Becker Business Podcast

Leadership Insights and Growth Strategies with Jim Feinstein of ENT Partners

Host: Scott Becker
Guest: Jim Feinstein
Date: December 3, 2025

Episode Overview

In this episode, Scott Becker interviews Jim Feinstein, a renowned leader in healthcare private equity and physician practice management. Their conversation explores Feinstein’s core leadership philosophies, strategies for scaling practices, balancing investor and physician interests, lessons from valuation pitfalls, recruitment challenges in healthcare, and views on current industry trends such as value-based care.

Key Discussion Points & Insights

1. Core Leadership Lessons

Timestamps: 00:49–01:58

• Empathy and Operational Discipline:
  Jim emphasizes the importance of leading with empathy blended with operational discipline. He believes these pillars drive positive culture and accountability, regardless of market conditions:

  "An empathetic leader or leadership team typically makes decisions for the right reasons, which helps create a positive culture."
  (Jim Feinstein, 00:49)

• Ownership and Accountability:
  Disciplined delegation fosters teams that feel empowered and responsible for outcomes.

2. Culture and Scaling Successful Practices

Timestamps: 02:37–05:14

• Entrepreneurial Physician Partners:
  Successful, scalable practices are led by entrepreneurial physicians who align in vision and remain engaged after partnering with corporate entities.

  "The scalable successful relationship starts with the entrepreneurial physician which typically has a culture and a practice with a wider and broader depth and breadth of ancillary services..."
  (Jim Feinstein, 02:37)

• Role of Corporate Partners:
  The best growth happens when the corporate partner functions as a supportive management consultant, helping realize and execute the founder’s vision without subsuming it.

  "It’s really a collaboration between the vision of the founder and having a diverse talented team to help support that growth strategy."
  (Jim Feinstein, 04:30)

3. Balancing Investors and Physicians

Timestamps: 05:14–08:09

• Valuation Discipline:
  Paying the right price is foundational—overpaying leads to difficult investor relations and jeopardizes future performance.

  "Sometimes walking away from a good deal becomes a better deal because it just doesn't fit the economic model from an IRR or an ROI perspective."
  (Jim Feinstein, 05:50)

• Transparent, Proactive Communication:
  Regularly alerting investors about “potential lurking landmines or surprises” is crucial. Data-driven discussions foster trust with physicians.

  "Nobody likes surprises, especially private equity investors... I pride myself on my ability to communicate effectively and proactively."
  (Jim Feinstein, 06:58–07:10)

  For physicians:

  "Leading discussions opportunities with data makes the process go much smoother. And I think the physicians have a lot more respect for a team and or leader that come prepared with data..."
  (Jim Feinstein, 07:50)

4. Lessons from Overpaying & Market Realities

Timestamps: 08:09–11:07

• Pitfalls of Overpayment:
  Overvalued acquisitions often lead to persistent financial difficulties, especially in low-margin sectors.

  "Some of the best deals are the deals you just walk away from because they're too expensive."
  (Jim Feinstein, 09:00)

• Growth Must be Realistic:
  Buying a practice only makes sense if there’s real potential for growth (new services, more providers, or better margins), not just cost-cutting.

  "You're not going to cut costs to growth and we pride ourselves at our ability to grow these practices double digits every year post close."
  (Jim Feinstein, 10:13)

5. Physician Recruitment Challenge

Timestamps: 11:07–13:44

• Growing Difficulty Filling Rural Positions:
  Despite strong historic practices in non-metro areas, recruiting new providers to these locales is increasingly difficult—even generous incentives sometimes fail.

  "We're seeing significant signing bonuses...and still an inability to recruit into those marketplaces."
  (Jim Feinstein, 11:39)

• Market Selection Is Key:
  Selecting practices in attractive regions is now more important than ever due to these trends.

  "Choosing assets in the markets where recruiting will not be an issue is going to be ever so more important moving forward..."
  (Jim Feinstein, 12:33)

6. Industry Trends: Underrated and Overrated

Timestamps: 13:44–16:19

• Underrated:
  Persistent, proactive recruitment—always “lines in the water”—is crucial as labor market tightens.

• Overrated:
  Value-Based Care (VBC): Jim finds that while VBC is much discussed, it may be overemphasized in terms of practical impact and momentum, especially given hospital self-selection and payer relationships.

  "I think the focus and attention on value based care is I think losing momentum and falls into that overstatement category for me."
  (Jim Feinstein, 14:33)

  Scott agrees, questioning whether fee-for-service isn’t just as value-focused in practice.

  "I think it's an insult to those that are doing fee for service medicine that believe they're actually giving value for care."
  (Scott Becker, 16:09)

Notable Quotes

• On Leadership:

  "An empathetic leader or leadership team... helps create a positive culture."
  (Jim Feinstein, 00:49)

• On Scaling Practices:

  "The scalable successful relationship starts with the entrepreneurial physician..."
  (Jim Feinstein, 02:37)

• On Walking Away from Bad Deals:

  "Some of the best deals are the deals you just walk away from because they're too expensive."
  (Jim Feinstein, 09:00)

• On Recruitment Crisis:

  "It's virtually impossible. We're seeing significant signing bonuses... and still an inability to recruit into those marketplaces."
  (Jim Feinstein, 11:39)

• On Value-Based Care:

  "I think the focus and attention on value based care is... losing momentum and falls into that overstatement category for me."
  (Jim Feinstein, 14:33)

Memorable Moments & Speaker Dynamics

• Candid Take on Industry Buzzwords: Jim offers a refreshingly direct perspective on value-based care, sparking full agreement from Scott.
• Honest Reflection on Mistakes: Feinstein openly discusses past errors and their consequences (“making those mistakes early in my career...” (09:00)), adding relatability and credibility.
• Shared Frustration About Recruitment: Both speakers note the growing urgency of recruitment challenges and express concern for the system’s future.

Important Segments & Timestamps

• Leadership Core Principles: 00:49–01:58
• Scaling Practices: Common Factors: 02:37–05:14
• Investor vs. Physician Balance: 05:14–08:09
• Lessons on Valuation & Deal-Making: 08:09–11:07
• Provider Recruitment Realities: 11:07–13:44
• Overrated/Underrated Trends in Health Care: 13:44–16:19

Summary

This engaging, insight-rich episode provides invaluable guidance on how to lead and grow physician practices amid shifting healthcare and financial landscapes. Jim Feinstein’s blend of empathy, operational rigor, and hard-earned wisdom supplies actionable advice for leaders, investors, and anyone navigating the physician practice industry. Both host and guest maintain a frank, collegial tone, providing both practical solutions and candid critiques of industry dogma.