When a DSO calls, the number they lead with is built to get your attention, not to tell you what the deal is worth to you. Before you decide anything, get clear on what you actually want from a sale.
If your goal is the most cash possible right now, weigh the offer against what a private buyer would pay and how much of the DSO price is guaranteed at close versus tied to future performance. If your goal is to keep practicing with the admin burden lifted, the employment terms matter as much as the price. If your goal is a clean exit on your timeline, the transition period and non-compete are the whole ballgame.
Read the structure, not just the multiple. Most DSO deals price off EBITDA, and a meaningful share of the total often comes as equity or an earnout that depends on the practice hitting targets after you sell. That money carries risk the headline number hides.
Then read the life terms. How many years must you stay, at what pay, with how much clinical and hiring autonomy. A strong price with three years of terms you would hate is not a strong deal.
The one thing that makes all of this easier: knowing your own number before you answer. When you already know what your practice is worth and what a fair structure looks like, you can tell in one read whether the offer is worth a conversation or a polite no.