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.

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.

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.

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.

Most practices chase growth by doing “more of everything”—more hours, more patients, more services. It feels busy but rarely produces sustained results. Instead, think of your practice as a dashboard with three levers of revenue. If you learn to separate them—and pull one at a time—you’ll grow faster, with less stress and greater clarity.

Consistency is what turns good habits into reliable numbers. Build a checklist so nothing slips through the cracks.

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.