Practice sales are often viewed as end-of-career decisions — something principals begin considering later in their professional lives, when retirement starts to feel within reach.
But many of the principals exploring their options today are not at that stage. They are in their thirties, forties and fifties, still ambitious, committed to clinical practice and proud of the businesses they have built. They are not necessarily ready to step away or hand over the business completely.
What they are looking for is a different way of working and a more sustainable way forward — because the pressures of practice ownership have become increasingly difficult to ignore.
The mid-career squeeze
Running an independent practice in 2026 looks very different from a decade ago. Compliance requirements have increased significantly,[i] recruitment and retention remain ongoing challenges, and the cost of operating a practice continues to rise while NHS contract values have remained largely stagnant.[ii] At the same time, practice owners are having to make increasingly complex decisions about investment — from digital workflows and patient experience platforms to AI-enabled tools, equipment upgrades and the capital required to stay competitive.
For many mid-career principals, this creates a very specific kind of pressure. They have spent years building successful practices, loyal patient bases, strong teams and trusted local reputations. Walking away entirely does not feel right, but carrying the full weight of ownership alone can begin to take its toll.
Too often, the conversation around practice ownership is framed as a binary choice: remain fully independent or sell and step away. For principals who do not identify with either option, it can feel as though there are very few meaningful alternatives available.
The cost of waiting
One response to this pressure is to continue as things are, assuming the right moment to make a change will eventually arrive.
But waiting can carry its own costs.
As practices grow in value, principals often accumulate significant unrealised equity — value tied up within the business and inaccessible until some form of transaction takes place. For principals still in the middle of their careers, that equity could potentially be supporting wider personal, professional or business ambitions much earlier.
There is also the less visible cost of continuing to operate alone. Without a strong peer network or wider operational support, principals are often left making important decisions in isolation while balancing the growing demands of HR, finance, compliance and day-to-day operations alongside clinical responsibilities. Over time, that level of pressure can become normalised, even when it is no longer sustainable. Waiting can also mean postponing the investment needed to modernise a practice, whether in technology, facilities, new services or team capability. Over time, that can create a gap between what owners want the practice to become and what they have the capacity or capital to deliver alone.
Growth can also become increasingly difficult to achieve independently. Expanding services, investing in technology, upgrading equipment, improving the patient experience, recruiting associates or developing additional sites all require time, capital and operational capacity. For principals already stretched thin, even positive opportunities can begin to feel overwhelming.
As a result, many practices can find themselves in a holding pattern — stable and successful, but increasingly difficult to evolve. Over time, that stagnation can begin to affect not only profitability and growth potential, but also the long-term enjoyment and fulfilment that comes with ownership itself.
Research consistently shows that isolation, especially professional isolation, is a significant factor in burnout among senior clinicians.[iii] The combination of clinical responsibility and sole business ownership only compounds this.
A different kind of conversation
For many mid-career principals, the question is not simply whether to sell. It is whether the current structure of ownership is still serving them, and whether there may be a better way forward.
Too often, the value of a practice becomes intertwined with the day-to-day experience of running it. But the two are not the same. It is possible to unlock the value that has been built within a practice while also reshaping the ownership experience itself.
A transaction does not have to represent an ending. It can instead be a restructuring — one that releases equity, creates access to broader support and expertise, and connects principals to a wider professional community, while still allowing them to retain autonomy over the practice they have built.
Viewed through that lens, the conversation around timing changes as well. Rather than waiting until retirement feels close enough to justify acting, principals can begin considering whether the right ownership model could make the next 10, 15 or even 20 years of practice more rewarding, sustainable and growth-focused.
At DeNovo Dental Partners, we work with principals who are not looking for an exit, but for a different kind of ownership model. Our shared ownership approach enables principals to realise full practice value upfront through a combination of cash and equity, while retaining clinical and operational autonomy. Partners also become significant shareholders in the wider group, creating opportunities to benefit from future growth and long-term value creation, while gaining access to support across areas such as HR, compliance, finance and operations.
Importantly, the goal is not to change what makes a practice successful. It is to change the experience of carrying the full weight of ownership alone.
For many principals, exploring these conversations earlier in their career — while they still have years of ambition, energy and clinical practice ahead of them — is precisely what makes the model worth considering.
Media Contact:
DeNovo Dental Partners
Kristen Pope
Chief Integration, Partnership & Communications Officer
Kristen.Pope@DeNovo.Partners
https://www.denovo.partners/
Author: Caron Best, Chief Operating Officer DeNovo Dental Partners
[i] Compliance or collapse: Why UK businesses must move governance beyond spreadsheets. Oneadvanced.com. Published 2025. https://www.oneadvanced.com/resources/compliance-or-collapse-why-uk-businesses-must-move-governance-beyond-spreadsheets/
[ii] NHS England. NHS England» Changes to the GP Contract in 2025/26. England.nhs.uk. Published 2025. https://www.england.nhs.uk/long-read/changes-to-the-gp-contract-in-2025-26/
[iii] Taranu SM, Ilie AC, Turcu AM, et al. Factors Associated with Burnout in Healthcare Professionals. Int J Environ Res Public Health. 2022;19(22):14701. Published 2022 Nov 9. doi:10.3390/ijerph192214701
