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For dentists

You already have
the recall habit.

Dentistry is the model of regular care. Your midlife patients visit more often than they see their doctor, and they ask questions no one answers. Here's what the data says, and how coordination builds on that trust.

Our promise

Done with you, not for you.

You decide how it works in your practice. Nobody owns us, so we can build it around you.

  • You decide. Which services, which days, which room, and how involved you want to be.
  • We build it with you. Not a box we drop on your doorstep. You oversee every piece, and you can change your mind.
  • Nobody owns us. No outside investor sets our rules, so we can shape the model around your practice and your life.
What staying the same costs

The cost of standing still.

Before we talk about what could change, here's what the research says the current model costs dentists. Every number links to its source.

Margins, hours and burnout

  • Owner general dentists averaged $965,660 in gross billings and $556,450 in practice expenses per dentist in 2025, so about 58% of billings went to expenses before the owner was paid (our math from ADA's averages). (ADA Health Policy Institute, Survey of Dental Practice 2025; industry data, not peer-reviewed)
  • Average net income for general dentists was $215,320 in 2025. ADA calls it a “fiscal squeeze”: over five years, revenue rose 1.4% while expenses rose 4.9%. (ADA Health Policy Institute, Trends 2025; industry data, not peer-reviewed)
  • Dentists averaged 36 hours a week in the office from 2021 through 2025, up from 35. The extra hour matches more time in the office not treating patients. (ADA Health Policy Institute, Trends 2025; industry data, not peer-reviewed)
  • A 2023 meta-analysis of 6,038 dentists put professional burnout at 13%. (Long et al., 2023)

We never invent a number. If we can't source it, it isn't here.

What it costs to keep going this way

  • Every year expenses grow faster than reimbursement, the margin compresses.
  • More hours in the office aren't more hours with patients. They're paperwork.
  • Open chairs still cost money, and the production treadmill doesn't stop on its own.

Questions worth sitting with

  • What would it mean for you to take the full week off without worrying about the schedule?
  • What happens to your margin if the squeeze keeps going for five more years?
  • If there was a way for patients you already see twice a year to get their next health step through you, what would that change?
Owner economics: before vs after

Where your practice and your life are headed.

“It's not what you do, it's where you're going.”

Before: thin margins, long days, running on empty

After: where you're going

  • Recall becomes the start of a coordinated circle of care.
  • Network pros refer patients to you.
  • Coordination and education run on systems we install and run with you. Your team keeps doing dentistry.
  • A practice you lead, rather than one that runs you.

The “after” describes what the model is built to do, not a promise of results. We describe buying back your time in plain words because we haven't measured it yet. When partners have documented results, we'll show them here with written consent.

What if this was possible?

What if the patients you already see twice a year became the center of your growth?

“If that was possible, I don't even know what I'd do. My life would change.”
What we hear from owners when they picture it.

More time for the people at home. Being there for your kids. Choosing what's next instead of having it chosen for you.

Thinking about selling because you're exhausted? Selling is an irreversible decision, and it's yours to make. Before you make it, see what's possible. No consultant retainer, no equity, and nothing to sign to find out.

Demand

Your patients are already looking.

The question isn't whether they want this kind of help. It's where they'll find it. Every number links to its source.

  • 32.3% of US women used an urgent care center or retail health clinic in the past year: care in a convenient place they could get to. (CDC NCHS Data Brief 409, 2021; government data, not peer-reviewed)
  • 48.1% of adults 50 to 80 have bought an at-home medical test, and 82% are interested in using one in the future (87% of women). (Rager et al., 2024; University of Michigan National Poll on Healthy Aging; university source, not peer-reviewed)
  • The average medical visit takes 121 minutes of a patient's day, including 37 minutes of travel, for about 20 minutes face to face. (Ray et al., 2015)
  • In a review of 1,016 women with bothersome hot flashes, about half waited more than 6 months to seek care, and nearly 40% had no prescription treatment recorded. (DePree et al., 2023)
  • 60.2% of US women ages 40 to 59 tried to lose weight in the past year. (CDC NCHS Data Brief 313, 2018; government data, not peer-reviewed)

Most of these are national figures, not numbers about your practice. They show what people are already seeking, often somewhere else.

The patient side

How much of your work is episodic?

Every number links to its source. Industry and government figures are labeled as not peer-reviewed.

  • 66.7% of US adults had a dental exam or cleaning in the past year. (CDC NCHS, FastStats; government data, not peer-reviewed)
  • 33.3% of dentists said they were not busy enough in Q4 2025, and new-patient waits averaged 13.4 days. (ADA Health Policy Institute, Q4 2025; industry data, not peer-reviewed)

What your patients are living with

  • Menopause appears to act as a systemic modifier of oral health. A 2026 review calls for awareness and a multidisciplinary approach across dental and medical pros. (Butera et al., 2026)
  • Using national survey data, researchers describe the dental office as a chance to spot people who may have undiagnosed diabetes. (Borrell et al., 2007)
  • In a national cohort, 13.7% of women developed metabolic syndrome by their final period. (Janssen et al., 2008)

Your field

This is what · This is why · This is how

What's happening, and what changes.

This is what
  • Midlife patients show up for recall, often more often than they see their doctor.
  • They mention dry mouth, gum changes and sensitivity, and ask health questions no one answers.
  • New patients cost more each year, and larger groups outspend you. (A pattern, not a research finding.)
This is why
  • The mouth is connected to the rest of the body, but the care isn't.
  • A health question in the chair has nowhere trusted to go.
  • Overhead is high, and open chairs still cost money.
This is how
  • We install a coordination system around your practice, done with you. You oversee it.
  • A health question gets a trusted next step with a licensed clinician in the network, with consent.
  • Network pros refer patients to you.
  • Where space and state rules allow, a licensed phlebotomist can do a draw at the same visit, ordered by her clinician.
  • Education builds your footprint as the practice that sees the whole person.

We don't publish the whole playbook here. We walk you through it in a conversation, after a webinar.

How we build it

The 70/20/10 approach.

70%

Proven business systems

Nothing fancy or new. Just how a well-run practice runs: follow-up, scheduling, education, coordination and measuring what changes.

20%

Your industry

What's specific to dentistry: recall, the chair, your team and the health questions patients ask there.

10%

Your day

You're our client too. If you have four kids and want to be home by 3, we build for that. If you love your schedule, we protect it.

The 70/20/10 split is how we plan our work with you, not a research finding.

Walk through the patient experience

Care that comes to her, where she already goes.

Judy is already in for her six-month cleaning. Her clinician ordered bloodwork, and instead of a separate trip across town, a licensed phlebotomist does the draw right after her cleaning. She gets her French vanilla latte on the way out, and her son, waiting in the lobby, gets his lemon Starburst. Results go to her licensed clinician, typically back within days.

And often, Dr. Pat Pachciarz® is right there in person: shaking hands, learning names and laughing along the way.

“We'll be laughing along the way. If it costs us a few coffees and some candy for the kids, that's not too bad.” — Dr. Pat Pachciarz®

Lab work is ordered and reviewed by the patient's own licensed clinician and performed by a licensed phlebotomist. Availability depends on your space and your state's rules.

The contrast, for your patients

Before and after coordination.

Before: episodic, chasing the next visit, working IN the practice

  • Recall visits that stop at the mouth.
  • Health questions with nowhere to go.
  • Working IN the practice and fighting for new patients.
  • Open chairs and rising overhead.

After: a coordinated, flowing methodology

  • A coordinated, flowing methodology that builds on recall.
  • Patients get a trusted next step for health questions.
  • You can breathe, step back and look at your practice.
  • Patients don't have to go anywhere else for the next step.

Partner stories will appear here, with written consent, once results are documented. We never invent or promise results.

How the partnership works

What we do. What it saves you. What it costs.

What we do
  • Install the coordination, follow-up and education systems in your practice
  • Build and run them with you, while you decide how they work
  • Connect your patients to trusted pros in the network, with consent
  • Build your name online with education from peer-reviewed research
What it saves you
  • The nights you spend on follow-up, content and marketing
  • Patients lost between visits and after discharge
  • A consultant retainer or an equity partner to “fix” the business
  • Starting cold with every new patient
What it costs
  • Zero up front. The value comes first.
  • Then a flat, fair-market rate. Set in advance, not tied to referrals or patient volume. Never a percentage of patient revenue, never a per-referral fee.
  • No equity, ever. No ownership stake.

The terms, plainly

  • Zero cost up front. The value comes as we go.
  • A flat, fair-market rate. Set in advance, not tied to referrals or patient volume. Never a percentage of patient revenue, and never a per-referral fee. No one pays or is paid for referrals.
  • No equity, ever. No ownership stake. If you want to go to private equity someday, great.
  • It's a license. We install the systems and coordinate everything, done with you. You oversee it.
  • We grow as you grow. When partners do well, more practices join. That's how we grow, within every compliance rule.
  • Built around the patient experience. We get to know your patients, and care comes to the places they already visit.

Yes, a steadier, more predictable practice can follow. But we lead with the patient experience, because that's what earns it.

Your options

Every path has a right and a wrong.

There's more than one way to bring coordinated, functional care into a practice. Here they are by what they do, with what the research says. Pick the one that fits you, even if it isn't us.

Option: A franchise model

You buy into a brand and follow its rules.

Can go right: A known brand, a playbook and training on day one.

Can go wrong: Ongoing fees, such as royalties, advertising and renewal fees, are part of the deal for as long as it lasts. Federal rules require them to be disclosed up front for a reason. (FTC Franchise Rule, 16 CFR 436; government data, not peer-reviewed)

Option: A licensing model

You pay to use someone else's system, often with ongoing fees.

Can go right: Faster than building from scratch, without buying a whole brand.

Can go wrong: Fees can continue for as long as you use the system, and terms can change at renewal.

Option: Selling to private equity

Capital now, but you may give up control and your patient relationships.

Can go right: Money now, plus back-office support. It's a real and common path: private equity deals for physical therapy clinics went from 4 in 2010 to 175 in 2023, and the share of dentists affiliated with private equity nearly doubled, from 6.6% to 12.8%, from 2015 to 2021. (Reddy et al., 2025; Nasseh et al., 2024)

Can go wrong: Prices often rise: after acquisition, allowed amounts per claim rose 11% at acquired physician practices compared with similar independent ones. (Singh et al., 2022)

Option: Building it yourself

Full control, but also the full cost and time.

Can go right: Every decision is yours. Concierge and direct primary care practices grew 83.1% from 2018 to 2023, so independent models can work. (Zhu et al., 2025)

Can go wrong: It takes time to fill: only 31.2% of direct primary care practices in a national survey reported a full panel. (Qiu et al., JABFM (in press))

Option: A done-with-you coordination partner (us)

We build it with you, inside the practice you already run.

Can go right: Zero up front, then a flat, fair-market rate, set in advance, not tied to referrals or patient volume. No equity, ever, and no percentage of patient revenue.

Can go wrong: We're new. Our first proof partners start in October 2026, so we don't have documented results to show you yet.

We describe models by what they do and never name companies. Studies describe averages, not any one deal. Talk with your own attorney before you sign anything.

See every option in full, with sources →

Flexibility

It's not one-size-fits-all.

Every practice is different, so every setup is too. Choose the pieces that fit your space, your patients and your week.

A patient success coordinator on site

Someone who knows every patient's name and next step. In a six-state study, NPs in practices with the most care-management and referral structure reported less burnout (19.3% vs 31.4%). (Schlak et al., 2023)

A phlebotomist on site

Blood drawn where patients already are, which can help keep costs and travel down. The average medical visit takes 121 minutes of a patient's day, and between 6.8% and 62% of lab tests in outpatient care weren't followed up, per a systematic review. (Ray et al., 2015; Callen et al., 2012)

An NP in the office or by telehealth

In person on the days that make sense, virtual on the days that don't. 37.0% of US adults used telemedicine in the past year, including 42.0% of women. (CDC NCHS Data Brief 445, 2022; government data, not peer-reviewed)

Some, all or none of the above

Start with one piece and add the rest later, or never. It's your call.

Clinical services are provided by independent licensed professionals under their own licenses. What's possible depends on your space and your state's rules.

Clinic revenue potential

Straight numbers, because you asked.

It's never about the money first. But you deserve honest math. Here's what a mature in-practice functional wellness and metabolic clinic with one full-time NP could bring in.

Conservative

Reasonable expectations

≈$21,000/month

150 members × $129 = $19,350
+ 10 new members × $199 onboarding = $1,990

Base

An estimate

≈$49,000/month

250 members × $179 = $44,750
+ 20 new members × $199 onboarding = $3,980

Strong

What happens when you really put your effort behind it

≈$69,000/month

300 members × $199 = $59,700
+ 25 new members × $199 onboarding = $4,975
+ GLP-1 management add-on = $4,500 (assumption)

Please read this. These are estimates, not promises. Results vary, and many clinics take 12 to 24 months to get there, and retention drives everything. Clinic revenue belongs to the independent clinical practice (the NP's own practice), not the host. The host practice is paid a flat, fair-market rate for its space and any real services it provides, and our fee is a flat, fair-market rate too. Both are set in advance, not tied to referrals or patient volume. So this is clinic revenue potential, not owner income. No one is paid for referrals.

See the full math and assumptions →

We're there every step of the way to help you.

Family protection and continuity

Your family is protected. The business doesn't die with you.

This is a side value. It's there if you ever want it, and it's not the point. Here's what it actually means.

Now your family is protected. God forbid something happens to you, the business doesn't die with you. Your patients are cared for and your family keeps the value you built.

What it means in real life

  • Your family is protected. If something happens to you, the business doesn't die with you. Your patients keep their care, and your family keeps what you built.
  • Fewer hours, steadier income. When more of your care is built around ongoing relationships, you can spend fewer hours in the practice and have more predictable income coming in. You don't have to keep chasing the next new patient.
  • From lifestyle owner to value creator. The practice can keep growing without you having to be in the room for every hour of it.
  • Room to breathe. As the pressure comes down, your own wellbeing can improve too, with more time for rest, family dinners and the life your work was meant to support.

These are things that can happen, not promises. Every practice is different, and results depend on your situation.

If you ever want to look at the numbers, we're here. If you already have someone, great. We simply collaborate with them. That's why we do it.

“Why are you helping me?”

People ask Dr. Pat Pachciarz® this all the time: “Why are you helping me?” The answer is simple: because we both benefit. When both people benefit, that's influence that's moral and ethical.

A rare window to build community

The next two to three years are a rare window to connect with people and build real community. With so much uncertain about jobs and the economy, we want people to have a softer landing, or at least to know their options.

Read the full section →

What happens if you don't?

Someone else will coordinate your patients.

  • Patients will still ask health questions in your chair.
  • Someone will coordinate those answers, likely somewhere else.
  • Dentistry already has the visit. Coordination is coming to places people already go. The question is whether that includes yours.

That's not a threat. It's where care is heading. We'd rather it run through the people patients already trust.

We're starting in Aurora, Illinois, and building carefully, one practice at a time, because trust can't be rushed.

Why we built this

It's never been about the money.

  • It's never been about the money. It's about giving you more time to connect with your patients.
  • Yes, we benefit too, and we say so plainly. But this is an ecosystem: when your patients are better served, every practice in the circle does better.
  • We'd rather be your collaborator for twenty years than your vendor for one.

“Did I have time to build a 14th company? No. But I saw it, and I was fed up watching good people get hurt, unable to do what they really want.” — Dr. Pat Pachciarz®

What we've seen go wrong

Practices that sold to private equity and lost their patients.

We've watched owners sell and then lose control of the care and the relationships. The research shows clinician turnover tends to rise after these deals: physicians at acquired practices were 6 percentage points more likely to leave, and after a later resale, 16.5 points less likely to stay. (Bruch et al., 2023; Berquist et al., 2025)

Wellness add-ons that weren't structured correctly or legally.

We've seen add-on clinics set up without the right ownership, referral or payment structure. That's why we start with structure, and why anything that touches referrals or payment goes to your own legal and compliance advisors. (From what we've seen, not a research finding.)

Franchise or licensing deals that looked great at the start.

But what happens when it's ongoing? Federal rules require franchisors to disclose ongoing fees like royalties, advertising and renewals because they keep coming for as long as the deal lasts. (FTC Franchise Rule, 16 CFR 436; government data, not peer-reviewed)

We're not here to plug in a revenue line. We want to be your collaborator.

How we got here

  • Dr. Pat Pachciarz® saw this fragmentation first in finance: every expert was good, and nobody was calling the play.
  • Then he lived it in his own functional medicine journey: separate appointments, separate labs, and nobody connecting them.
  • It took a decade to build the systems behind The Pinnacle Group. Because they're systematized now, we could build this in a month, which frees us to focus on people.
  • We'll go slow, because trust lasts. We're here to be a strategic partner for the long haul.

How could this fail?

Only if no one builds it. So we're building it, starting in Aurora, Illinois.

Why human connection

Technology will never replace human connection.

Our systems handle the repeat work so people can do the human work: remembering names, stories and what matters to each patient.

  • The Harvard Study of Adult Development, begun in 1938 and now directed by Dr. Robert Waldinger, is one of the longest-running studies of adult life. Its researchers report that close relationships, more than money or fame, keep people happy throughout their lives, and are better predictors of long and happy lives than social class, IQ or even genes. (Harvard Gazette, 2017; university source, not peer-reviewed; Harvard Study of Adult Development; university source, not peer-reviewed)

“Trust is the hardest thing to scale, and the best thing to scale.”

Everyone else your patients visit

She sees more pros than you know.

  • 36.7% of US adults used at least one complementary health approach in 2022, up from 19.2% in 2002. Meditation (17.3%) and yoga (15.8%) led; acupuncture use more than doubled to 2.2%. (Nahin et al., 2024)
  • Medicare patients saw a median of 2 primary care doctors and 5 specialists across 4 practices in a year. (Pham et al., 2007)

See everyone in the circle →

Questions dentists ask

Straight answers

Why dentists?

Two in three US adults had a dental exam or cleaning in the past year. You already have the regular visit and the trust, so coordinated care fits naturally around it.

Will this add work for my team?

We install and run the coordination systems, done with you. Your team keeps doing dentistry.

Is this a medical service inside my office?

No. Pinnacle Coordinated Wellness is a coordination company, not a medical office. Any clinical service is provided by independent licensed professionals under their own licenses.

I'm burnt out and thinking about selling. Is this for me?

Maybe. Selling is an irreversible decision, and it's yours to make. Before you make it, see what's possible when coordination, follow-up and education are installed and run with you, with no consultant retainer and no equity. A fast no is better than a forever maybe, so join a webinar and decide.

What does ‘done with you, not for you’ mean?

You decide how it works: which services, which days, which room and how involved you want to be. We build and run it with you, and you can change it as you go. Nobody owns us, so we can build it around you.

Do patients really want these services?

Many are already looking. About half of women with bothersome hot flashes in one large review waited more than 6 months to seek care (DePree et al., 2023), 60.2% of women 40 to 59 tried to lose weight in the past year (CDC NCHS Data Brief 313, 2018; government data, not peer-reviewed), and 48.1% of adults 50 to 80 have bought an at-home medical test (Rager et al., 2024).

Is the clinic revenue on this site what I'd earn?

No. Those are estimates of clinic revenue potential for a mature clinic, not promises. Clinic revenue belongs to the independent clinical practice. A host practice is paid a flat, fair-market rate for its space and any real services, and our fee is a flat, fair-market rate too, set in advance, not tied to referrals or patient volume. Plan on 12 to 24 months, and only 31.2% of direct primary care practices in one national survey reported a full panel (Qiu et al., JABFM (in press)).

What does it cost to start?

Zero up front. The value comes as we go. After that it's a flat, fair-market rate, set in advance and not tied to referrals or patient volume. Never a percentage of patient revenue and never a per-referral fee.

Do you take equity or ownership in my practice?

No. Never. No equity and no ownership stake, ever. If you want to go to private equity someday, great. We grow as you grow, because when partners do well, more practices join.

What does 'it's a license' mean?

We license our systems to your practice and install them with you: coordination, follow-up, education and the network. It's done with you, not for you. You decide how it runs, oversee it and entrust us with coordinating for your patients, and we earn that trust.

Is Pinnacle Coordinated Wellness a medical office?

No. It is a coordination company. It does not diagnose, treat or prescribe. Clinical care is provided by independent licensed clinicians in their own practices.

When is the next practitioner webinar?

Webinars come first, and dates will be announced soon. Join the list on this page and we'll email you the dates.

Webinars come first

Join an upcoming practitioner webinar.

Free education before any conversation about working together. Dates will be announced soon. Leave your email and we'll send them first.

A fast no is better than a forever maybe. Come, listen and decide. Either answer is a good one.

  • What the research says about the patients you already serve
  • How coordinated care works around a practice like yours
  • Straight answers on cost, compliance and what we never do

We'll email webinar dates and practitioner education. Unsubscribe anytime. Please don't share health information here.

Sources

Where the numbers come from

Research findings describe published studies. They are not promises about any one practice or patient.

  1. American Dental Association Health Policy Institute. Survey of Dental Practice: Income, Gross Billings, Expenses (2025 results), Tables 5 and 13. https://www.ada.org/resources/research/health-policy-institute/dental-practice-research industry data, not peer-reviewed
  2. American Dental Association Health Policy Institute. Trends in Dentists' Income, Revenue and Hours Worked (2025 Survey of Dental Practice data). https://www.ada.org/resources/research/health-policy-institute/dental-practice-research/trends-in-dentist-income industry data, not peer-reviewed
  3. Long H, Li Q, Zhong X, et al. The prevalence of professional burnout among dentists: a systematic review and meta-analysis. Psychol Health Med. 2023;28(7):1767-1782. doi:10.1080/13548506.2023.2208364 peer-reviewed
  4. CDC National Center for Health Statistics. FastStats: Oral and Dental Health (2025 National Health Interview Survey early release). https://www.cdc.gov/nchs/fastats/dental.htm government data, not peer-reviewed
  5. American Dental Association Health Policy Institute. Economic Outlook and Emerging Issues in Dentistry, Q4 2025. https://www.ada.org/resources/research/health-policy-institute industry data, not peer-reviewed
  6. Butera A, Maiorani C, Scribante A, et al. Oral health across the menopausal transition: biological pathways, clinical implications, and future perspectives. J Clin Med. 2026;15(15):5757. doi:10.3390/jcm15155757 peer-reviewed
  7. Borrell LN, Kunzel C, Lamster I, et al. Diabetes in the dental office: using NHANES III to estimate the probability of undiagnosed disease. J Periodontal Res. 2007;42(6):559-65. doi:10.1111/j.1600-0765.2007.00983.x peer-reviewed
  8. Janssen I, Powell LH, Crawford S, et al. Menopause and the metabolic syndrome: the Study of Women's Health Across the Nation. Arch Intern Med. 2008;168(14):1568-75. doi:10.1001/archinte.168.14.1568 peer-reviewed
  9. U.S. Bureau of Labor Statistics. Occupational Outlook Handbook: Dentists (May 2025 median pay). https://www.bls.gov/ooh/healthcare/dentists.htm government data, not peer-reviewed
  10. Nahin RL, Rhee A, Stussman B. Use of complementary health approaches overall and for pain management by US adults. JAMA. 2024;331(7):613-615. doi:10.1001/jama.2023.26775 peer-reviewed
  11. Pham HH, Schrag D, O'Malley AS, et al. Care patterns in Medicare and their implications for pay for performance. N Engl J Med. 2007;356(11):1130-9. doi:10.1056/NEJMsa063979 peer-reviewed
  12. Mineo L. Good genes are nice, but joy is better. Harvard Gazette, April 11, 2017 (on the Harvard Study of Adult Development). https://news.harvard.edu/gazette/story/2017/04/over-nearly-80-years-harvard-study-has-been-showing-how-to-live-a-healthy-and-happy-life/ university source, not peer-reviewed
  13. Harvard Study of Adult Development (study website). Director: Robert Waldinger, MD. See also Waldinger R, Schulz M. The Good Life. Simon & Schuster; 2023. https://www.adultdevelopmentstudy.org/ university source, not peer-reviewed
  14. Black LI, Adjaye-Gbewonyo D. Urgent care center and retail health clinic utilization among adults: United States, 2019. NCHS Data Brief No. 409. 2021. https://www.cdc.gov/nchs/products/databriefs/db409.htm government data, not peer-reviewed
  15. Rager JB, Kirch M, Singer DC, Solway E, Malani PN, et al. Use of at-home medical tests among older US adults: a nationally representative survey. Inquiry. 2024;61:469580241284168. doi:10.1177/00469580241284168 peer-reviewed
  16. University of Michigan Institute for Healthcare Policy and Innovation. National Poll on Healthy Aging: At-Home Medical Tests (adults 50-80, July 2022). https://ihpi.umich.edu/national-poll-healthy-aging/national-findings/home-medical-tests university source, not peer-reviewed
  17. Ray KN, Chari AV, Engberg J, Bertolet M, Mehrotra A. Opportunity costs of ambulatory medical care in the United States. Am J Manag Care. 2015;21(8):567-574. https://pmc.ncbi.nlm.nih.gov/articles/PMC8085714/ peer-reviewed
  18. DePree B, Houghton K, Shiozawa A, et al. Treatment and resource utilization for menopausal symptoms in the United States: a retrospective review of real-world evidence from US electronic health records. Menopause. 2023;30(1):70-79. (Industry-funded.) doi:10.1097/GME.0000000000002095 peer-reviewed
  19. Martin CB, Herrick KA, Sarafrazi N, Ogden CL. Attempts to lose weight among adults in the United States, 2013-2016. NCHS Data Brief No. 313. 2018 (data table: women 40-59). https://www.cdc.gov/nchs/products/databriefs/db313.htm government data, not peer-reviewed
  20. Schlak A, Poghosyan L, Rosa WE, et al. The impact of primary care practice structural capabilities on nurse practitioner burnout, job satisfaction, and intent to leave. Med Care. 2023;61(12):882-889. doi:10.1097/MLR.0000000000001931 peer-reviewed
  21. Callen JL, Westbrook JI, Georgiou A, et al. Failure to follow-up test results for ambulatory patients: a systematic review. J Gen Intern Med. 2012;27(10):1334-48. doi:10.1007/s11606-011-1949-5 peer-reviewed
  22. Lucas JW, Villarroel MA. Telemedicine use among adults: United States, 2021. NCHS Data Brief No. 445. 2022. https://www.cdc.gov/nchs/products/databriefs/db445.htm government data, not peer-reviewed
  23. Reddy M, Li G, Singh Y. Trends in private equity acquisition of US physical therapy clinics, 2010 to 2024. J Am Acad Orthop Surg. 2026;34(8):e1136-e1143 (epub Oct 2025). doi:10.5435/JAAOS-D-25-00650 peer-reviewed
  24. Nasseh K, LoSasso AT, Vujicic M. Percentage of dentists and dental practices affiliated with private equity nearly doubled, 2015-21. Health Aff. 2024;43(8):1082-1089. doi:10.1377/hlthaff.2023.00574 peer-reviewed
  25. Zhu JM, Marsh T, Polsky D, Huntington A, Song Z. Growth in number of practices and clinicians participating in concierge and direct primary care, 2018-23. Health Aff. 2025;44(12):1473-1481. doi:10.1377/hlthaff.2025.00656 peer-reviewed
  26. Federal Trade Commission. Franchise Rule, 16 CFR Part 436 (disclosure requirements, including Item 6: Other Fees), and A Consumer's Guide to Buying a Franchise (Sept 2020). https://www.ecfr.gov/current/title-16/chapter-I/subchapter-D/part-436 government data, not peer-reviewed
  27. Singh Y, Song Z, Polsky D, Bruch JD, Zhu JM. Association of private equity acquisition of physician practices with changes in health care spending and utilization. JAMA Health Forum. 2022;3(9):e222886. doi:10.1001/jamahealthforum.2022.2886 peer-reviewed
  28. Qiu K, Chandarana S, Huffstetler A. The characteristics of direct primary care practices in the United States: a national survey. J Am Board Fam Med. In press (accepted June 2026); 465 practices. https://www.jabfm.org/content/characteristics-direct-primary-care-practices-united-states-national-survey peer-reviewed
  29. Bruch JD, Foot C, Singh Y, Song Z, Polsky D, Zhu JM. Workforce composition in private equity-acquired versus non-private equity-acquired physician practices. Health Aff. 2023;42(1):121-129. doi:10.1377/hlthaff.2022.00308 peer-reviewed
  30. Berquist B, Klarnet A, Dafny L, et al. Sale of private equity-owned physician practices and physician turnover. JAMA Health Forum. 2025;6(2):e245376. doi:10.1001/jamahealthforum.2024.5376 peer-reviewed
  31. Exit Planning Institute. 2023 National State of Owner Readiness Report (survey of US business owners; 2013 comparison). https://exit-planning-institute.org/hubfs/Member%20Center%20Resources/2023%20National%20State%20of%20Owner%20Readiness%20Report.pdf association survey, not peer-reviewed

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