Kevin Cumbus 

Hello and good evening. Welcome to our year-end review. Happy New Year, Josh. It’s good to see you.

Josh Swearingen

Likewise, it’s been a great, great year.

Kevin Cumbus 

Yeah, it has been an incredible year to see all that has happened in the plastic surgery market over the last 12 months. And really, what we’ve got in store for the next 12 is pretty overwhelming. We’ve had so much success for our clients in the months leading up to this year, and some big closings sitting there waiting in the wings, and just see the buy side come back as voraciously as they have, and to see new buyers come into the market that we didn’t once have, it has led to a dynamic and exciting period in time. I really don’t think there’s any better time to own a plastic surgery business than today.

Josh Swearingen

Yeah, I think it’s, it’s a really fun conversation. I know we’re going to get into a lot of this a little bit later, but I think, you know, you look at a lot of the healthcare verticals, and plastic surgery in particular is one of the most rapidly evolving from the buyers side. And I think that presents a lot of really interesting opportunities for not just, you know, prospective end of career sellers out in the market, but also mid-career entrepreneurs who are really looking at maximizing, you know, the remaining 10,15, 20 years of their career and their business. So super excited to be talking about that today.

Kevin Cumbus 

Yeah, I am too. Well before we dig in, just quick introductions, I’m Kevin Cumbus, President and Founder of TUS Practice Sales. Just to give you a brief background, I’ve got 10 years of finance and investment banking experience before getting involved in healthcare and have loved every second of being in this space. Just personally love creating multi-generational wealth events for our clients. There’s no greater joy to get to do what we do. And I’m joined here with Josh Swearingen today. Josh, can you introduce yourself?

Josh Swearingen

Yeah, I’m Josh Swearingen, Director here at TUSK Practice Sales. I’ve been in the healthcare space for about 25 years in a kind of a broad range of roles, from you know, starting in sales all the way through executive leadership, and ultimately having an opportunity to kind of sell a large MSO off to a private equity backed group. So, bring a lot of different kind of angles of experience to the table, and have a lot of fun dissecting opportunities from all different angles.

Kevin Cumbus 

Speaking of angles, I think it’d be good idea to look at the team and kind of give our audience a sense of who we are in our backgrounds. What’s unique about our team here is that they come from a completely diverse background, right? So that we’ve got folks who are CEOs like yourself was in the MSO space, folks who’ve been in operations inside of these businesses, folks who worked in business development, where they’ve been responsible for going out and finding potential partners and targets to really try to partner with and build a larger MSO. I’ve worked at large bulge bracket investment banks, I’ve worked for a small dental broker, and I’ve worked inside of a monstrous MSO that ultimately was sold for $800 million, and I’ve never been surrounded by a team like this before. They all take the relationships and engagements personally and recognize what a gift and joy it is to be engaged by someone to help them sell their life’s work. So can’t say enough good things about our team. You know, when you’re in a business like plastic surgery, your team is the most important thing. And we feel the same way.

Kevin Cumbus 

Our company is has grown dramatically and had a lot of success in 2025. We’ve done over 125 healthcare deals, about $1.3 billion transactions. And we’re excited to add to that number in 2025. Broadly, we work with all healthcare providers that are interested in selling to either an MSO or to a private equity company. What we’ve realized over time is that’s where the most value and flexibility and opportunity for young entrepreneurs that think about growing and scaling truly live and at the end of the day, that’s where transformational wealth gets created.

Kevin Cumbus 

So that’s a little bit about us. We get asked all the time, what makes us different? It’s really simply a couple things. One, we only work for the seller, meaning we only get paid by the seller. We’re inextricably linked with you, our client, and as such we get paid a commission on the total value of your business when you decide to sell it. We don’t ever get paid by the buyer. So, be on the lookout and ask the question if you’re interviewing potential advisors, “Hey, how do you get paid?” You really only want to work with folks that get paid from you and by you. Secondly, we have a team approach when it comes to working with entrepreneurs, because we believe that you really want to have the best and the brightest experts in each functional area as we’re working with you. And I’ll give an example of that: we’ve got a team of analysts here that spend all day, every day, peeling apart financials, digging into income statements, general ledgers, balance sheets and cash flow statements that are the best in the business, that really by the time they’re done with their work, many times, know your business better than you do, and certainly your CPA does. So, we lean on those guys, and then also the folks like Josh and his team, they go to the market, are in constant conversations with the buyers, really understanding what they’re looking for. They really package up this opportunity and take it to market with a confidential information memorandum along with an operating model to help them understand where we see the value. Yeah, we’re financial analysts and investment bankers, but at the end of the day, we’re storytellers, because we really want to make sure that that story lands perfectly with each unique buyer. And I’m sure Josh can speak to this, not everybody is looking for the same thing, so we always want to tell the truth, but we’re going to tell a version of the truth that resonates with each unique buyer in a very special way to where they find your opportunity and the idea of partnering with you irresistible.

Kevin Cumbus 

Third our go to market strategy is custom crafted for each one of our unique clients. For some it’s a broad-based approach where we’re going exclusively, so where we’re going broadly to private equity companies and existing MSOs and investors we know that are interested in getting involved in the space, because it’s such a unique opportunity. We know there’s going to be such broad appeal that we want to go out to 100-200+ buyers.

Alternatively, if we’re working with a business owner who says, “Listen, I really want to work with a unique group of practice of business owners, or MSOs, or private equity companies located in the southeast,” then we’re going to call that list right, and we’re going to cut it down to the really the really the best and the brightest and the groups that have, I would say, the most valuable equity that have the highest likelihood of turning that equity into cash upon a recapitalization. So, each one of our strategies is custom crafted for our clients to make sure that we, one, meet and exceed their needs, and also, two, we’re able to get them the deal they want in the most, let’s call it efficient way possible.

Kevin Cumbus 

Finally, is really post-LOI representation. There are more and more folks out there in the industry that have decided that they want to broker plastic surgery practices. And I will tell you, this is not an easy, easy job. There are hundreds of hours of work that go into each one of our engagements, and where most of the market stops, meaning upon the signed letter of intent, we really dig in because that’s where the opportunity lives. And to give you a sense of what this takes upon working with us, we’re going to do the rigorous financial analysis of the business. We’re going to build the marketing materials so Josh and his team can take it to market. We’re going to be talking with the buyers and ultimately negotiating the offers to get you to a signed letter of intent.

At that point, we re-engage our analytics team, because they’re going to engage third-party accounting firm to a quality of earnings. Which means they’re going to stress test, all the assumptions, all the numbers, everything we did to build up to an adjusted EBITDA on which the buyer has applied a multiple to equal the enterprise value that they’re willing to pay you for your business. That CPA firm is going to beat up our analysis to the best of their ability to prove to their client (the buyer) that it was worth paying them the $100,000 to do that analysis. Well, that’s where our analytics team digs in and gets really excited, because we know every one of those CPA firms, and we know that the tricks that they try to pull, and we’re able to kind of certainly combat that along the way, and it’s our goal to maintain or grow the EBITDA on which they’re applying the multiple so you end at the same place or better over the course of diligence.

Final thing I’ll say about this is, upon the signing of a letter of intent, they’re probably 15 to 20 deal terms that are included in that LOI. But over the course of the negotiations of your employment agreement, your non-compete, your asset purchase agreement and your shareholder agreement, there are hundreds of additional details that are negotiated over the life of that process that we want to make sure that you are well aware of and that you win the points that are most important to you.

And the way I’d sum this up is what we do it the hard way, simply because it’s the right way. So, it’s a lot of work, but at the end of the day, we want to make sure our clients are taken care of, because you really get one chance to do this. And we want to make sure that we do it the right way with you.

Kevin Cumbus

All right, so that’s enough about us. Josh, you want to dig into the economy a little bit.

Josh Swearingen

Yeah, you know, I do want to comment on this just for a brief second. You know, I think that you look at this process, and it can be really, really overwhelming for clients. And I think that, you know, the first quarter of the process, there are a lot of buyers out there that will send out unsolicited offers, they’ll put their own kind of market/development teams in your offices talking to you, they’re easy to get along with, and they may put a nice number on paper that looks really, really good and might satisfy what you’re looking for in a transaction. And where these deals often fall apart is during that LOI process, and you see a lot of deals get re-traded because the work wasn’t done at the front end to ensure that all the numbers matched up correctly, and all that because, quite frankly, the buyers are incentivized to pay enough for your business, or at least show on paper, a value that’s high enough that you’ll want to move forward with them, but ultimately pay as little for your business as they possibly can, so that they can then later trade that business at a higher multiple or a higher value and make up the difference. So I think part of what sets us apart, and we know this sets us apart from not just, you know, a process that you go into blindly with only a buyer present, but also with other representatives that are in the space that don’t take the time to do this work, is that we spend as much time on the front end ensuring that the entire deck is accurate and will survive that back end LOI, post-LOI, quality of earnings closing process, as we do the actual closing process itself. And that really helps streamline a lot of things.

Josh Swearingen

And the final point on that is, you know, we’ve been in the plastic surgery market for been going on three years now. And one of the reasons that we really got heavily involved in the space is because there were a lot of buyers out there that, you know, were running into issues with brokers that weren’t putting together full sets of data for them, and it really, really slowed down the process and made it really cumbersome. And they were essentially telling us, “Hey, you know, the space doesn’t have anybody in it like you, and we’d love it if you would join.” And we did, you know, our initial analysis of it and moved forward, and it’s really been kind of a match made in heaven. We’ve had a lot of fun working with sellers in the space, and a lot of the buyers that we have really good relationships with.

Kevin Cumbus 

Yeah, it’s awesome. We did get pulled into the space, and we’re glad to be here now, that’s for sure.

Josh Swearingen

Very much so.

Kevin Cumbus 

Alright, so let’s kind of take this at 10,000 feet, then we’ll zoom in a little deeper. So, we’re going to start here with really, why is private equity even interested in healthcare businesses? And to do that, I think we need to get some definitions and some clarity around what private equity really is.

So why is private equity invested? Why are they looking to invest inside of health care anyway, or specifically into plastic surgery? Well, for one, it’s a highly fragmented market. Most of you on this, this zoom, this evening, have individual practices, you’re an individual provider, or you might be in a small group, but the majority of you are not in a large group, right? So, there’s a fragmented market, and frankly, the providers that either you or your providers do exceedingly well financially, and there could be, and likely are a lot of operational inefficiencies or redundancies inside of your business that they’re seeing, that they can actually ring out of that business once they start to cobble together 3,4,5,6, of these practices all together.

Kevin Cumbus 

Secondly, there’s a really high barrier to entry. You guys went to school for a very, very long time to achieve the knowledge and degrees that you did, to be able to do the work that you do. So the thought of someone coming in and taking away market share relatively quickly is just a very, very low risk, and they like to invest in businesses that have deep, deep moats around them that gives them security, knowing that they will likely be able to continue to grow that business in the years to come.

Kevin Cumbus 

Like all of us as investors, they love high margins and the opportunity to increase the margins, along with businesses that are relatively recession resistant. So, you know, we saw during covid, everybody got very, very excited about their appearance. And there’s been a boom when it comes to folks getting plastic surgery done, get getting work done, I mean we saw adult braces, I mean, just take off. My wife now is doing Invisalign. It’s crazy how much focus is now on this health, wellness, beauty and appearance. And we believe that this is something that is here to stay, maybe kicked off by zoom, but certainly has been propelled further, even with social media. So, I think this is, this is a trend that’s here to stay, Josh.

Kevin Cumbus 

And then finally, and I think about my father, who was a pediatric dentist down in Alabama, his business did very, very well and but he did not tighten every screw and find every opportunity to turn, you know, to negotiate every fee, probably as much as he could. And there’s opportunities that were inside of his business that he looked at and said, “Yeah, it’s really just not worth the effort.” And private equity companies come and come in and say, you know, “We can optimize the operations, we can optimize the cost, and we can optimize the technology,” Really, it’s working on the business side of the business, not really forcing any changes from a clinical care perspective.

Kevin Cumbus 

All right, so what’s their goal? So private equity is not investing their money, but also LP’s money. So, they’re going to invest this money into these highly fragmented markets. They begin with an initial platform, really this is typically somewhere between $2 to $3 million of EBITDA. Used to be a lot higher than that, but as more private equity dollars have been growing over time, and there’s more money sitting on the sidelines, they’ve started to go lower and lower and lower into the market. Just to get started, I know, Josh, you’ve got a deal right now, you have two deals that you’ve been working on that are of this size. Do you want to talk a little bit about what the reception was in the market from different pools of buyers?

Josh Swearingen

Yeah, I think, I think once you get into the high twos and low threes, you’ve got almost an endless number of private capital that are looking to get involved, and that’s that that ranges from existing platform businesses, existing MSOs that have already been formed, that are looking potentially at maybe entering a new market, and they’d like to have some sort of scale in that new market, and then build around it, all the way to search funds that are out there that have put together an investment thesis around plastic surgery and med spa and possibly derm, or, you know, some sort of the esthetics industry vertical, and are just looking to get a foot in the door and have something that’s large enough that it can justify the investments of their limited partners. So, I mean, I want to say for both of the deals that we’re really kind of heading into the closing process with right now, we probably had north of 35 buyers that put their hand up and were interested and ultimately received, I think, 10+ LOIs for both of them.

Kevin Cumbus 

Yeah, this is a magic number that Josh is talking about, this $2 to $3 million of EBITDA. It unlocks both the financial and strategic buyers, right? And this is where you get 30 folks looking at the data room, 10 LOIs, and we’re able to pit those against one another and help you choose the right partner. And this is an important concept. It’s not just the highest dollar value, the way these deals are structured, you really have to look at, you know, the 5 and 10 year cash flow projections, because in many cases, you’re going to be rolling equity into the business you are selling, or into the MSO that they are building, much like the limited partners inside of a private equity company are. So a lot to unpack there, and frankly, this is why the work is so exciting, is because the buyers are ever changing and the structures are ever changing, so they’re going to make that initial investment, go ahead, Josh.

Josh Swearingen

No, I just, I think it’s a lot of fun, because we’re in a situation now, and you know, there are other verticals that are a little bit more mature, but we’re in a situation now where we’ve got a broad spectrum of prospective buyers, and we can actually go to the sellers that will we represent and figure out, right, what does the best opportunity look like for you? What are you really looking to obtain over the next three to five to seven years? What does that next stage of your career look like? And then ultimately, you know, we’re really trying to whittle it down to three or four prospective buyers that all kind of ring the bell within, you know, the clarity that you have provided us and allow them to compete for your business. And I think that, you know, you get into some of the younger spaces, you know, med spa is a great example of a little bit younger space. There aren’t as many really clearly defined mature buyers in that space. It’s getting there, but there aren’t as many. So, you’re a little bit more restricted in how well you can, you know, truly bring five or six buyers that all serve the same need to the table, but plastic surgery is very different. There’s, it’s a really good group of solid buyers with really good capital partners that have been in healthcare elsewhere. So, it’s, it’s a lot of fun. I absolutely love it.

Kevin Cumbus

Yeah, well, I’ll just close the loop on this, and we’ll get right to it. So initially, they’re going to make an investment a platform, right? This is kind of their starting point. Typically, they’re going to wrap their hands around that business and really understand it, discover where the opportunity where the opportunities are, where they are centers of excellence, that it can be leveraged as they’re building out this platform, and where there could be opportunities for improvement. From there, they’re going to aggressively grow through acquisition. So those of you who’ve said, “Listen, I’m not at $2 or $3 million of EBITDA, is there an opportunity for me? Absolutely. So that we’re working with a lot of doctors that are below $2 million of EBITDA and that call it $2 to $5 million of revenue range, you’re a perfect partner for an existing platform. And their game is to buy low and sell high, and our game is to make sure they pay the most possible amount for your practice, right? So there, so we’re going to help facilitate that transaction for you, get you in there and make sure that you’re able to share the upside that this private equity company is going to create for their limited partners and for the initial platform that they brought on.

Kevin Cumbus 

And then the great private equity backed groups, the great MSOs, really focus on increasing revenue and decreasing expenses to increase the EBITDA margin across the entire network of affiliated practices, and then ultimately they’re going to take that business to market. So, they might start with $2 million of EBITDA, grow it to $20 million of EBITDA. On that $20 million of EBITDA, maybe there’s a blended acquisition multiple of somewhere around six times, and they’re going to take it to market and try to sell that for 12,13 times. And the difference between where they buy and where they sell, that’s the arbitrage, and really that is where they make their money. They’re hoping to produce returns of somewhere between two to four times, return on invested capital, and do this typically within about a 60 month time period, or five years. So that’s how it works. That’s why they’re interested.

Kevin Cumbus

Now, let’s shift the economy and see kind of what’s been going on. Interest rates drive, because there’s leverage in these deals, because there’s so much debt attached to these deals, interest rates really do drive valuation from their perspective, right? So, they’re looking at what’s the cost of capital to go ahead and buy this business. You know, back in, let’s say, 2000 they might be able to get up to five turns of leverage, and that’s five times the amount of EBITDA on the business, is how much debt they would be able to get from their lender. And the interest rates back then, frankly, were really freaking low. I mean, money was close to, you could get money for close to 0% interest. If you remember that time, it feels like forever ago, but we were in that world for close to two years.

Kevin Cumbus 

So, they built their businesses with that option, they built the business that assumption, and now the world has changed, right? So, interest rates shot through the roof, and effectively, you know, the Fed funds rate go from effectively zero to north of five. Everybody said, “Whoa, wait, wait, wait, I can’t, I can’t keep buying at this rate, because my cost of capital has gone up. My interest expenses have gone up.” There was one MSO that gave us a call and said, “Look, my annual interest payments went up over a million dollars a year over the last 12 months.” Well, you’ve got to hit pause, and really a lot of the industry hit pause at this point and said, we really need to rethink what we can afford to pay for these businesses. Oh, by the way, their lenders looked at their covenants inside of their documents and said you’re out of covenant as well. We’re not going to allow you to go out and buy additional plastic surgery businesses. So, this was certainly a slowing down of the market, not necessarily a bad thing, because it really was a pause on the M&A side where folks began to work more and more on the operations of their business, tightening expenses and finding additional ways to increase revenue and, frankly, build culture. So many times people are just stacking, EBITDA, stacking EBITDA and not focused on “Let’s make sure we build a business that is built to last.” Certain the businesses that survive, or the ones that you’re working with now, Josh, are the ones that are going to be at the finish line and survive, you know, 5, 10, 20, 30, years down the line.

Kevin Cumbus 

So, it’s in the rear view mirror, rates are coming down, and we’re seeing the velocity of M&A really begin to pick up, because there are more and more buyers out there, which creates more demand. More demand drives prices up and is good for anyone who owns a plastic surgery business.

Kevin Cumbus 

Finally, I’ll just talk about inflation for a quick minute. Post-covid inflation was very, very real. It’s more expensive to go the grocery store, it’s more expensive to fill up your car with gasoline. It’s also more expensive to pay your staff and get the supplies that you need. So, profit margin inside of plastic surgery businesses we have certainly seen taken a hit, and geography matters here. We have seen, in many cases, folks leave states to move somewhere else, so you see massive retirement in some areas. So this, this is a fact of health care, because look, if you’ve got a, you know, a roommate who’s able to work from home, and you’re seeing them, him or her work from home every day, and you want that flexibility, it could be that you left the market.

Kevin Cumbus 

Short story is this, we have seen costs go up at a rate that has cost plastic surgeons somewhere between two to five margin points, right? Is that fair, Josh?

Josh Swearingen

Yeah, that’s probably dead on.

Kevin Cumbus

Yeah. So, we’ve lost that in profitability, which translates to a decline in EBITDA. And during this higher interest rate environment, we saw a decline in valuations as well. Here’s the good news that offset in EBITDA right now, because the rates are coming down, is that can be made up for with increased valuation multiples, and that’s why I think we’re starting to be so busy on the plastic surgery side is, although margins are down, valuations are beginning to tick up, it’s become more and more enticing to sell again.

Josh Swearingen

Yeah. I think one other point I’d like to hammer on this is, you know, I think we talk a lot about, specifically about the cost of overhead as it relates to staff costs. And a couple of things that come into play here on the inflation side, number one, you know, as a plastic surgeon, you probably do reasonably well. And that inflation number you can absorb it to some extent in your personal life, that hits a lot of your team members and providers a lot harder than it than it might hit you. And I think that it is created somewhat of an environment where a lot of those providers are starting to look outside of your four walls for other employment. And that has caused some of the churn that we’ve seen on that mid-level provider, side assistance, surgical assistance, front desk, nurse practitioners across the board.

Josh Swearingen

I think another thing that has hit really hard is that we’ve had, you know, if you just look at kind of your sister industry, or maybe your little sister industry, the med spa space, there have been a lot of nurse practitioners and nurses that have opened up their own shops over the last three to five years, and that has pulled some of that ready supply of providers away from the plastic surgeons into the entrepreneurial space. Now, for better or for worse, a lot of those shops opened up, you know, you know, at a really good time to open a business, and then quickly realized that it was not a great time to operate a business, and many of them have closed over the last 18 to 24 months, which is reintroduced some of that supply into the plastic surgery space. And we’re actually starting to see some of those overhead costs decline a little bit, because they’re coming back into the fold. And I think all of these are starting to work together to the benefit of the M&A space, valuations, and the health of the overall of the underlying business that you run.

Kevin Cumbus

Yeah, this is all good points. If we can see some of those staff members come back into the plastic surgery world, it will help these pricing pressures on wages.

Josh Swearingen

Yeah.

Josh Swearingen

All right, so let’s, let’s get into some of the nitty gritty here. We don’t have a ton of time left. We want to be respectful of your evenings, so I will just kind of tick through some of this stuff.

Some of the plastic surgery industry trends over the last you know, several years, it shouldn’t come as any surprise to anybody, but the plastic surgery space is exploding right now. It has grown rapidly over the last three to five years, even in the midst of a covid slump, and it is anticipated to grow at an even greater rate over the next five to seven years. And I think that one of the big drivers of that is the population and the patient base is broadening. You are seeing a lot younger patients now getting surgical and aesthetic procedures done. You’re now seeing men enter the fray as an ideal patient, and you have more, a larger, larger percentage of men that are getting treated. And I think that we have, we’re just much more cognizant of, kind of the visual aspects of what we are presenting out in the world. And it is paying off in spades for the plastic surgery space and the med spa space.

Josh Swearingen

So, let’s talk a little bit about investor interest. I know that Kevin touched on this a little bit earlier, but you know, we’ve had, we’ve had a lot of reasonably new entrants into the market over the last probably three to five years. What I love about where the space is right now is that there are some really, really good, solid private equity groups that have been incredibly successful in other healthcare verticals that have now entered the fray of the plastic surgery markets. You know when, whenever you have a an industry that is growing as quickly as plastic surgery is, that is kind of, you know, as attractive to private equity as plastic surgery is, you’re going to have some initial entrance into the space that that may not have experience in in provider based health care systems and may not really truly understand what it means to work with doctors and team members and patient bases and things like that. They’re just looking to make their money, create some arbitrage, and then get out while, you know, while it’s still young.

Kevin Cumbus

Josh, I look at this list, and I see the Thurston Group, I see Latticework, I see Varsity, and I’m looking at the investors here, I look at VSS, we have worked with so many of these private equity companies in you know, throughout let’s called it, other healthcare verticals, and to see them involved in plastic surgery does not surprise me at all. They’ve had such successful investments and exits throughout the kind of healthcare services world that to be in the plastics or medical aesthetics world makes perfect sense to me.

Josh Swearingen

Yeah. And I totally agree. And I love the fact that, you know, as we’ve been in this for, you know, three, four, you know, three years now, we’re actually talking to a lot of the same people on the plastic surgery side that we’ve spoken to in other healthcare verticals. I mean it’s the same relationships, it’s the same deal structures, the same points that they’re looking for and information that they need to process with their investment committees, which has really helped facilitate a much smoother process as we as we’ve gotten ramped up over the last couple of years.

Josh Swearingen

So, you know, I think we have a great group of buyers, and then the one final point on this is, you know, when you have a group of buyers like this, you’re going to see valuations increase, because you now have a fully competitive environment. And many of these buyers are nationally based, or have practices across the entire country. So, they’re looking for platforms and new markets. They’re looking to support their existing markets. They’re open to new states and when a good opportunity comes down the pipeline, you could have as many as you know, 10, 15, 20, really solid buyers come to the table that may already have a presence in the market, which, which is a huge help.

Josh Swearingen

Alright as far as you know, continuing to attract private equity groups, we’ve seen accelerating consolidation in the plastic surgery, and in the med spa sectors. One of the things that I think is a really interesting development over the last, you know, over the last probably year or so, we didn’t really see it prior to that, but over the last year, when, when a lot of these groups get formed, most of them kind of start out as pure-play groups. So, they are either a plastic surgery group or a med spa group or a dermatology group. And as we’ve gotten as the space has evolved over the last couple of years, and you can see just rapid growth in the medical surgery and plastic space. But as the space has evolved over the last couple of years, you’re now seeing a lot of graying of the lines, and in particular in plastic surgery, where you’re starting to see plastic surgery businesses that are picking up med spas in the surrounding geographies as referral centers. And they’re building out these kind of pods in a local geography, with the help of their private capital partner, and really expanding rather rapidly in their local market. So, I think that it’s great because it opens up the space to some actually, some really interesting and unique deal structures, but it also further broadens the buyer base that is out there.

Kevin Cumbus

Yeah. I mean, one thing investors will love is that recurring revenue, right? And recurring revenue lives really nicely inside the med spa world. So, you have the patient coming back, month after month, quarter after quarter, year after year, it’s an opportunity to educate them about what you know, what opportunities live in the plastic surgery world? Oh, by the way, that recurring revenue is super, super valuable, so it’s strengthening their the patient’s tie to the brand, to the patient experience, they become a referral as well. And now, all of a sudden, “Hey, I’m ready for a surgical procedure. Where am I going to go?” Well, there’s no other choice. You’re going to go upstairs and see our surgeon up, you know, up the elevator.

Josh Swearingen

Yep, absolutely. It’s a fantastic structure, and it actually plays out well in the deal structures that are coming down the pipeline, especially if you’re an entrepreneurial plastic surgeon and you want to kind of grow your empire.

Josh Swearingen

So who are today’s buyers and what are some of the different equity structures? And we’ll just kind of just kind of zip right through this again in the interest of time. So, you have well known and established MSOs. These are the groups that have been out there for four or five, six years, that have established infrastructure scale, usually some sort of an MSO structure involved with an opportunity for, you know, equity ownership by all the partners, and they may or may not be approaching a recapitalization event. You have your upstart MSOs that were formed post covid. Now in our in this particular space, I’d say probably two thirds of the market fits into this space. They’ve really only opened up in the last 2, 3, 4, years, and really that’s a result of some of those really high level PE groups that Kevin referenced earlier, and many more, that have decided that it’s the right time to get into the space. So, they’ve begun to kind of build out their empires as well. And then you have private equity groups that are out there that many of whom have been in healthcare, some of them may have not have been, but have identified plastic surgery as an ideal kind of next step from their investment committee standpoint, and are looking for that initial platform investment of, you know, probably two high twos, $3 million, $4 million, $5 million in EBITDA, and hopefully some internal structure involved.

Kevin Cumbus

Yeah, Josh, what I’m hearing you say, it sounds like if I’ve seen one MSO or one private equity group, I’ve really, really had no idea what the entire landscape opportunity is. And you know, if I was entertaining a conversation a year and a half ago, there could be 20 new investors or new MSOs that would be interested in talking with me about a potential partnership.

Josh Swearingen

Absolutely, we’re doing a transaction with, really, I’m actually very excited about it, we’re doing a transaction with a buyer now that that they came out, they made an initial splash, they made some initial investments, and then, of their own accord, stepped back to really work on their internal, operational excellence, to their credit, and it kind of started building out the infrastructure of their business. And when we took this opportunity to market, I think a year and a half ago, that group was sitting on the sidelines, and I kind of knew that it was the perfect structure for my seller, but unfortunately, they weren’t available. And, you know, after communicating with our seller, he kind of wanted to wait, and couldn’t really find the exact opportunity that he was looking for. And, you know, after waiting a little bit and kind of working with the buyer and the seller through some initial questions, they came to the table and said, “Hey, this is, this is the next step that we want to make.” And they kind of actually came out off the sidelines to make their next investment in a new market that they have identified as an ideal market. And it’s been, it’s been awesome. And I think that you know you’ve got, you’ve got that across the board, and you really don’t know what is available to you if you don’t talk to 5 or 10 or 12 different buyers out in the space, you’re just, you’re just, you’re selling yourself short.

So really, really quickly, there are some, you know, some things to be aware of in the equity structures. You know, when you have a transaction, there’s going to be a percentage of the transaction value that is cash at close, there’s going to be a percentage of it that is probably in the form of some kind of a holdback or something. And then there’s going to be a portion of it that is probably going to be in some form of a rollover equity. And this is, you know, one of the ways that number one you can kind of tag on for that second bite of the apple. When the group that you partner with recapitalizes at a higher valuation, and you kind of get to tag along with some of that higher valuation. It’s also a means for these MSOs to kind of keep you tied to the business and working and tied into the success of the practice that you’re operating.

Josh Swearingen

So, hold co quite simply, that is, that is parent company equity. That is equity of the broad, large organization as a whole. So, they essentially issue shares, and when you sell, they issue you some shares in your name, and you hold those shares, and in a recapitalization event, you can sell those shares, and those shares are usually repriced annually or some sort of cadence, maybe quarterly or annually, so that you get a feel for how much they’ve grown. But yeah, that’s you’re essentially holding the parent company.

Joint venture is a really popular option for younger doctors who are looking to continue building they may not want to pull all the chips off the table. They feel like they’ve got a long runway ahead of them, and they don’t want to give up all of the cash flow that being an owner entails you to. So you enter into a joint venture partnership with an organization, essentially, you know they may buy 60% of the business from you, you maintain ownership of 40% of the business in partnership with them, they help you manage the business. You receive 40% or so of the distributions of that business, so you maintain that cash flow, and then they may be able to utilize all of their internal resources and their capital to help you continue building out your platform. If you want to add two or three more surgical centers, or add a couple of med spas, or build some density in your market, or maybe enter a new market. It’s a really nice structure that allows your ownership and your profit distributions to continue growing as you continue expanding the business with that partnership. Really, it allows you to de-risk significantly from an entrepreneurial standpoint, rather than taking that all on yourself, if that’s kind of wired into your personality.

Kevin Cumbus

It feels like folks who believe in their business, believe in their growth, know where they’re going and want to continue the entrepreneurial journey, this feels like the right fit for them.

Josh Swearingen

Absolutely. I think you know the big pushback we get from younger doctors when we speak to them about potentially selling their businesses is “Well, why? You know, I’m making great money now I sell my business. Sure I’m going to have a really nice influx of capital, and I’ve de risked and I’ve taken chips off the table, but I want to work for another 10 years or 15 years or whatever. And if I just annualize out, take my annual income out over 10 or 15 years, it’s going to vastly outweigh what, what the transaction value will very likely be.” And there is, there is some truth to that. I mean, you have to kind of weigh that, that risk, to frame it as a part of it. But yeah, if you are, if you’re looking at pulling some of the chips off the table, but not all the chips, and you’re interested in remaining on long term and maintaining cash flow, and all of these things that joint venture structure is, it’s an ideal structure for a younger surgeon who just may want to divest some of the operational business elements and take some chips off the table.

Kevin Cumbus

Yeah.

Josh Swearingen

And then hybrid is really quickly, that’s just kind of a combination of each I think a lot of the groups are one or the other. I think we are going to start seeing more of a hybrid approach to it for a lot of different reasons that we won’t get into today, but those are really kind of what you’re looking at out in the space today.

Josh Swearingen

All right. So, you know, I think whenever we talk about MSOs and private equity groups, it’s kind of a loaded conversation in many cases, and some of that is deserved, because there have been situations that have not worked out well for sellers and MSO partners, and there are situations that have worked out remarkably well for sellers and MSO partners. And I think that having a baseline understanding of what this looks like in your environment is critical going into the process, so that you can be prepared to ask the right questions and ensure that you know the partner that you that we are helping you select, is the right one for your business. So, you know, in general, and this varies a little bit, there’s certainly, you know, some outliers that do make some of these changes, but in general, most of the existing strategic groups, or MSOs private equity groups, are not going to change your culture, your name. They’re buying your business in large part because of what you have successfully built. And when they look at your business and value your business, their primary concern going into the process is ensuring that the business largely operates the same way post close as it does pre close. And that means the same team members, the same processes, initially, things like that, and then as they get to know your business better, and as they get acclimated to your markets and you as a partner, then the then it becomes very collaborative, and they really try to make structural changes or minor tweaks here and there that will be additive to the business and hopefully to the team members. So, I think you know, on the will not side, not going to change your culture, they’re not going to inform your patients and colleagues that you’ve partnered with a large group or that you’re now corporate, they’re not going to be terminating your team members, they’re not going to dictate treatment planning or doctor philosophy and really tell you how to run your practice, and in in large part, and this is another topic entirely. You know, their goal is that your life will, you know, from pre-close to post-close, at least, from a clinical standpoint, will be largely the same. They want to offload a lot of those business responsibilities, make your life easier, simplify things a little bit, but ultimately, they are focused on you, you know, depending upon kind of the path that you go down, being a leader in the business, or being, you know, a clinical mentor in the business, or things like that, and allowing you to focus on being a doctor.

Kevin Cumbus

Josh, I think about these companies you represent, and the multiples you’re able to achieve for our clients. So, if I’m paying 10 times somebody’s TTM EBITDA, I’ve got two thoughts in my mind, one is, how do I increase revenue with what access I have, so like it’s increase reimbursement rates. How can I help them save on costs? Maybe I can help them with the cost of implants, or the cost of anything else that they need to operate their business, and then, really, the other piece is, how do I not break it? I do really do not want to disrupt the apple cart, right? I’m so terrified that things are going to go south, and that basically, if we look a year down the line, and you look at that, TTM EBITDA, instead of paying 10 times, I spent 15 times on the business, right? So, there is complete alignment there and a deep desire to keep the business heading in the same trajectory that it was in. Also, people don’t pay 10 times for businesses that aren’t like self-sustainable, right? This is a support organization, not a not someone who’s going to come in and really run the business. They’re here to support our clients that partner with MSOs.

Josh Swearingen

Yeah, that’s really well said. And, you know, I think, and I’ve talked to different MSOs or different groups and different PE sponsors, and the very last conversation that they ever want to be a part of or have is with either the PE sponsor or their limited partners, saying, “Hey, we screwed something up. It’s just not operating the way it was when we purchased it.” They will do everything they can to ensure that it remains, you know, largely intact, or 100% intact, and they are purely additive to the business. So, yeah, really, really well said.

Josh Swearingen

And I think if you’ve, if you’ve been out in the space, and you’ve read the articles, and you’ve kind of paid attention to the you know what’s going on in the plastic surgery space. You know that the difference between private party valuations, you know, selling to another doctor and selling to a private equity back backed group are vastly different. You’re going to get tremendously more value partnering with a group.

And in addition to that, and I think this just can’t be, this can’t be hit on enough, you have a lot of different options in structuring deals with a private equity sponsor and a lot of different buyers out there that all have different goals for the business post-close. So, you have a really good opportunity to pick the one that is the best fit for, for what your goal goals ultimately are.

Kevin Cumbus

That’s right.

Josh Swearingen

So, benefits of a changing environment, you know, really, when we sit down with you, you know, as we’re working through the engagement process, as we’re working through analytics, a lot of my part of the of the process is getting a good feel for what you’re looking for post-close. What does this mean to you? What do you need? What are the, you know, the four or five trackers that are that are leading you to go down the process of finding a partner or selling the business or whatever, and then ultimately representing those properly in in the marketplace. So almost always, there’s, there’s some level of risk mitigation, you know, you want to take some chips off the table. It’s one of the largest investments that you probably have in your life, and pulling some of those chips, depending upon what time you are in your career, is critically important to help diversify some of that, some of that risk management.

Kevin Cumbus

Can I just bring up one point on this? It’s a point that many times gets glossed over, and I want to just really underscore here. If you’ve got a business that’s worth $10 to $20 million in today’s market, in a potential sale to an MSO, and you have $5 million of assets under management, I would argue, you are probably too exposed to the plastic surgery market, right? And any good financial planner talks about diversification, right? That’s why you buy the index. Now you have more control over that asset, meaning you’re practicing your business than you do on what the Magnificent Seven is going to do, obviously. But there’s a point in time in which your exposure to plastic surgery is too rich. You need to think long and hard about de risking that exposure.

Josh Swearingen

Yeah, yeah. Perfectly said, I think that, yeah. I don’t have anything to add to that.

And then on top of that, you know, I think when we’re talking to, you know, prospective partners that come, that come along, when we’re bringing them on board, you know, I think overwhelmingly, work life balance is something that that’s mentioned. We get a lot of mid-career plastic surgeons that come in that have built successful businesses, but now they have young kids who are getting into their teens, who are playing, you know, sports, and there’s a lot of draw on their personal life, and they just want to, they want to offload some of that admin support. They want to allow for some growth and development, potentially personally in their own lives, but also for their team members, and there are lots of expansion opportunities out there for team members that they can participate in.

Josh Swearingen

And then, in many cases, you know, when you run a small business, you’re kind of out on an island, and I think that, you know, you don’t think about it as much when you start you know, kind of conjecturing what a sale process would look like, but being inside of a collaborative environment with a lot of like-minded surgeons similar to yourself who are in potentially similar stages of life, can really kind of revitalize your career and really kind of launch you into that next stage of your life and allow you to have a lot of fun. Because you’ve now, you’ve taken a lot of risk off the table. You can kind of relax a little bit from that standpoint, and you can really have a lot of fun with like-minded people moving forward.

Kevin Cumbus

Can’t tell you how many times we’ve heard that from folks in their 40s and 50s like and they say, you know, “I’ve had the same job for the last 20 years, and it’s been a great job, and it pays really, really well, the personnel headaches kind of are what they are, but for all intents and purposes, I could do this job for the next 20 years and have the exact same experience.” Compare that to a sale of your business, taking some chips off the table, leveling up with a syndicate of best-in-class surgeons with a leadership team that is, frankly, is really expensive and really bright, what I’ve heard time and time again is “I didn’t know I could have this much fun, because I’m not just focused on the business I’ve built. It’s the business we are building. And I’m using a different side of my brain, and I wake up more excited and energized than I have in 10 years.” And to us that that is the sign of a great partnership. Josh Swearingen

Kevin Cumbus

Yeah, I couldn’t agree more. And that’s I, that’s really when, I think I can speak for Kevin, when we kind of walk away from a transaction when it’s been finalized, and you know, many of our clients we remain friends with permanently, for the rest of our lives, which I’m very proud of. But you know, when we’re walking away from that transaction, like there’s just a feel you get when you know it’s a perfect fit, and that doctor is excited about what the next stage looks like, and all the people that they’re surrounding themselves with, and all the opportunity that’s going to present, it’s just, it’s a very cool part of our jobs, and one that I think brings the most satisfaction to us.

Kevin Cumbus

Yeah, for sure. For sure.

Josh Swearingen

Then obviously it goes without saying, but securing your exit strategy, you know, the longer you wait in your in your career, you know, there are pros and cons to that. I think at some point you get to a point where you kind of want to understand what that next step is going to look like, and you don’t want to have a lot of questions up in the air. And bringing on a partner, you know, whether that’s, you know, 5, 6, 7, years before you retire, or 10, 15, 20 years before you retire, can really open up a lot of doors and put your mind at ease as far as what that what working the remainder of that time is going to look like?

Kevin Cumbus

Yeah, I would, as we’ve been discussing this, I would just add one additional thing is, if you have associates throughout your business and you’re looking for a pathway to partnership, this actually is a really great way to kick that off, where you have a predetermined value, you have a pathway to equity for them, it’s crystal clear, like, what that equity could be worth in the future, and know that you’re partnering with a private equity company whose sole objective is to turn that equity into cash over and over and over again. So, it’s a really great way to kick off partnerships inside of your business on a go forward basis.

Josh Swearingen

Yeah, I would agree. And I also think that, you know, final point to hit on this, on this slide, but you know, if you’re an entrepreneur, you know, building one really successful business is difficult. Building multi building multiple locations and multiple sites is incredibly difficult and very self-limiting. At some point, even the best of us get to a point where we run out of real estate within our own lives to be able to continue expanding and kind of feeding that entrepreneurial bug. You know, I think the wonderful thing especially about the plastic surgery space is that there are some really great partners out there that were created specifically for entrepreneurial surgeons and entrepreneurial doctors, with the thought being that they can come alongside provide capital for growth, provide all of the internal development team members to help build out new markets and help these entrepreneurial medical professionals kind of build out their own little organizations within the markets that they currently inhabit. And I think that’s a really cool thing that a lot of kind of younger, mid-career surgeons don’t think about when they’re when they’re contemplating this thing, but it could be a really fun conversation. And we have two of them in process right now that we’re really excited about, and those doctors are ultimately going to, instead of having, you know, one, two or three locations, probably have 7, 8, 10, locations with the right partner, and continue kind of building out their little empire.

Kevin Cumbus

And their using somebody else’s balance sheet to execute on that vision.

Josh Swearingen

Yeah. And all of the internal resources and the hiring and the human resources, all of that stuff plays into it, and those are, those are actually my favorite conversations to have, so just something to kind of give us a call and talk about.

Kevin Cumbus

Awesome.

Josh Swearingen

All right, so which plastic surgery practices receive the best deals? You know, if you’ve seen one plastic surgery practice, you’ve seen one plastic surgery practice very similar to, you know, what we say about large groups and MSOs and PE groups and things like that. Everyone’s a little bit different and has subtle nuances, but kind of as a broad overview, most of the buyers out there are not really looking for anything under $2 million in revenue, especially on the plastic surgery side. When you get into dermatology and med spa, sometimes we’ll see them dip into that space, especially on the med spa side. But in plastic surgery, you’re really looking for that $2 million+ kind of floor to for them to take a good, solid swing and really provide value to you for the business.

Josh Swearingen

Having multiple providers is critical. I can’t say this more, it is and that is multiple providers, multiple surgeons, is a huge help. And then multiple nurse practitioners, nurses, additional providers that may, may be providing more med spa-specific types of services within your business. So, one of the things that buyers are the most leery of is what we would consider to be key man risk, and that is really, you know, a business where a significant percentage of the revenue is running through two hands in that business. And if something were to happen to those two hands, likely yours, the whole business can be in jeopardy. So you know, if you can set it up, bring on a partner, even if they’re not doing as much work as you, if we can draw a path to their growth, helping to assume some of your responsibilities, and then you have nurse practitioners, things like that in the business as well, it really helps defray risk from the buyer’s standpoint, and get them comfortable paying a higher multiple and a higher evaluation for your business.

Kevin Cumbus

I’ll add one more thing on key provider risk. The reality is, I think over the last 24 months, we’ve seen age of clinician play a larger role inside of transactions. So, with these MSOs in market to try to find a larger private equity group to purchase them, there are two numbers that really drive interest: one is the average age of your clinicians, and two is the turnover rate of your clinicians, right? So, they’re trying to get a feel of how quickly do we have to replace the surgeons inside of this business. So younger providers, that have younger businesses, with younger providers, with more providers, trade at a premium, and there’s kind of this invisible line depending on your geography, especially if you’re a solo provider, where ultimately you just won’t, you won’t receive offers. And that’s the reality. And I’d say it’s a moving target depending on geography, but it is certainly a real thing that we have seen.

Josh Swearingen

Yep, I absolutely agree.

So, beyond that, this kind of dovetails off of the last one, but practice with practices, with diversified service offerings, if you’re out there and you do nothing but breast augmentations all day long, and you have no other services in the business, and you’re the only provider that’s a good bit of risk for the prospective buyer. But if you have med spa services, and you have a good retail side of your business and a surgical side of your business, again, we’re looking for anything that they can, you know, they can take to their investment committee and say, “Hey, if the worst case scenario happens and the primary surgeon goes down, this is how we maintain and grow out of that.” And that’s really the conversations that they’re having. And it’s very helpful to have a very diversified service offering.

Josh Swearingen

And then this, you know, finally, you don’t think about it a lot, but a clean compliance and risk profile. The regulatory environment is really interesting and really in the aesthetic space as a whole, and this is largely built off of the med spa space, which is really kind of the wild-wild-west of the regulatory environment, and states are starting to clamp down a little bit on some of these organizations that are kind of run a little bit loosey goosey, or maybe they’re not owned exactly the way that they should be, or maybe they have providers that aren’t providing the right kind of oversight, like those types of things really do play into a transaction, and they they’ll come up as they’re as the buyers are doing their due diligence as they should. So just run a tight ship. Make sure you’re, you’re dotting your eyes and crossing your T’s and handling the things that need that should be handled. And if you know, if you have any questions about what those may be, we’re happy to, you know, point you in the direction of some providers that can kind of talk you through that a little bit.

Kevin Cumbus

Yeah, for sure.

Josh Swearingen

So, what can you do to prepare and capitalize? Well understand the value of your business today. I think it’s really helpful to get a valuation, we’ll talk about this in a minute, but get a market valuation today and get a feel for whether or not that’s a number that that you’re comfortable taking for your business. And I think the first step is getting that valuation, and the second step is sitting down with your wealth planner and getting a really good feel for how that valuation could fit into your long-term wealth planning.

Josh Swearingen

Kind of determine the path that you want to move towards. We’ve talked about this a little bit off and on here. But are you looking to continue growing your existing business? Are you looking to sell or partner? Are you looking to grow your existing business with a partner? Are you looking to exit in, you know, a couple of years? And I would tell you, if you’re looking to exit in a couple of years, we probably should have had this conversation three years ago. So you know, most of these buyers, if not all of them, are really looking to get a three year minimum, but five year commitment from the sellers to remain on and help grow, because that’s it takes them at least that long to make up, you know, make up their investment in your business. So, you know, having those conversations now and what your long term timeline looks like is really important to the overall valuation of the business that you will receive.

Josh Swearingen

Plan to account for post-sale commitments, that goes back to the last comment, consult with your wealth advisor. We are happy to provide you with a myriad of TUSK clients that have gone through this process, that have gone through this process with different types of organizations and different verticals in plastic surgery and are comfortable having, you know, a really frank conversation about all the things that were really easy, all the things that were difficult, things they may have done a little bit differently and will really give you an honest take you know, about what, what this looks like from your perspective. Because I think from our position, the last thing that we want to do is go through this entire process of data gathering and all of these other things, and interviewing buyers, and interviewing, you know, different people within these buyers organizations, and setting up dinners and things like that, if ultimately, you aren’t ready. So, we’re going to spend the time on the front end, really sitting down, walking you through what this could look like, and make sure that you’re a really good feel for what your life post-close will look like.

Kevin Cumbus

Can I just add, I would say the best outcomes we get for clients are ones who come to us. Engage us to work with them early. Let us take the opportunity to dig into their business, work with their financial advisor, understand what the proceeds are going to be on an after-tax basis, what potential cash flows are going to look like, identify the low-lying opportunity enhancement. Let’s think about ways to de-risk the asset in advance of taking it to market. When we’re able to work in an advisory capacity before we act as your M&A advisor, it typically more than covers our fee when it’s all said and done with.

Josh Swearingen

Yeah. And to put your mind at ease, I would say we have, we have more than a couple of dozen clients, or prospective clients that we don’t have an engagement agreement set up with yet, but they’ve come back for a TUSK valuation, 2, 3, 4, years in a row, in the hopes that, you know, they’re preparing for that eventual exit, and as we continue to track their numbers and continue having conversations with them, really, that plan starts to crystallize in their minds and they have a really good feel for all right, you know, the market is giving us all of these signals, now is the time we’ve been preparing for it. Let’s go. And I think, I think to Kevin’s point, like, if you can do this in a couple of different phases, you know, it will pay off in spades on the other side.

Josh Swearingen

So and this, you know, this goes back to a little bit what Kevin talked about earlier this evening, and really primarily talking about where we are in the market today. And I think that we believe that things within the plastic surgery space are about to accelerate really, really rapidly. So, it’s a perfect time to kind of be first in line to get a good look. We know that there are a lot of private equity groups on this that have been sitting on the sidelines for, you know, a long time at this point, that are looking to deploy capital, that have a lot of dry powder that they need to spend. And being, you know, being in a limited pool of prospective sellers with a very, very large pool of prospective buyers is a really good position for you to be in and can create a really nice competitive market for your business.

Kevin Cumbus

Josh, I can’t, thank you enough. This has been an incredible evening. I mean, really, just knowing, getting the insights from you, someone who’s sitting there, working daily on the front lines in the trenches with your clients, talking to the buyers, understanding their perception of risk, their desire around valuation, and your insistence that they pay more if they’re going to partner with one of your clients, is it’s always awesome to see. If you can’t tell, we actually relish the battle. We relish the opportunity to go toe to toe, fist to fist with these guys. Ultimately, it’s best for them too, right? They want to partner with the best, and we’re lucky enough to work with the best, so they got to come through Josh or somebody else on our team to gain access to them. Yeah, it’s going to cost them a hell of a lot more. But at the on the on the other side of that, I think it makes a better partnership.

Kevin Cumbus

So we’re always happy to help you with an evaluation of your business, give you an adjusted EBITDA and I think more importantly, walk you through what structure looks like in today’s market, there’s so much energy spent on what’s the multiple and what’s the enterprise value but I would argue what is more important is how you receive that value over time. And all comes down to structure, like Josh was sharing with earlier about the three buckets of hybrid, hold co and JV, and we want to make sure you’re fully read in on all that, so we are always happy to work with you. It’s a complimentary assessment. Our goal, just like in this webinar, this evening, is for you to leave with more information than you came with. So hopefully you’ve learned a lot. If you want to book a call with either of us, feel free to reach out directly to Info@TuskPracticeSales. We love just learning from you and educating others as well. So, Josh, thanks for an incredible evening. This has been outstanding.

Josh Swearingen

Loved being here. Always a good time with you. Kevin. Have a good night, everybody.

Kevin Cumbus

Thanks, everybody.