnings margin that reflects a lean, physician-run cost structure and a loyal returning patient panel. Its service mix spans routine care, annual wellness visits, chronic disease management (diabetes, hypertension, cholesterol, thyroid, arthritis, respiratory conditions) plus cash-friendly ancillaries like allergy testing and immunotherapy, weight management, men's health, hormone care, vaccinations, and injections.

The practice competes on continuity and personalization, positioning itself against impersonal hospital-owned systems by offering same-day scheduling, extended hours, telemedicine, and on-site lab services. That model drives patient stickiness, which is the entire economic engine of a primary care panel: patients return year after year, and chronic conditions require ongoing management visits.

What makes this notable is the combination of essential, recession-resistant demand with an efficient single-provider footprint in a market where population growth is a structural tailwind. The practice is still accepting new patients, so the panel has room to grow, and the ancillary services offer margin expansion for a buyer with the right clinical scope. It fits a physician stepping into ownership or a strategic group building density in the Raleigh-Durham area.

Why we like it

The 64% SDE margin on $810k of revenue is exceptional for primary care and signals a genuinely lean, physician-run cost base. Cash flow of $514,607 gives a buyer real downside protection, and with 100% bank financing available the equity check can be modest relative to the earnings on offer.
Primary care and chronic disease management are among the most durable revenue streams in any economy. Patients with diabetes, hypertension, and thyroid conditions need ongoing visits regardless of the business cycle, and a returning patient panel behaves like recurring revenue without the volatility of discretionary spend.
Raleigh and Wake County are among the fastest-growing markets in the US, so the practice benefits from organic population inflow and rising demand for accessible adult primary care. The practice is still accepting new patients, meaning growth is a matter of capacity, not demand generation.
The ancillary menu (allergy immunotherapy, weight management, men's health, hormone care, injections) layers higher-margin cash-pay revenue on top of the insurance base. An operator who leans into these lines can expand margin and reduce payer-mix dependence.

How to improve it

Recruit an advanced practice provider (NP or PA) within the first 90 days to add appointment capacity without adding physician-level cost. With the practice already turning away no one and accepting new patients, incremental provider hours convert directly into new panel revenue.
Audit and reprice the cash-pay ancillary services (weight management, hormone care, men's health, allergy immunotherapy) and build a clear self-pay menu. These lines carry stronger margins than standard E&M visits and reduce exposure to payer reimbursement pressure.
Launch a structured local digital marketing and referral program targeting the fast-growing Raleigh-Durham population. Same-day availability and telemedicine are differentiators worth advertising against impersonal hospital systems, and each new patient adds durable annual recurring value.
Formalize chronic care management and annual wellness visit workflows to maximize billable recurring touchpoints per patient. CCM and remote patient monitoring codes are underused revenue in solo practices and convert existing diabetic and hypertensive patients into higher annual value.
Extend and optimize office hours and telemedicine scheduling to capture demand outside standard windows. Filling currently unused calendar slots is the cheapest possible revenue growth given fixed lease and staffing costs.
Negotiate improved payer contracts and clean up the fee schedule during transition. A solo owner rarely optimizes reimbursement rates, and even a few points of uplift on the primary insurance base flows almost entirely to SDE.
Document all clinical and administrative processes to de-risk the single-provider dependency and prepare for adding staff. Systematizing the practice makes it easier to layer in providers and, eventually, to roll into a multi-site group.

Diligence notes

The entire practice runs on one solo physician, so confirm exactly how patient relationships and referral flow transfer post-sale. If the departing owner is the draw, a buyer needs a credentialing and transition plan that retains the panel, and the listing only vaguely commits to a negotiable transition period.
Verify the payer mix, reimbursement rates, and accounts receivable aging in detail. Primary care economics live or die on the insurance contract mix, and you need to know how much of the $810k is Medicare, commercial, or cash-pay before underwriting the margin.
Scrutinize the adjustments used to reach $514,607 adjusted SDE against actual tax returns. A 64% margin is high enough that the addbacks (owner comp, benefits, personal expenses) deserve line-by-line validation before treating that number as sustainable cash flow.
Confirm the lease terms, remaining runway, and any assignability restrictions on the medical office, since real estate is leased and the listing defers facility details. A short or unfavorable lease materially affects continuity and future capacity expansion.
Clarify the founding date, patient panel size, retention rate, and new-patient acquisition trend. The listing omits years in business and panel counts, both of which are essential to judge whether revenue is stable, growing, or dependent on the exiting physician.
Ensure the buyer meets clinical and credentialing requirements to maintain the ancillary revenue lines. Services like immunotherapy, hormone care, and injections may hinge on the current physician's scope, and a buyer without matching credentials could lose that revenue on day one.

Source

Originally listed on BizBuySell. View original listing →