I feel the acquisition is more difficult.
As I work with smaller mental healthcare providers – an industry very heavily pursued by PE firms, you can definitely see a division in cultures which can impact the acquisition and integration.
From a healthcare perspective – the owners and clinicians are typically more emotionally attached to the business (as I believe most family businesses are also). Quite often the approach by PE firms are very cold and focused on numbers and metrics than on clinical matters, which can create frictions in the acquisition.
As an intermediary this is the part of the transaction you have to be privy of – the people and their emotions throughout the process.