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April 1, 1998

A Prescription for Growth?

By Stephen Lacey

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  • A Prescription for Growth?

Physician practice-management companies (PPMs) first stormed the initial-public-offering market in the mid-1990s, promising to consolidate highly- fragmented medical specialties and to reduce operational costs.

A juicy story, to be sure, given that public companies still only control about ten percent of physicians' practices. High expectations, however, were soon followed by monumental disappointments, leaving a foul taste that still sours the industry. As a result, few sectors have faced more resistance from the capital markets, or been as volatile in the aftermarket than PPMs.

"A lot of factors have contributed to this," said Minneapolis-based Piper Jaffray analyst Brooks O'Neil. "These include very early-stage consolidation among young, fast-growing companies, limited information technology and high investor expectations."

Coastal Physicians (NYSE:DR) and Physician Resources Group (NYSE:PRG) are perhaps classic examples of companies that failed to fulfill investor expectations.

Coastal Physicians priced 3 million shares at $11 1/2 in June 1991 through a syndicate led by Smith Barney Harris Upham (now part of Wall Street giant Solomon Smith Barney), climbing to $40 1/4 in 1994. Heavy debt whittled away most of the gains in the second half of 1995. The stock recently closed trading at three-quarters of a dollar.

Physician Resources Group, a Smith Barney-led June 1995 IPO priced at $13 a share, suffered the wrath of investors for a different reason no intrinsic value gained as the company expanded. In 1996, the Dallas-based operator of ophthalmic and optometric practices acquired 140 practices for about $500 million, financed in large part through the company's strong stock price.

"They grew too fast and were never able to really add value to the practices," said one industry analyst, who requested anonymity.

During the acquisition spree in June 1996, the company's stock peaked at $33 3/8 before investors had second thoughts after the company's poor 1996 second-quarter operating results were posted. The stock recently closed at $4.

Despite the appetite for additional capital among PPMs, such horror stories have made it difficult, if not impossible, for underwriters to drum up support for proposed offerings. In 1997, three companies were unable to attract sufficient investor interest, despite the fact that 13 PPMs were previously able to price IPOs, raising $369.4 million in capital.

In the fourth quarter of 1997, Dentalco postponed its Morgan Stanley Dean Witter, Discover & Co.-led offering, citing market conditions. In December, First New England Dental withdrew its proposed $27.6 million offering, through New York-based Furman Selz.

Pentegra Dental (AMEX:PEN), which originally filed its intent to go public in October with Lehman Brothers in New York serving as lead for the deal, is making another run at the public markets with Minneapolis-based Dain Rauscher, the deal's former co-manager, serving as lead.

"Unfortunately, it's set at a pretty low valuation," said Wade Massad, director of equity syndication at Dain Rauscher, referring to the deal's proposed $5 to $7 asking price.

Still, all is not pessimistic. Massad for one, sees a silver lining. "This [latest deal] is slowly but surely coming along," he said. "If you look at how these [PPMs] have performed over time, they have done pretty well."(Pentegra Dental was slated to price the week of March 23, according to Massad.)

Through the close of trading on March 27, the average return for last year's 13 IPOs within the sector stood at 33.23 percent above offering.