Sometimes you just gotta pull yourself up off the couch, brush off the crumbs, and say, "Dang it, I ain't gonna take it no more!" So when fellow Fool Seth Jayson slaggedPainCareHoldings
First of all, let's start with some full disclosure. PainCare is a risky stock -- probably the riskiest stock I own today. Given my investments in biotech and energy tech, that says something. Since I hate going to casinos and I'm something of a tightwad, investing a small amount of cash from time to time in highly risky stocks is my way of living vicariously.
But enough about me -- what about the business at PainCare?
PainCare is riding a wave that is only beginning -- an increasing recognition of how prevalent chronic pain can be and an increasing intolerance among patients to just "grin and bear it." It is estimated that somewhere around 30 million people suffer from chronic pain in this country, and that adds up to a $100 billion market for pain treatment. Baby boomers are getting older and more prone to pain-inducing ailments; add that in, and you can see the growth potential.
While there are competitors in the field already, including companies like AmSurg
What's more, there are an increasing number of options for treating pain. Companies like Advanced Neuromodulation Systems
Now, there's absolutely no question that PainCare derives a lot of its growth from acquisitions, though investors shouldn't overlook or underestimate the contracted practice management business. There's also no question that those acquisitions have led to dilution.
But I'd argue that it takes money to make money, and 33% fully diluted earnings-per-share growth is OK by me for now.
PainCare has also been following a pretty sound and disciplined strategy with its acquisitions -- it's targeting only quality practices and paying about five times trailing operating income. In addition, "clawback" provisions reduce the price if certain performance targets aren't met. What's more, PainCare focuses on boosting margins at its acquired practices and adding in ancillary services to boost revenue. This is no simple "hack and slash" acquirer that achieves growth through cost-cutting.
Now, is it possible that this is all smoke and mirrors and that things aren't as good as they seem? Well, looking back at the Enrons, WorldComs, and HealthSouths of the world, I suppose the answer has to be "yes, it's possible." But isn't that true, on some level, of almost any small growth company?
Given that I'm convinced pain won't go away, I'm sticking by PainCare for now. The growth is there, the valuation seems reasonable relative to that growth, and I love the concept behind the business. That doesn't make the stock automatically right for you, but I do think aggressive investors with a little streak of speculator in them might want to roll up their sleeves and do some due diligence of their own. If you have to incur pain to make a gain, maybe you can gain from pain.
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