Medical practice financing
that respects the practice.

A medical practice is a small business buried under a regulatory layer most lenders don't understand. Revenue arrives through a contracted payer mix on lag cycles measured in weeks. Payroll is concentrated in skilled clinical labor that cannot flex during slow weeks. Equipment lives on long depreciation tails. Compliance overhead — HIPAA, coding audits, state licensure, malpractice — adds fixed cost most other businesses don't carry. And the practice owner is usually a physician whose clinical training said nothing about the capital math that determines whether the practice survives a slow quarter or grows into a regional group.

Conventional bank financing for practices works well at two ends and poorly in the middle. At the small end, a personal-credit revolving line covers a quarter-end bridge. At the large end, an SBA 7(a) loan funds a major acquisition over a 60-to-120-day closing. In between — equipment refreshes, small acquisitions, leasehold improvements, payroll bridges through insurance remittance gaps, opportunity capital for new service lines — banks rarely move fast enough or flexibly enough to be useful. Goliath operates entirely in that middle zone, underwriting from net practice deposits, funding inside a week, and structuring repayment around how practices actually receive money.

What we fund inside a medical practice

Practice acquisitions and partner buy-ins from $100K to $2M, often as a complement to senior bank financing on larger transactions. Equipment purchases including imaging systems, surgical lasers, dental chairs and CBCT, dermatology and aesthetic technology, ultrasound and diagnostic systems, EHR migrations and integrations, and the supporting renovation costs. Leasehold improvements and new-location buildouts for satellite offices and second locations. Working capital bridges through slow payer remittance periods, including the predictable end-of-year insurance reset and the post-holiday January slowdown. Marketing investments in patient acquisition, referral systems, and digital presence. Hiring and onboarding costs for additional clinicians, including signing bonuses and contract guarantees. Tax payment plans and IRS settlements that compress operating cash flow.

A specific niche we fund heavily: dental practices and dental-service organizations (DSOs) consolidating multiple practices, recapitalizing partner equity, or investing in technology upgrades that move the practice toward a higher-end procedure mix. Dental cash flow is unusually clean for underwriting because the payer mix typically includes a heavier patient-pay share than most medical specialties, and the procedure margins are unusually visible at the bank statement level.

What we don't ask for and never touch

We don't request patient records, claim-level data, charge masters, ICD or CPT coding detail, or anything that crosses HIPAA boundaries. We don't pull tax returns or P&L statements from your CPA during pre-qualification. We don't notify your malpractice carrier, your state board, or your hospital affiliation. We underwrite from operating bank statements, basic entity documentation, and the texture of the practice's operating history — the same variables that predict repayment in any cash-flowing professional services business.

A medical practice's bank statements have a signature that requires a practiced eye. EOB-driven deposits arrive in clusters, often Tuesday through Thursday, with weekly variance that depends entirely on payer mix. Outflows concentrate around bi-weekly payroll runs that are unusually large relative to revenue because clinical labor is skilled and expensive. Vendor outflows cluster around lab fees, supply orders, and medication purchases. Lease, malpractice premium, and licensure payments hit on calendar cycles that vary by state. The practice runs on a different rhythm than a retail or trade business, and underwriting that doesn't recognize the rhythm misprices the risk.

The strongest practice files share a few signatures: a payer-mix deposit pattern with a consistent floor month over month, payroll-to-deposit ratios in the expected band for the specialty, low NSF activity even during seasonal lulls, and an operator personal-credit profile in the mid-600s or higher. We can fund through messier files — practices with one weak quarter, practices owned by physicians in personal-credit repair, practices in active IRS payment plans — though tighter pricing reflects the additional underwriting work involved.

Practice segments we fund every week

Primary care, internal medicine, and family practice across solo and group structures. Pediatric and OB/GYN practices, including practices integrated with hospital affiliations. Urgent care centers and walk-in clinics. Dental practices across general, pediatric, orthodontic, periodontal, and oral surgery, plus emerging DSO structures. Dermatology, plastic surgery, and aesthetic-medicine practices. Ophthalmology and optometry, including practices integrated with surgical centers. ENT, GI, cardiology, orthopedics, and pain management specialty groups. Veterinary practices and animal hospitals across general and specialty. Med spas, IV bars, and aesthetic clinics. Chiropractic, PT, and rehab clinics. Behavioral health and outpatient mental health practices. Concierge and direct-pay primary care models.

Common medical practice funding scenarios

A retiring partner's buyout is structured over three years but the practice needs to settle the equity inside six months to avoid a tax penalty. We fund a 24-month working capital position that compresses the buyout into a single payment and the practice retires it from operating margin. A satellite location becomes available at a below-market lease and the buildout needs to start before the next quarter to capture the patient panel. We fund the leasehold improvements and opening payroll in a single position. A CBCT scanner unlocks a $300K annual upgrade in case mix but the manufacturer wants payment-in-full to honor the volume discount. We fund the equipment outright at a lower total cost than a five-year lease. A major commercial payer delays a quarter of remittances during a contract renegotiation and payroll runs Friday. We bridge the gap and the position retires when the remittances flow.

The shape under all of it: capital that respects the practice as a professional services business with its own cash rhythm, sized to specific opportunities, structured to retire as the revenue catches up. Practices that grow into regional groups are the ones with capital infrastructure that doesn't drag clinical decision-making.