INDUSTRY · HEALTHCARE AND WELLNESS INDUSTRY
Selling a healthcare or wellness business in Quebec
In healthcare, the buyer tests clinical continuity: loyal patients, scarce staff, compliant records and the professional order that decides who can buy.
The healthcare and wellness market in Quebec
Healthcare in Quebec isn't a homogeneous industry. It covers very different business models — each with its own sale logic.
- Consolidatable professional clinics (dental, veterinary, optometry, physiotherapy, general or aesthetic medicine) — The core of the SME transaction market in Quebec healthcare. Voting ownership is reserved for members of the order, and corporate buyers come in through management structures (MSOs). Focus of this page.
- Community pharmacies — A regulatory case of its own. The Pharmacy Act (P-10) reserves ownership exclusively for pharmacists. Peer-to-peer transactions only.
- Senior residences — Hybrid operation-and-real-estate model. Large senior residences are valued at the real estate cap rate, not at an EBITDA multiple. Small senior residences are going through a viability crisis documented by CIRANO.
The healthcare sector by the numbers
25%
Of the population will be 65+ in 2031
Institut de la statistique du Québec
$399B
Projected health spending in Canada (12.7% of GDP)
Canadian Institute for Health Information, 2025
6.3x
Average EBITDA multiple — dental acquisitions
Dentalcorp, 2025
The tailwind is structural: according to the Institut de la statistique du Québec, people 65 and older could make up a quarter of Quebec's population by 2031. At the Canadian level, the Canadian Institute for Health Information projects total health spending of $399 billion in 2025 — 12.7% of GDP. The chronic bottleneck in the public network is pushing a growing share of the population toward private clinics.
Consolidation is real but segmented. In dental, Dentalcorp acquires at 6.3x pro forma EBITDA on average. In optometry, FYidoctors completed 22 acquisitions in 2025 to reach 370 locations (including the Visique banner in Quebec). In rehabilitation, Lifemark Health Group (a Loblaw subsidiary) is consolidating aggressively in Quebec. In veterinary, more than 20% of hospitals in Canada are corporate.
Sources: Institut de la statistique du Québec, demographic aging dashboard; Canadian Institute for Health Information, national health expenditure trends; Dentalcorp, second quarter 2025 results; CIRANO, private senior residences in Quebec (2024).
What's different about selling in healthcare
Selling a business in Quebec follows steps that are common to every industry. But in healthcare, the buyer isn't paying for inventory or machines — they're paying for an ecosystem of trust, tightly regulated practice licences, and recurring patient flow. Three issues structure the transaction.
The professional order decides who can buy
In Quebec, full ownership (voting shares) of a clinic is reserved for professionals registered with the relevant order. In dental, veterinary medicine and medicine, 100% of voting rights have to be held by members. In physiotherapy and optometry, the rule is more flexible: more than 50%.
For a corporate buyer, that forces an MSO — Management Services Organization structure. The corporate entity buys the assets (equipment, lease, commercial goodwill) and signs a management contract with the professional corporation, which keeps clinical responsibility and voting control.
EBITDA normalizes in reverse
In most SMEs, the owner's salary is added back to EBITDA. In healthcare, it's the opposite: it has to be deducted. If you generate $500,000 of clinical production while paying yourself dividends without a formal salary, the buyer will need to hire a practitioner to replace you — typically at 35 to 45% of production. Normalized EBITDA is what's left after that deduction.
Patient files are both the goodwill and a liability
The patient database is the heart of the clinical goodwill. But its transfer is subject to Law 25 and to each order's regulations on cessation of practice: notify the order, transfer files to a qualified custodian, send a written notice to patients. A digital, compliant clinic speeds up due diligence and justifies a premium; paper files create documentary friction at closing.
Special cases. In pharmacy, the P-10 Act locks the buyer pool to pharmacists: no MSO is allowed. In senior residences, the transaction covers two distinct assets (operating business and real estate) that follow different valuation logics — operating multiple or real estate cap rate depending on size.
Sources: Légis Québec, incorporation regulations of professional orders (D-3, M-8, C-26, O-7, P-10, M-9); Act respecting the protection of personal information in the private sector (Law 25); CIRANO, report on private senior residences in Quebec (2024).
Typical multiples
Valuing a healthcare SME starts with identifying the basis. For consolidatable professional clinics, it's normalized EBITDA (after deducting the owner's clinical replacement cost). For solo practices that depend too heavily on the founder, it's often a percentage of revenue — typically 70 to 100%. For structured senior residences, it's a real estate cap rate. Mixing these bases produces misleading gaps. Our analysis of valuation multiples by industry documents these gaps more broadly.
Multiple ranges — Consolidatable professional clinics
Base: Normalized EBITDA (after deducting the owner's clinical replacement cost)
Dental clinics (multi-practitioner, EBITDA > $500K)
Dentalcorp acquires at 6.3x on average (second quarter 2025 results, pro forma EBITDA after rent). EBITDA above $1 million attracts consolidators.
Veterinary clinics (general practice)
Stratified by size — about 5x for EBITDA of $500K to $1M, up to 8.5x for $1M to $5M. More than 20% of veterinary hospitals in Canada are corporate.
Veterinary clinics (emergency and specialty)
Specialization premium — high-volume referral centres are rare and heavily targeted by consolidators.
Optometry / physiotherapy platforms
Active consolidation — Lifemark (Loblaw), FYidoctors (370 locations, 22 acquisitions in 2025). Optometry benefits from the clinic + eyewear retail mix that lifts margins.
Indicative market benchmarks, not a price promise. Final value is established deal by deal: normalized valuation basis, transferability, sector-specific risks, deal structure and real buyer competition.
What pushes the multiple up
- Spread-out clinical production — multi-practitioner team, hygiene above 40% in dental, prevention plans. Revenue keeps coming when the owner steps back.
- A stable team of practitioners and regulated staff, tied by non-compete clauses — retention is the central argument for clinical continuity post-closing.
- Compliant digital files aligned with Law 25 and the order's regulations — no documentary friction, direct software integration for the consolidator.
What pushes the multiple down
- Production concentrated 80-100% on the owner — heavy discount, long transition window, earn-out tied to client retention. On very small solo practices, valuation falls back to seller's discretionary earnings (SDE).
- A corporate structure that doesn't comply with the order's requirements — voting rights misallocated, share transfers not framed by agreement. The buyer finances that risk through escrow or net price discount.
- Paper files or an obsolete information system — diligence friction, no access to the digitization premium.
Sources: Dentalcorp, second quarter 2025 results; FOCUS Investment Banking, healthcare EBITDA multiples 2026; First Page Sage, veterinary practice EBITDA multiples 2025.
Who buys healthcare businesses in Quebec?
The healthcare buyer market is dictated by two variables: the rules of the order governing the sub-segment, and the size of the business. Below a certain threshold, only professional successors are in the running; above it, corporate consolidators step in.
Who buys and why
Default buyer pool imposed by the professional orders. Dominant for solo practices and small clinics (EBITDA below $500K). In pharmacy, this is the only allowable profile (P-10 Act).
Dentalcorp, FYidoctors, Lifemark, VetStrategy. Target multi-practitioner platforms with EBITDA above $500K. Enter through MSO structures; buy typically at 6 to 8 times EBITDA.
Real estate investment trusts (REITs) and institutional real estate operators. Target large senior residences (100 units and up) with a real estate yield logic, not a clinical logic. Small senior residences generally fall outside the scope.
Indicative view of the buyer pool, not market data. Percentages show the relative weight of profiles to approach; the outcome of a transaction depends on file quality, process confidentiality and the competition created.
Concrete case — Axo Physio and Lifemark. In the summer of 2024, Groupe Santé Universelle (a Lifemark Health Group subsidiary, owned by Loblaw) completed the acquisition of Groupe Axo Physio — a Quebec network of ten clinics across the Capitale-Nationale and Portneuf regions. The goal isn't to fold the operations together on the ground: it's to plug the local patient flow into its national ecosystem of more than 3 million annual visits. The same logic applies, scaled down, to an independent neighbourhood clinic: corporate buyers prefer growth by acquisition over organic openings, especially when staff scarcity makes hiring slower.
Putting a corporate consolidator and a professional successor in competition, without exposing the clinic to local competitors or making the practitioner team walk away — that's a frame few practitioner-owners can carry on their own while continuing to see patients. That's exactly the role of a business broker in Quebec: structure the process, protect information, and bring the right buyers to the table.
Sources: KRB Lawyers, Groupe Axo Physio joins Groupe Santé Universelle (July 2024); Lifemark Health Group, Universelle expansion across Quebec (September 2025); Competition Bureau of Canada, self-regulated professions and ownership rules.
Frequently asked questions — Selling a healthcare business
Can a non-practitioner investor buy my clinic?
Not in voting control — except in physiotherapy and optometry, where the rule is more flexible (more than 50% of voting rights held by members of the order).
The professional orders (dentists, physicians, veterinarians) require all voting rights to be held by members. Corporate buyers get around that restriction through a management structure — an MSO (Management Services Organization). The corporate entity buys the assets (equipment, lease, commercial goodwill) and signs a management contract with the professional corporation, which keeps clinical responsibility.
One strict exception: in pharmacy, the Pharmacy Act (P-10) reserves ownership exclusively for pharmacists. No MSO is allowed.
Why do buyers prefer EBITDA over rules of thumb (% of revenue)?
Because the "85% of revenue" rule of thumb ignores operating costs. Two clinics with $1 million in revenue don't have the same value if one runs 25% margins and the other runs in the red.
On top of that, EBITDA normalization in healthcare is inverted: you have to deduct the owner's clinical replacement cost (typically 35 to 45% of their production) before applying a multiple. Without that adjustment, profits are artificially inflated and the valuation is disconnected from the market.
What happens to patient files when a clinic is sold?
Clinical files aren't commercial inventory. They're subject to Law 25 and to each professional order's regulations on cessation of practice.
The seller has to notify the order, transfer files to a qualified custodian, and send a written notice to patients. A digital, compliant clinic speeds up due diligence and justifies a premium; paper files create documentary friction at closing.
Do I have to stay on after the sale?
Almost always, yes. Buyers are buying your reputation and your trust relationship with the community.
Offers almost always include a retention clause of 12 to 36 months, during which you keep practising as an associate. A portion of the price (an earn-out) is often conditional on maintaining revenue during that window.