In a valuable episode of the Wealth Planning for the Modern Physician podcast, host David Mandell, JD, MBA, welcomed two guests who have navigated a common trend in independent medicine today: private equity. Dr. Steve Hamilton, sports medicine physician and orthopedic surgeon at Beacon Orthopedics, and Andy Blankemeyer, CEO of Beacon and OrthoAlliance, shared their firsthand experiences with practice growth, private equity partnerships, and what physicians should consider when approached with these opportunities.

Their story offers a candid look into how one group balanced clinical autonomy with the business realities of scaling a modern medical practice, an issue increasingly relevant across specialties.

Building a regional orthopedic leader

Beacon Orthopedics has undergone remarkable growth over the decade prior to being purchased by private equity. When Hamilton and Blankemeyer first joined, the practice had around 10 to 15 physicians and only a handful of locations. By 2019, Beacon had expanded to 26 physicians across eight offices. Today, with the formation of OrthoAlliance, the organization includes more than 70 physicians, 1,000 employees, and 26 locations across Ohio, Kentucky, and Indiana.

Blankemeyer explained that the motivation for growth was twofold: to insulate the practice from competitive pressures from hospitals and payers, and to establish themselves as the regional leader in orthopedics. This required not only recruiting physicians but also expanding infrastructure, building surgery centers, and investing in ancillary services such as imaging and physical therapy.

Deciding on private equity

One of the pivotal decisions in Beacon’s trajectory was whether to accept private equity investment. Both Hamilton and Blankemeyer admitted that their initial reaction was hesitation. Horror stories from other practices loomed large: Tales of private equity firms dictating patient quotas, limiting autonomy, or prioritizing profits over care.

Over time, however, the group realized that not all firms operated this way. By educating themselves, speaking with peers, and interviewing multiple firms, they learned that the right partner could provide capital and strategic expertise without interfering in clinical decisions. As Blankemeyer emphasized, “It’s about culture. Every firm can write the check, but not every firm will align with your values.”

Ultimately, Beacon partnered with Revelstoke Capital Partners, a firm they felt had a reputation for respecting physician leadership. Hamilton likened the relationship to a marriage, one that required time, trust, and shared values. This partnership provided Beacon with the resources to expand beyond Cincinnati while allowing physicians to maintain full control over patient care.

The physician’s perspective

From the physician side, Hamilton described the process as both exciting and daunting. Like many doctors, he had little formal business training, so learning terms like EBITDA and multiples was a crash course in finance. Still, he and his colleagues recognized that to grow further and expand their model of care, they would need capital and business support.

Importantly, Hamilton stressed that patient care has remained unchanged since the partnership. “Day-to-day clinic and surgery have not been influenced at all,” he said. “They haven’t told us how many patients to see or how to treat them. That autonomy was non-negotiable.”

The biggest adjustment, he explained, has been adapting to rapid growth. Going from 15 physicians to more than 70 required flexibility in scheduling, use of surgery centers, and integration of new colleagues into the culture. It has been a challenge, but one he described as a “good problem to have.”

Challenges and opportunities after the deal

Blankemeyer pointed out that scaling so quickly (from 500 employees to 1,000 in just a couple of years) requires more than capital. Infrastructure, administrative support, and IT systems all had to expand in step with clinical growth. One of the biggest risks in such rapid expansion, he noted, is diluting culture. To avoid this, OrthoAlliance has been selective in the practices it adds, ensuring new groups share their commitment to quality, access, and physician-led care.

Both guests highlighted the pandemic as an important test. Less than a year into the partnership, COVID-19 forced Beacon to shut down operations temporarily. Rather than pushing to keep clinics open, Revelstoke supported the physicians’ decision to prioritize safety. That alignment of values, Hamilton and Blankemeyer agreed, validated their choice of partner.

Key lessons for physicians

For physicians considering private equity, both guests emphasized several takeaways:

• Do your homework: Learn the language of finance, ask questions, and seek outside advice.
• Don’t settle for the first offer: Interview multiple firms to find the best cultural and operational fit.
• Protect clinical autonomy: Ensure any agreement safeguards the physician’s ability to practice medicine as they see fit.
• Value culture over dollars: Financial terms may be similar across firms, but culture determines long-term success.
• Be flexible: Growth requires adaptation, whether in scheduling, staffing, or working with new colleagues.

Conclusion

The Beacon Orthopedics story highlights both the opportunities and complexities of private equity in medicine. For Dr. Steve Hamilton and CEO Andy Blankemeyer, success has come from deliberate planning, careful partner selection, and a commitment to preserving physician leadership. Their experience underscores a broader lesson for physicians: Private equity can be a tool for growth and stability, but only if the cultural and clinical fit is right. In today’s health care landscape, where consolidation is accelerating, their insights offer a valuable roadmap for practices of all sizes.

Click here to listen to the entire conversation with guests Andy Blankemeyer and Dr. Steve Hamilton and host David Mandell, or access the full library of Wealth Planning for the Modern Physician episodes and subscribe on your favorite podcast platform.

David B. Mandell is an attorney, wealth manager, author, and partner in the wealth management firm OJM Group, LLC, where he and his team provide comprehensive and multidisciplinary financial planning services tailored specifically for physicians across the United States.

David hosts the Wealth Planning for the Modern Physician Podcast, now in its fifth season with over 95 episodes and 50,000+ downloads. The show focuses on the unique wealth planning concerns faced by today’s doctors and features interviews with physicians across specialties and stages of their careers, as well as insights from financial and industry experts. Listeners gain practical tips on building wealth, protecting assets, reducing taxes, and achieving long-term financial goals. Click here to listen and subscribe.

He is also the co-author of more than 15 books, including the newest release, Wealth Strategies for Today’s Physician: A Multi-Media Playbook. This innovative guide includes over 250 pages of actionable content and more than 90 embedded links to videos and podcast episodes. Organized into seven key strategies, the Playbook helps physicians reduce taxes, invest wisely, choose the right insurance, protect their assets, and plan for retirement. Click here to get your free print copy or eBook download, available exclusively to members of the KevinMD community.

David has spoken at major national medical meetings, including those hosted by the American Academy of Ophthalmology, the American Association of Orthopaedic Executives, and the International College of Surgeons. He earned his bachelor’s degree from Harvard University, his law degree from UCLA School of Law, and his MBA from UCLA Anderson.

Connect with David and OJM Group on their website, LinkedIn, Facebook, Instagram, YouTube, and X @OJMGroup.

Disclosure:

OJM Group, LLC. (“OJM”) is an SEC-registered investment adviser with its principal place of business in the State of Ohio. SEC registration does not constitute an endorsement of OJM by the SEC nor does it indicate that OJM has attained a particular level of skill or ability. OJM and its representatives are in compliance with the current notice filing and registration requirements imposed upon registered investment advisers by those states in which OJM maintains clients. OJM may only transact business in those states in which it is registered or qualifies for an exemption or exclusion from registration requirements. For information about OJM, please visit http://adviserinfo.sec.gov/ or contact us at (877) 656-4362.

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