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.

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.

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 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.

Debt in medicine often carries stigma. Many providers view it as a sign of overreach or mismanagement. In truth, debt itself is neutral—it’s the structure of that debt that determines whether it becomes a burden or a catalyst. Smart financing doesn’t weaken a practice; it strengthens it—when guided by strategy and discipline. That’s the essence of a debt detox: not avoidance, but alignment.

When you hand over your practice, you’re not just transferring assets—you’re transferring identity.Your successor inherits more than a patient roster and a revenue stream. They inherit your name on the door, your standards of care, and the trust your community has placed in you. That inheritance is sacred—and one wrong hire can erode it faster than any market downturn or billing error. Finding the right successor isn’t just a business decision; it’s the hardest hire you’ll e

When your “visit” metric mixes provider work with ancillary services, your data stops reflecting reality. Staffing plans, clinician compensation, and even hiring decisions all become distorted.

When most healthcare owners hear “debt consolidation,” their first thought is usually more paperwork. In reality, smart consolidation is one of the most powerful cash-flow tools a practice can use. It turns scattered obligations into a single, predictable payment—freeing up time, capital, and mental bandwidth.

Great CFOs are not just data collectors; they are energy allocators. They design reporting systems that are efficient, not exhaustive. For example: Track payroll by department, because it’s significant and actionable. Estimate rent by square footage, because precision there adds little insight.

Too often, practices treat accounting like a project with a finish line: set up QuickBooks, build a few reports, and call it done. But six months later, the questions have changed — and the numbers no longer tell the full story. Your business has evolved. Your accounting should too.

Therapy, psychiatry, assessments, and telehealth all depend on the same space and staff, yet contribute differently to the bottom line. And here’s the hard truth: there’s no perfect way to allocate shared costs. Every method has tradeoffs. That’s okay. Because the goal of cost allocation isn’t mathematical perfection—it’s managerial clarity. The moment you chase “perfect,” you risk making your finances so complex that they stop being useful.