How a physician assistant bought a $4.5M medical practice with $120K down

Zach is a physician assistant who spent most of his career in trauma surgery and heart surgery ICU.

He wanted more financial freedom and believed medical practices function best when medical professionals lead them.

Less than a year after joining Acquisition Ace, he and a partner closed on a $4.5M occupational medicine clinic, putting down just $120K on a deal generating $975K annually.

Here’s the full breakdown 👇

Finding the Deal

Zach initially focused on med spas but stayed open to other opportunities in healthcare.

He found a partner through the Acquisition Ace community after posting about a different Illinois deal that ultimately fell through.

They kept searching together and found an occupational medicine clinic (Zach’s exact specialty) with a full team of PAs, nurse practitioners, physicians, and physical therapists already in place.

The clinic specialized in workplace injuries and workers’ comp insurance, which requires expertise most practices don’t have.

(Finding partners and getting deal feedback happens all the time inside Acquisition Ace, where members team up to close deals they couldn't do alone. If you think joining a supportive community like that could be beneficial for you, too, book a call with our team here.)

The Deal Breakdown

Purchase price: $4.5M

Advertised cash flow: $850K

Actual cash flow (after quality of earnings): $975K

Down payment: $120K total (100% financing through private lender)

Financing: 6.4% interest, 10-year amortization, 7-year term, first year interest-only

Instead of the typical SBA loan requiring $450K down (10%), Zach’s loan broker found a private lender specializing in professional services who financed 100% of the purchase price.

The seller also left $250K in working capital and $150K in receivables (both at 0% interest for one year).

After paying the loan broker’s 2% fee and bank closing costs, Zach and his partner walked into a $4.5M deal for roughly $120K.

What They're Doing Now

Zach works 5-10 hours per week on the business while keeping his full-time PA job (and adding a second per diem position).

The practice runs itself with existing leadership in place.

They’re projecting $250K in profit in year one (after paying the seller extra salary for a 338(h)(10) tax election that saves them $1.5M over 15 years).

That’s over 200% cash-on-cash return in year one.

Oh, and Zach also bought land, built a house, got married, and went on a honeymoon during this entire process!

His Key Lesson

“If you can find a partnership that works, do it. I closed this deal during the craziest year of my life because my partner could handle things when I couldn’t, and vice versa.”

Zach didn’t let a busy life stop him from building wealth through acquisitions, and neither should you.

If you’re ready to find and close your first acquisition…

Join the Acquisition Ace community with 2,000+ members who are learning to find, finance, and close deals just like Jason and Charlie.

👉 Book a call with our team here, and we’ll talk through if it’s the right fit for you.