Booth Healthcare Advisory

When a Portfolio Company Isn't Performing, You Need an Operator — Not Another Advisor.

I embed directly with portfolio company leadership to diagnose execution breakdowns, stabilize performance, and build the operating infrastructure that sustains value creation through your hold period.

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How I Engage with PE Firms

Four engagement structures — each designed around a specific stage of the investment cycle.

01

Embedded Operating Partner

6 – 18 months

Ongoing, dedicated operational support for a portfolio company through a defined engagement period. I work inside the business — not from the outside looking in.

  • Embedded directly with the leadership team
  • Weekly cadence with deal team and board
  • Full operational accountability for defined outcomes
  • Structured 30/60/90 day performance milestones
02

Interim Operational Lead

3 – 9 months

Step in as interim COO or operations executive to stabilize a platform, bridge a leadership gap, or lead a turnaround. Transition to permanent leadership when appropriate.

  • Immediate operational continuity — no ramp-up lag
  • Stabilize performance while permanent search runs
  • Define the role and requirements for the permanent hire
  • Transition with full documentation and handoff
03

Pre / Post-Acquisition Support

Project-based

Operational due diligence before close; integration planning and execution post-close. Reduce operational risk at the most critical moment in the investment cycle.

  • Operational assessment of target before LOI or close
  • Identify execution risk, leadership gaps, and margin leakage
  • Build 100-day integration plan post-close
  • Stand up accountability and reporting infrastructure
04

Portfolio Performance Advisor

Ongoing / periodic

Periodic engagement across multiple portfolio companies — performance reviews, leadership assessments, operational gap identification — without a full-time commitment to any single asset.

  • Quarterly or monthly performance reviews across portfolio
  • Early identification of execution and leadership risk
  • On-call escalation support for high-priority situations
  • Consistent operational lens across all holdings

Common Situations

These are the triggers that typically start the conversation.

Missing EBITDA TargetsA portfolio company is missing targets and management cannot identify the root cause.
Inconsistent Location PerformancePerformance varies significantly across locations — some markets work, others don't.
Post-Acquisition Integration StrainA recent acquisition has created integration challenges and leadership misalignment.
Growth Outpacing InfrastructureGrowth has outpaced operational infrastructure and margins are compressing.
Key Executive DepartureA key operational leader has departed and continuity is at risk.
Physician Alignment BreakdownPhysician alignment is weakening and hospital partner satisfaction is declining.

If your platform isn't performing, it's fixable.

If you have a portfolio company that is underperforming, approaching a growth inflection, or navigating a leadership transition — let's have a direct conversation. No pitch deck. No generic framework. Just a clear discussion about what's happening and what can be done.

Or reach me directly: don@boothhealthcareadvisory.com

Schedule a Conversation

Booth Healthcare Advisory

Don Booth

Operational turnaround and executional partnership for PE-backed and physician-led healthcare organizations.

Engagements

Operational TurnaroundMulti-Site OptimizationPhysician AlignmentGrowth InfrastructureEmbedded Operating PartnerInterim Operational Lead

Sectors

CardiovascularEmergency MedicineAnesthesiologyHospital MedicineAmbulatory SurgeryWound CareMultispecialty Clinics

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