Anatomy of a search success
Metro Vein Centers
A nine-year climb, one clinic at a time
In 2017, we acquired a small family of vein clinics with a thin footprint and an unproven model. There was no roadmap for what came next. Nine years later, Metro Vein Centers is 80+ nationwide clinics strong with no signs of slowing down.
What follows is the story of how our dynamic team turned Metro Vein into one of the most successful outcomes in search fund history—built almost entirely through de novo growth and an obsessive commitment to patient experience.
The story
How a dream team broke the mold, in their own words.
Watch us grow
Clinics Opened
Patients Served
Five-Star Reviews
Visits per state
2017
Buying the company
Acquired a small varicose vein treatment practice for $9m. The idea seemed simple enough: build a great healthcare company and expand it nationally. The first lesson came quickly. Buying a company and knowing how to run one are very different skills. The original plan would be rewritten many times in the years that followed.
2018
Learning what we bought
As Metro Vein grew, deeper problems began to surface. Operational weaknesses, clinical issues, management gaps, and inherited problems made the clinics far more complicated to run than they first appeared. Growth remained slow as we learned what worked, what did not, and why.
2019
Growth meets reality
Problems were compounding. Legacy lawsuits, insurance audits, clinical issues, physician departures and unprofitable clinics were taking a toll. Eventually, cash overwhelmed every other problem, with Metro Vein burning $1.5m a month.
2020
Starting over
Reduced the workforce by 80%, replaced management, closed underperforming clinics, and defaulted on the bank debt. Working alongside frontline teams from the Long Island City call center, we stopped trying to preserve everything we had inherited, and focused on what was actually worth saving. What worked stayed. What did not was rebuilt. Mistakes became lessons, and lessons led to better decisions.
2021
Finding what works
Once the business stabilized, the focus shifted to understanding why some clinics performed better and turning those lessons into a repeatable model. Launched a fully bilingual patient experience, improved digital patient acquisition, and added personal touches such as handwritten welcome and thank you notes. Act, observe, learn, improve, repeat. That cycle became our operating model.
2022
Developing a service culture
Great patient care could not rely on a handful of exceptional people. It had to be consistent across every clinic and every interaction. The patient journey was reimagined from start to finish. The real lesson was that every aspect of the business ultimately shows up in the patient experience.
2023
Building the growth engine
Standardized the de novo playbook and doubled the clinic footprint. Growth could no longer be improvised. Hiring, training, systems, and operations had to be codified into a repeatable model. The challenge was no longer proving that one clinic could work. It was building an organization capable of doing it again and again.
2024
Scaling through people
Built the leadership team and a system for recruiting and training physicians based on values and potential, not prior vein experience. Better operating data and faster feedback surfaced problems earlier, empowering teams to respond quickly. The company was learning to develop people and improve at scale.
2025
Empowering others to lead
Built out leadership across every core function and empowered teams to improve their pieces of the puzzle. Delegation became less about assigning tasks and more about enabling talented people to succeed. The goal was no longer to solve every problem. It was to build teams that could solve them better.
2026
From business to institution
On track to be our fastest year of expansion yet. What once depended on a few of us is now institutional capability at scale: opening clinics, attracting patients, improving performance, and recruiting, training, and retaining exceptional physicians. Those closest to the work have the input and ownership to test new ideas and solve problems. Leadership’s role is to recognize and expand the reach of what works.
2027
Built to keep getting better
Next chapter is about building a platform that keeps growing and improving without depending on any one person. For searchers, the journey begins with acquiring a business. The ambition is to build one that keeps getting better long after the search is over.
Andrew Provost
CEO, Metro Vein Centers
“Metro Vein’s growth is a product of determination, ingenuity, and the right partnership. As someone who lived it alongside him, I know just how well Dmitri knows what it really takes to grow something successful and resilient from humble beginnings. If you're serious about building something real, talk to him.”
Dmitri Ivanov
Managing Partner, TBD
“Building Metro Vein taught us that exceptional companies are built by extraordinary people who are trusted to take ownership, challenged to grow, and given the opportunity to do the best work of their lives. We don’t pretend to have all the answers. Our role is to share what we’ve learned, ask thoughtful questions, and be there on the hard days so the searchers we back can build great teams and companies in their own way.”
We search for operators with heart
We are operators first, proven in the field, not just on paper. We build differently by fueling insight, creativity, endurance, and the type of innovation that comes from hands-on work and courage.
See how we operate