Alex and Wayne interview Brad Smith of Vertes, a healthcare M&A firm focused on DME/HME, to discuss the grow-vs-sell decision and current market dynamics. Brad shares his background building a Texas DME company, expanding from mobility into oxygen via acquisition, completing a private equity recap in 2004, pursuing a continuum-of-care acquisition strategy, and ultimately selling after Medicare competitive bidding in 2008; he then shifted into transaction work and co-founded Vertes. He describes how acquisitions can be faster and less risky than organic growth and stresses transaction nuances and buyer protections. Brad notes 2020–2022 were boom years with higher valuations, 2023–2024 saw declines, and 2025 feels normalized but uneven; smaller DME valuations are lower unless there’s scale or a niche. He advises sellers to avoid single-buyer situations, focus on cash flow and strong teams, and says private equity-backed platforms will keep gaining share.