“So is it fair to call Ascend a rollup?”
"You know what? I really hate that term."
That’s David Wurtzbacher, CEO of Ascend, responding to my characterization of his PE-backed accounting firm on the Earmark Podcast.
David doesn’t like the term “rollup.” That’s because when most people hear "private equity rollup," they think of corporate dentistry pushing unnecessary procedures, or emergency room doctors complaining about profit-driven quotas.
The PE playbook in accounting is similar: acquire firms, cut costs, maximize billable hours, flip in 3-5 years. It’s great for EBITDA, but not always for the people who work there.
David's doing something different.
Before starting Ascend, he built Lightwave Dental as the "anti-corporate dentistry" company. While other PE-backed dental chains pushed doctors to diagnose more aggressively and use cheaper overseas lab work, David refused to compromise clinical autonomy for profit.
"We said we are never going to do that ever," he told me. "Are we going to make less money than someone who does do those things? Yes. But the whole point was to have happy dentists."
Now he's bringing that same philosophy to accounting. When I asked recent comparisons between accounting and medicine under private equity, David didn't dismiss the concerns.
"I think you are right to be worried," he said candidly. "The reputation of private equity is not unwarranted."
But David also believes that PE-backed firms can be great places to work. And that’s what he’s building at Ascend.
So what makes Ascend different?
Time horizon: While most PE firms flip investments in 3-4 years, David thinks in decades. He says, "I'm 37 years old. This very well could be the last thing I do."
Firm independence: Firms keep their names, brands, client relationships, and strategic autonomy. No forced consolidation into a single brand.
Employee ownership: Ascend offers equity to managers and senior managers across their firms.
Professional judgment: Like in his PE-backed dentistry business, David respects the professional autonomy of the CPAs working at the subsidiary firms.
The results? Firms that were struggling with capacity constraints now have solved their talent problems. Managing partners who were stressed and overwhelmed have transformed into energized CEOs. The firms are growing revenue without burnout.
"We want to have the most engaged employees in a profession that we have revitalized," David explained.
To me, it sounds like the best aspects of the partnership model enhanced by the resources and scale possible under a corporate model.
Check out Episode 91 of the Earmark Podcast for the full conversation.
