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.

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.

Every multi-location practice eventually faces the same question: do we keep separate tax IDs, or merge into one? A common mistake: merge first, figure out reporting later. Revenue and costs pool together, and suddenly managers don’t trust their P&Ls. Without guardrails, every “why is this site underperforming?” conversation turns into guesswork. The good news: this is fixable with the right design up front.

Too often, practice owners assume that if their QuickBooks is reconciled and their CPA is satisfied, the financial side of the business is “good enough.