You don’t need 47 sub-accounts for supplies. You need clean, consistent, reliable data. Excess complexity leads to inconsistent coding, noisy reports, and financial statements you stop trusting. Once that happens, your accounting becomes a compliance exercise instead of a decision-making tool.

You may be one of the best clinicians in your city. But if your financials are unclear, inconsistent, or undocumented, buyers don’t see a business. They see a high-paying job that disappears when you leave. And you can’t sell a job.

The practice had an office manager who had been with them for years. She was a good worker. Reliable. Familiar with the systems and trusted by the team. Like many long-tenured employees, she wasn’t perfect. She could have used a small attitude tune-up, but overall, she did the job and kept the office moving. There were no major red flags.

The office thought they had struck gold. Billing had been a persistent pain point, so when a coder applied claiming nearly twenty years of experience, strong confidence, and fluency in all the right terminology, it felt like the solution they had been waiting for. The interview went smoothly. The résumé looked solid. The explanations sounded convincing.

For practices, this can be an unexpected hiring pipeline. For students like her, it’s a head start on adulthood. Real responsibility. Real skills. Real confidence earned early. That doesn’t mean every homeschool student is a fit. Just like any hiring pool, you still need structure, training, and clear expectations. But it does mean many practices may be overlooking capable candidates simply because they don’t match the traditional profile.

Years ago, while managing a team of about 15 people in Phoenix, one of my employees, Carol, said something that stuck with me. She told me my office was messy. Not in a rude way. Not critically. Just honestly. She said it didn’t match how professional I was—or how professional I should be—and that it felt beneath me. She wasn’t attacking my work. She was pointing out a disconnect between how I showed up as a leader and the environment I allowed around me. She was right.

Bringing on a partner can be one of the most powerful growth moves a business makes. It can also be one of the fastest ways to damage trust if it is done on top of a messy financial structure. In this case, the business is preparing for a potential partner buy-in during a period of rapid growth. Revenue is strong. Demand exceeds capacity. Expansion has raised the fixed-cost baseline. On paper, the opportunity looks attractive.

But refinancing is neither good nor bad, it’s a tool. Used thoughtfully, it can stabilize a growing business under pressure. Used carelessly, it can quietly magnify risk and delay problems until they’re harder and more expensive to fix.

Most office managers have felt the pressure to track everything. New fields get added to intake forms. New spreadsheets appear. Reports multiply. Before long, every patient interaction seems to require ten extra clicks.

Most practices believe they’re doing an adequate job with referral tracking. There’s a “How did you hear about us?” field. There’s even a report you can run. On paper, it looks fine. But when you compare that report to reality, cracks appear. Practices often discover they had hundreds of new patients last year—yet only a fraction have a referral source recorded. The rest are blank.

Every day, office managers and administrative teams make dozens of micro-decisions: categorizing an expense correctly, attaching proper documentation, reconciling schedules, or flagging an unusual transaction. Any one of these actions may seem trivial in isolation. But together, they determine whether leadership receives clean data, whether month-end closes are smooth, and whether strategic decisions are based on reality rather than guesswork.

As medical and dental practices grow, expanding into multiple locations—or consolidating several entities under one tax ID—often feels like a smart operational move. But there’s a common downside that shows up quietly and then all at once: the numbers get blurry. Money flows into one bank account, expenses hit from every direction, and soon no one can confidently answer a basic question: Which location is actually performing well?

Most office leaders agree on one thing: their teams need better financial skills. Fewer agree on how to make that happen.

Clinically, the treatment may be identical. Emotionally, these are completely different journeys. When a future patient watches your content, they’re not asking, “Do I also have this diagnosis?” They’re asking “Is this person like me?

Here’s the key insight most practices miss: "A one-patient day is not a production day." Start with math. If vacations, holidays, or light schedules reduced capacity, fix the calendar first. If APC is drifting, look at coding, pricing, and operational consistency. If new-patient numbers are soft, that’s a marketing and access issue, not a clinical one.

When financial or performance data shift after the fact—even slightly—it creates anxiety for doctors, disrupts payroll accuracy, and weakens leadership’s ability to make informed decisions. Yet many practices unknowingly operate with reporting processes that produce unpredictable results. And the fallout isn’t small. It affects morale, decision-making, and even the culture of trust inside the practice. This article breaks down why reporting instability happens, the operationa

When cash flow starts to pinch, most practice owners look outward—new marketing campaigns, new devices, even expansion plans. But the fastest way to boost cash flow isn’t out there. It’s inside your existing patient flow. The key is your Average Patient Charge (APC)—the amount you actually collect per visit.

All adjustments fall into two categories. Knowing which is which helps you separate what’s normal from what’s fixable. Contractual Adjustments These are the discounts you’ve agreed to with insurance companies. They’re built into your payer contracts and are part of the cost of doing business. They can’t be avoided—and they shouldn’t be feared. Think of them as the difference between your retail price and your contracted price. Write-Offs Write-offs are different

Many small healthcare practices run at or near break-even once you account for the fair cost of the owner’s work. On paper, it might look like a solid operation: Years of service to the community Loyal staff and steady patients A history of “profitability” But once you normalize expenses—especially provider compensation—the math often changes.

Many medical offices glance at their billed charges and assume that’s their income. It’s not. The real measure of your financial health is your Average Patient Charge (APC). Average Patient Charge tells you how much money you actually collect per patient visit, not what you billed. It’s the difference between thinking your practice is profitable and actually knowing it is.