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.

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 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 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

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 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.

You can rebuild pricing for any procedure in under fifteen minutes using four building blocks: Consumables – List items consumed per case and calculate true per-unit cost, including wastage. Labor – Convert provider and staff minutes (including setup and documentation) into cost. Commission/Performance Pay – Factor in any incentives or case-level bonuses. Overhead Spread – Allocate the fair share of rent, admin, marketing, and software costs. Once the math is done, add your t

When growth stalls, the reflex is usually: “We just need more customers.” Sometimes that’s true. More often, it’s not. Most businesses don’t grow by piling on volume—they grow by pulling one of three levers: Capacity, Price, or Patient Mix. The real challenge is identifying which lever matters right now, then focusing relentlessly on it for the next 30–90 days.

CFOs help you make better decisions about the future: pricing, capacity, cash, and risk. Both are essential. They’re just not the same. Think about it like a vehicle. A CPA is the licensed mechanic who ensures your car is safe and road-legal. The CFO is your crew chief and navigator—choosing routes, pit stops, and race strategy. If you keep asking the mechanic why your lap times are slow, you’ll get great maintenance…and no improvement plan.

Seasonality isn’t a surprise—it’s a system. The sooner you treat it as such, the sooner your clinic can win every month of the year.

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.

Picture this: the seminar just ended. The speaker was dynamic, the slides were sharp, and the energy in the room was electric. You walk out with a thick notebook of ideas, convinced the next quarter will be different.

Beyond revenue and expenses, three often-overlooked factors tell a powerful story about a practice’s financial health: fee schedules, adjustment percentages, and patient cancellations.

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.