THE ADVICE THAT CHANGED EVERYTHING

“That contract cost me $3,500. But it was probably the best investment I made in my professional career.”
— Eric Mann, MD

Coming out of residency, Eric Mann, MD, saw what most young doctors quickly realize—there’s no real playbook for landing your first job—and almost zero guidance on how to structure a career that leads to ownership, not just employment.

“Most of my classmates were focused on finding any job that would take them. But I wanted something different. I wanted to work toward building something that would eventually be mine.”

That decision didn’t come out of nowhere. It started two years earlier, when Eric was a second-year ophthalmology resident watching the class ahead of him try to land their first jobs.

“They’d pick one or two practices to interview with, wait around for a contract, send it to a lawyer—and by the time they asked for any real changes, it was too late. The practice would say no, and they had no leverage.”

Why? Because by March or April of their final year, most residents were out of time and out of options. Student loan payments were looming, and every other job had already been filled.

“I watched them spend $700 on contract reviews that changed nothing. They signed anyway. And most of them ended up in jobs they didn’t even like.”

That’s when Eric made a decision:

“When I’m a third-year, I’m going to do this differently. I’m not going to wait around and hope someone hands me a good deal. I’m going to create one.”

Eric had a vision, but no clue how to get there. That changed during his chief residency year at an American Academy of Ophthalmology meeting, when he attended a dinner with 30 to 40 people from his program. All his friends were seated at one end of the table—Eric ended up at the other, next to a man named Herve Byron, MD.

What started as small talk quickly turned into a career-altering moment.

“Turns out Herve had built a monster practice in Manhattan and had recently retired. You’d never know it from the way he carried himself. He asked what I was planning after residency, and I told him I was interviewing at a few practices.”

That’s when Herve dropped the kind of advice you don’t forget:

“He said, ‘Whatever you do, the biggest piece of advice I can give you is to get a shark of an attorney. I’m going to give you the name of someone. He’s a healthcare attorney and all he does is buy and sell practices. Usually, he’s the one the older doctors hire to negotiate against people like you. But you should hire him.’”

Eric listened. He hired the lawyer and used him to negotiate not just his employment terms, but a full 10-year roadmap:

• A clear employment agreement
• A structured partnership pathway
• A pre-set valuation for buying into the practice
• Terms for the original owner to transition to part-time and eventually exit

“I was negotiating with three practices at once. I picked the one I liked best and used Mark to lock in everything—buy-in, buyout, the owner’s exit. That contract cost me $3,500, but it gave me control over my career.”

Today, Eric owns Eye Associates of North Jersey, serves on the medical staff at St. Barnabas Medical Center, and mentors early-career doctors through Lucens, which he founded and serves as the CEO.

This PDF outlines the exact playbook that helped him go from job seeker to full practice owner—and how you can use the same approach to shape your future.

💰 THE BUY-IN STRATEGY, UNPACKED

So what exactly did Eric Mann do—and how can you use the same playbook?

Eric treated his first job offer like a strategic investment, not just a paycheck.

“I didn’t want to just work for a practice. I wanted to grow into owning it. And I knew that meant getting everything—buy-in, valuation, transition—on paper from the start.”

With the help of a specialized healthcare attorney, he negotiated a full 10-year roadmap:

• A standard employment agreement
• A defined path to partnership
• A buy-in valuation model (set in advance, no surprises)
• A buyout structure with price clarity
• A 3-year exit plan for the founder to stay part-time before retirement

“We negotiated the terms of partnership, the cost of buying the practice, and the owner’s exit—all before I even started.”

🔄 Should You Buy In—or Build From Scratch?

Buy-In Pros

• Established patients, location(s), customer data, websites, etc.
• Mentorship + transition support
• Revenue from day one
• No need to reinvent systems

Buy-In Cons

• Higher upfront legal costs
• Culture/infrastructure limitations
• May inherit liabilities

Startup Pros

• Full control from day one
• Build your culture from scratch
• Potential for faster scaling

Startup Cons

• High overhead and risk
• Zero revenue runway (if you bill for a visit, it can take 30-90 days to see any revenue)
• You need a good line of credit to scale
• Hiring, credentialing, and contracts from scratch

🛑 Why Some Older Docs Might Resist (And What It Means)

Even if you’re ready to buy in, not every senior doctor will be open to it. Here’s why:

• Fear of Losing Control: Some owners aren't ready to let go—even if they say they are.
• Unrealistic Valuations: They believe their practice is worth far more than market value.
• Sunk Cost Fallacy: They want "one more year" of full profits, over and over again.
• PE Temptation: They’re flattered by PE offers and want to keep options open.
• Emotional Attachment: It’s their baby, and handing it off feels like "retirement" (even if it’s not).

🚩 Red Flags to Watch For

• The owner keeps "kicking the can" on setting a timeline.
• Partnership terms are vague, moving, or verbal-only.
• Valuation methods aren't discussed early and clearly.
• Private equity reps are already visiting the office.
• The owner shows no interest in mentorship or gradual transition.

🛡️ Smart Counterarguments to Common Resistance

If they say:

"Let's wait and see how you do for a few years first."

You can say:

"Of course—I want to prove myself. But having a framework now, even if it's contingent on performance, gives us both clarity."

If they say:

"Private equity is offering me more money than you can."

You can say:

"True—and PE is great for some. But your name and your culture will live on here if you transition internally. Also you have an ability with me, a physician, who respects what you’ve built here and you’re in position to make your transition look how you want it to. PE can’t promise that."

If they say:

"My practice is worth way more than you're offering."

You can say:

"Totally fair to want a great price. Let's agree to an independent valuation process now, so it’s based on real data later—not emotions."

If they seem emotionally stuck:

"What do you want your next chapter to look like—for your patients, your staff, and yourself?"

(Sometimes, reminding them that they control the narrative, not PE, can help.)

“Everyone’s got a plan until they get punched in the face. Expect resistance. But come prepared.”
—Dr. Eric Mann

🛡️ HOW TO START THE CONVERSATION

✅ Want to Do the Same? Start Here

1. Get Clear on Your Long Game

Write down what you want. Ownership? Equity? Leadership?

This is critical. Many young physicians are told (by parents or well-intentioned advisors) that they should ask for “x” because that is what they would want, but the only person a physician needs to answer to is themselves. Make sure it’s what you want, and what you think you'll want later on. It’s not an easy task and should be taken with lots of time and deliberation.

A spouse or partner can also help ensure your long-term plans are aligned, but ultimately, it's your happiness and daily work-life balance that you have to live with.

Be honest with yourself, and don’t just say what sounds good, but what actually will be realistic. Know your strengths and weaknesses. Know your destination before you step into a negotiation.

2. Ask Early, Ask Smart

Open the door with language like:

“I’m looking for a role that allows me to grow into leadership or even ownership. Is that something your practice is open to?”

This signals vision, not entitlement.

Before you ask about ownership, know who you’re competing against: private equity.

For many older physicians nearing retirement, PE firms offer a fast, clean exit. They show up with high valuations, aggressive term sheets, and teams of lawyers. But what they don’t offer is continuity, legacy, or control.

That’s your leverage.

If you can position yourself as the internal successor—someone who shares their values, understands the patients, and wants to preserve the culture—they just might say “yes” to you instead of selling to a spreadsheet.

“I knew PE was circling. So I positioned myself as the person who could continue the practice—on its terms, not theirs.”

3. Bring in the Pros

Hire a healthcare attorney who specializes in buy-ins and practice sales.

“The lawyer usually worked for the senior doctors. But this time, he worked for me.”

Plan to invest $5,000 - $7,000. It’s not cheap, but it’s nothing compared to the cost of missing your chance.

🟦 🗣 What to Say to an Owner Considering Private Equity:

It sounds simple when you hear Eric’s story, but the pressure is on when you’re sitting across from a seasoned doctor with an offer from private equity on their desk.

Here’s what Eric suggests you lead with when negotiating with a doctor:

“I know PE is knocking on your door—but have you considered what you’re really getting, and what you might be giving up?”

Then walk them through a few PE caveats that Eric Mann has seen firsthand:

🔍 1. The Money Isn’t Always What It Seems

“That signing bonus? It might not be the final payout. Most PE deals include performance metrics you probably won’t hit. And they know that.”

Physicians often overperform right before a sale to inflate their numbers. Once sold, they scale back—and suddenly, they’re not hitting targets. PE firms claw back the difference.

“You told them you were generating $1 million. A year later, it’s $700K. That $300K gap? They come for it.”

🧠 2. The Golden Handcuffs

“You took the money. You got the gold. But now your hands are tied.”

Eric calls this the golden handcuffs: once you sell to PE, it can become harder to deliver care the way you believe in—especially when cost controls and efficiency metrics start to drive decisions.

“You can’t always treat patients the way you’d treat your own parents—because it’s not profitable. And now, you answer to people in suits, not physicians.”

Private equity means ceding control: over scheduling, staffing, even how your patients are treated. Eric seen this a number of times over his career. A doctor goes from being the ultimate person their staff is trying to please to being the cause why they don’t get as much vacation time or work longer hours. The doctor sold. The doctor got paid, the staff didn’t. That feeling is palpable. It kills the doctor’s ego and makes it difficult to interact with the staff

“When the front desk no longer answers to you, the culture shifts. You may still feel like the leader, but you’re not the one signing the checks anymore.”

Disempowered employees, upset patients, and diminished autonomy become the new norm.

❤️ 3. Ask the Bigger Question: What Do You Want Your Legacy to Be?

“Some people care about legacy. Some don’t. But it’s a question worth asking.”

Do they want their name to live on through the practice? Do they want to mentor someone who shares their values? Or do they just want the fastest exit? Either is okay—but they deserve to know which one they’re choosing.

🔸 4. Skin in the Game

“I had ownership in my future from day one. That made me hungrier to build the practice into something great.”

A young physician with equity in the outcome is a powerful thing. Eric had clear buy-in terms before he ever saw his first patient.

That created a mindset of investment, pride, and long-term thinking from the start. Practice owners want to leave their life’s work in the hands of someone who cares as much as they do—and nothing shows that more than skin in the game.

This future-owner mindset will ensure the practice gets an employee aligned with ownership, rather than focusing on their career path. Instead, the owner has a built-in collaborator with a mindset of what's best for the practice.

They aren’t a hired gun; they stay an extra hour to see emergency patients, or won’t leave when their hours are up.

These are valuable traits that come with an ownership mindset.

🟨 THE TAKEAWAY

“I knew the number. I knew the terms. I had a roadmap. And most importantly, I had leverage. That contract gave me the foundation to eventually own the practice.”

—Dr. Eric Mann

Too many doctors wait for permission—or hope a buy-in opportunity shows up eventually.

That’s not how it works.

Ownership isn’t something you’re offered.

It’s something you negotiate—on day one.

“BUT I MISSED DAY ONE…”

That’s okay. Because the best time to ask for ownership was yesterday.

The second-best time? Right now.

Even if you’ve been in your role for a year—or five—you can:

• Ask for a review of your current contract
• Propose a buy-in clause with a long-term runway
• Reopen the conversation using performance as leverage
• Bring in a lawyer to model different ownership structures

Don’t wait for the perfect time. There’s no badge for being passive.

🧾 What This PDF Gave You:

• A real story from a doctor who’s been there
• A breakdown of how to structure a buy-in
• Sample language to open the door
• A strong case for investing in legal expertise

🔶 Ready to design your career, on your terms?

Lucens is a professional development platform for doctors who want more than just a job.

We offer mentorship, a community of like-minded doctors, contract strategy, and the kind of inside knowledge that no one teaches in med school.

🔗 Join the Lucens Community → wearelucens.com

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