Stop Confusing Your CPA with Your CFO

Most owners toss every finance task into one mental bucket: “the accounting stuff.” In reality, two different jobs live in that bucket—and blurring them is expensive. CPAs keep you compliant: taxes, filings, and clean historical records. 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.

Here’s a quick way to separate the roles:

• CPA (Compliance): tax returns, elections, depreciation schedules, sales/use tax, payroll filings, financial statements tied to standards, audit support.

• CFO (Decisions): forecasting, pricing models, capacity planning, scenario analysis, debt strategy, KPI scorecards, cash conversion, team/comp plans.

A Simple Story

A dental practice kept hiring more hygienists, thinking more staff meant more revenue. Their CPA made sure payroll and filings were correct, but couldn’t answer why profits weren’t improving. A CFO analyzed capacity and visits per chair and realized scheduling—not staffing—was the bottleneck. With better scheduling and chair utilization, revenue rose without more hires.

Why This Matters

When owners expect decision support from a compliance engagement, they either (a) don’t get it, or (b) get it reactively, after opportunities have passed. The result is chronic underpricing, reactive hiring, and stress around debt service.

A simple fix is to run the business on a five-metric scorecard that blends leading and lagging indicators:

• Visits/Encounters (leading)

• New-Client % (leading)

• Cancellation/No-Show Rate (leading)

• Revenue per Encounter (bridge)

• Collections/Net Revenue (lagging)

With those five, you can diagnose 80% of performance questions in minutes. For example, if collections are fine but visits are down, the issue isn’t your billing—it’s your pipeline, scheduling, or show rate. If visits are healthy but collections lag, shift focus to payer mix, coding quality, or follow-up cadence.

Plan with Levers, Not Wish Lists

Many teams stall because “we need to build the budget together.” In practice, CFOs should propose a first draft that encodes strategic trade-offs, then owners react. Start with three levers: Capacity, Price, Mix.

• If rooms and schedules are maxed out, a price tune-up may do more than another marketing push.

• If pricing headroom is limited, consider mix: emphasize higher-contribution services or segments.

The goal isn’t a 30-tab spreadsheet—it’s a plan you can actually act on.

Implementation in 30 Days

• Publish the five-metric scorecard as page one of your monthly report.

• Draft a one-page budget tied to those metrics (days open, visits/day, price, mix).

• Identify the binding constraint (capacity vs. price vs. mix) and pick one lever for this quarter.

• Schedule a 45-minute “flash” forecast review each month to recalibrate quickly.

Bottom line: Keep your mechanic. Add a navigator. Your CPA and CFO should collaborate, but they should not be interchangeable. When you separate compliance from decisions, your numbers stop being a rear-view mirror and start becoming a windshield.