Startup vs. Acquisition: Which Path Should You Take as a Practice Buyer?
If you’re exploring practice ownership, one question comes up every time:
“Should I buy an existing practice, or should I start one from scratch?”
The real answer is: it depends on you — and the vision you have for your future.
Know Your Vision — and Your Flexibility
At Wicklow, we see this pattern daily: some buyers come to us with a very specific vision for how they want to practice and run their business. They know:
The exact geographic location they want — sometimes down to a single town or neighborhood.
The type of facility that aligns with their goals — size, style, and layout.
The client base or patient mix that fits how they want to practice.
The technology, equipment, and workflows they believe in.
If that’s you — and you’re not interested in compromising on those details — then the reality is, it’s unlikely you’ll find an existing practice that checks every single box. If you’ve been looking at practice after practice, always spotting that one thing (or four things) that hold you back from making an offer, it may be time to admit that a startup could be the better path.
The Trap of the “Perfect” Acquisition
A lot of buyers get stuck waiting for that unicorn practice — the one that’s in the perfect location, with the exact equipment, the right layout, the right clientele, the right staff, all wrapped up with a bow.
From our experience, that rarely exists. Practices are living, breathing businesses. There will always be trade-offs. The real question is: are you willing to flex your vision and take something good that you can improve — or is compromise off the table?
Location, Location… Limitation
One key point we always stress: Geography can lock you in. If you’re absolutely fixed on practicing in a single area — maybe your hometown, or where your partner’s family is — you’re limited to whatever comes up for sale there. In a competitive market, it could be years before something viable even hits the market. Wicklow routinely advises buyers that have a clearly defined single town or area, to consider both acquisition opportunities and looking for spaces that would fit their needs for either an acquisition or a start-up.
Wicklow’s Perspective
So, is a startup better than an acquisition? Or vice versa? The answer is: It’s up to you.
Here’s what we encourage buyers to ask themselves:
✅ How specific is my vision — and how flexible am I willing to be?
✅ Am I open to compromise — or will I keep passing on good opportunities because they aren’t perfect?
✅ Is my location so defined that waiting for the right practice could take years?
A solid acquisition saves time, generates revenue from day one, and can always be reshaped over time. But if your vision is unshakeable — and you know exactly what you want — a startup may be the right move.
A Final Thought
At Wicklow, we never push buyers toward one path or the other. Our role is to help you see your options clearly, weigh your true risk tolerance, and build a plan that aligns with your version of ownership — not just today, but for years to come.
If you’re weighing your options, let’s talk. A quick strategy session can save you years of wasted searching — and get you closer to the path that fits you best.
Thank you for your interest in Wicklow!
Our team understands how to help you find the right opportunity that fits your specific needs, and we’re committed to helping you succeed. Should you have any questions, fill out the form below with your details, and we'll get back to you as soon as possible. Your information is secure and will only be used to assist you.
