Who Will Inherit the Exam Room How Enventure is Bridging the Primary Care Succession Gap

By Street Register 

When Dr. Mehta closed the doors of his family clinic in rural Ohio after 32 years, the loss rippled far beyond his practice. His patients—many elderly, many on Medicaid—were left without local care. His daughter, a newly minted dermatologist, chose the coasts and a specialty with better work-life balance. There was no successor. No plan. Just an empty exam room.

Multiply this story across thousands of American towns, and you begin to see the dual crisis gripping U.S. healthcare: a growing shortage of primary care physicians and a succession vacuum among family-owned clinics.

According to the American Medical Association, nearly 1 in 5 physicians plans to leave the profession in the next two years. The American Association of Medical Colleges forecasts a shortfall of up to 48,000 primary care doctors by 2034. These numbers are dire on their own—but become even more alarming in light of the fact that almost 40% of family-run practices lack any formal succession plan.

Enter Akit Shrivastava and Enventure

Amid these converging threats, one name is emerging as a quiet force for continuity: Akit Shrivastava, founder of Enventure, a cross-border advisory and investment firm operating in both the U.S. and India. Unlike traditional private equity firms that prioritize profit extraction, Enventure’s mission is preservation—preserving legacy, care continuity, and the local trust that many small clinics have built over decades.

“We're not just looking at spreadsheets—we’re looking at lives, communities, and institutions of trust,” says Shrivastava. “The collapse of a clinic isn’t just a business failure. It’s a healthcare access crisis.”

Enventure helps founders professionalize their operations, prepare for leadership transitions, and introduce new care models that reduce physician burden while maintaining quality. Their approach often includes co-ownership models, where founders stay engaged during transition periods, ensuring stability for patients and staff while enabling operational transformation.

Bridging the Gap with Innovation and Sensitivity

A key component of Enventure’s strategy is integrating team-based care, leveraging nurse practitioners and physician assistants to offset physician workloads. But Shrivastava is quick to note: restructuring care teams only works when paired with investment in workflows and digital systems—something small practices often struggle to implement alone.

With deep operational roots in India and the U.S., Enventure is also uniquely positioned to assist immigrant-founded clinics, where cultural dynamics, family expectations, and financial planning must all be delicately balanced. In many of these practices, the next generation is not entering medicine—making external leadership planning essential.

“We treat succession like we treat clinical care: early intervention leads to better outcomes,” Shrivastava adds.

A Structural Challenge, A Strategic Opportunity

Despite the growing dominance of hospital systems, independent clinics still outperform on many patient care metrics, particularly in chronic care management, according to a 2022 Health Affairs study. And yet, these practices are vanishing—often not due to poor care or finances, but because there’s simply no one prepared to take the reins.

Shrivastava believes the solution to America’s primary care crisis lies not only in medical school recruitment or reimbursement reform—but in succession planning as a pillar of health policy.

As small practices age out, Enventure’s work is proving that sustainable transitions are possible—ones that maintain trust, modernize operations, and preserve access to care for the communities that need it most.

Because if no one inherits the exam room, patients inherit the burden.