Executive Search for Private Equity in the Healthcare Market

Each investment case is based on two assumptions: a market thesis and a management thesis. The market thesis can be proven with data, comparison groups and scenarios. The management thesis – whether the existing team can carry the outlined appreciation path – is much harder to grasp, but often decides on the outcome of the holding period. Therefore, a structured management due diligence does not check personality in general, but the conformity of ability profile, experience history and leadership behavior with the concretely planned value increase levers.

Specifically, these are questions such as: Who has really been responsible for what results in comparable situations, who has led add-on integrations operationally, who can withstand reporting discipline towards institutional investors, who has ever accompanied an exit? This assessment results in clean options: Strengthen existing management, complement it in a targeted manner, or plan a follow-up at an early stage – each with a clear time window and governance consequences.

The first 100 days after closing are rarely the moment for symbolic immediate action and usually the moment when it is decided whether the value creation roadmap wears at all. This phase is about keeping the existing operations stable, establishing reliable reporting, visibly synchronizing priorities of the investor and the management and sobering the critical decisions – CFO change, establishing an integration officer, strengthening sales, succession at individual locations.

Speed does not mean actionism here, but clear order: first tender the roles that carry the greatest value creation leverage, then the roles that reduce risks, then the roles that structure the organization for the later exit. Errors in this order can be corrected later only with additional costs.

Clean governance is not a formalism in the PE environment, but the framework in which value creation takes place at all. The G20/OECD Principles for Good Governance explicitly assign responsibility to the Board for the selection of the CEO and, where appropriate, other key positions, as well as for remuneration, supervision and succession planning [1]. For PE-held portfolio companies, this means that the board, usually composed of investor, chairperson and independent members, decides on CEO selection and succession, not a single deal partner ad hoc.

As an overarching governance principle, it is worth looking at the supervisory practice of institutional investors themselves. In 2025, the European Securities and Markets Authority (ESMA) launched a joint supervisory action on compliance and internal audit functions of alternative investment fund managers; it is aimed at AIFMs, i.e. fund managers, and not at portfolio companies, but shows the importance of clear control and audit lines in institutional structures [2]. For governance in the portfolio, this principle translates into robust responsibilities for finance, compliance and reporting – and into a board practice that actively requires these functions.

What a PE-held company needs in terms of leadership visibly changes with the investment phase. Early holds focus on integration strength, reporting discipline and implementation of the first value creation leverage; Here, CFOs with documented PE experience and integration officers often wear, making add-ons a workable whole.

In the mid-stage — expanding sales, internationalizing, building additional locations — the need shifts to COOs, chief commercial officers and country managers who are operationally scaling. In the late stages, when exit readiness comes to the forefront, resilience of numbers, portfolio clarity and the ability to present a professional management team to potential buyers or capital markets become crucial. Buy-and-build strategies reinforce this rhythm because each add-on changes the requirements for leadership structure, reporting and governance once again.

A search process for private equity is resilient if it takes the investment case seriously. The roles and appreciation of each position, documented PE experience of the candidates, guided integrations, handling of institutional reporting, exit experience and cultural fit to investor and chairperson must be clarified.

Equally important is a transparent assessment basis: search and assessment need the same pre-agreed evaluation criteria, which are documented to the Investment Committee and Board. Optional certified aptitude diagnostics complements personal judgment without replacing it. Confidentiality towards acting management members, structured reference work with former PE supervisors and peers, and clear governance of the selection process are standard.

Investment Committee and Board can measure each search process against a few questions. Does the role description cover exactly the value creation leverage for which it was written — or does it depict a historical organization chart? Is it clearly documented which experience can actually be proven in comparable situations, instead of general industry membership? Is the process designed to keep incumbent management members confidential without undermining board governance?

Next: Does the planned compensation structure fit the holding period, exit scenarios and what the market pays for comparable roles? Are the same pre-agreed evaluation criteria documented for search and assessment? And finally: Does the consultant process the mandate personally – or is it passed on internally? Hannes Sommer works for this very reason mandate-based and with a maximum of three parallel searches.

Private Equity investments in the healthcare market win or lose along the lead. Anyone who understands management due diligence, first 100 days, board building and exit readiness as a coherent management work – and not as isolated individual mandates – creates the basis for the investment thesis to actually be translated into value. A search process that knows these connections, is personally led and takes governance seriously is not a freestyle, but part of the investment case.