The model of PE in dentistry / veterinary clinics is to buy out all the private clinics in a region, then gradually raise prices. Small businesses would pop up, but the training horizon for new dentists / vets is quite long.
It isn't really about economies of scale so much as using local monopolies to set prices. They have a good moat because regulatory bodies have not regulated monopolies for 30 years, and professional organizations limit entry to each field.
It isn't really about economies of scale so much as using local monopolies to set prices. They have a good moat because regulatory bodies have not regulated monopolies for 30 years, and professional organizations limit entry to each field.