Comprehensive Practice Review
A fixed-fee review of the whole business, across the five areas that drive cash flow, patient flow, team performance, and long-term value. You walk away with a valuation of the entity and a triage plan for the next ninety days.
The real problem
The harder part is knowing what to fix first. Ask around and you get a marketing answer from the marketing people, a scheduling answer from the scheduling people, and a software answer from the software people. Each is probably right about their own piece. Nobody has measured the whole thing.
The Comprehensive Practice Review measures all of it at once. Five areas, one review, a valuation, and a triage plan for the next ninety days.
What you walk away with
Valuation, efficiency quotient, and benchmarks against industry norms. Where the practice actually stands today, in numbers rather than impressions.
What to fix first and what can wait, ordered across 30, 60, and 90 days. Where the cash is leaking, where the margin is hiding, and where the fastest lift lives.
A straight answer on what happens next, and whether broader support is worth it, before you commit a dollar to anything.
How it runs
Nothing here requires you to close a day, pull the team off the floor, or announce anything.
You provide financials, marketing reports, practice metrics, and staffing details. One upload, one conversation.
We assess the business across all five areas, normalize the earnings, and value the entity.
We identify the highest-impact opportunities and put them in the order you should act on them.
We review the findings and the recommended action plan together, page by page, and you ask whatever you want.
The deliverable
You receive a written report and a live walkthrough. It is short enough to read and specific enough to act on.
Delivered as a PDF and walked through live
Every finding carries a number, a cause, and a recommended action. Not a list of observations you already had.
The action plan is written so you can hand it to your team, your accountant, or another advisor and they can execute it without us. That is deliberate. A plan you can only run with our help is not a plan, it is a subscription.
You keep the document and the findings regardless of what you decide next. There is no version we hold back.
The marquee component
Ask five people what a practice is worth and you will get five numbers. A percentage of collections repeated at a study club, a multiple from an article, a figure that arrived in the mail with a letter attached. None of them show their work and no two agree. This replaces all of it with one number you can hand to another professional and have it hold up.
We adjust out owner compensation, personal expenses, one-time items, related-party rent, and non-recurring costs, and we document each adjustment so a third party can trace it.
We apply multiples supported by comparable transaction activity to normalized EBITDA, then adjust for size, growth, payer mix, and provider dependency.
We cross-check the result against percentage of collections and comparable transaction data instead of leading with either one.
We treat equipment, technology, leasehold, and working capital explicitly so that nothing gets double counted or quietly ignored.
We name provider concentration, lease terms, payer mix, staffing stability, and referral dependency as the factors that move the range, and we show the effect of each one.
Where the line sits. This is a valuation prepared by a transaction advisor with more than one hundred completed practice transactions on both sides. It is not a certified appraisal issued under formal appraisal standards by an accredited appraiser.
That specific document is required in a narrow set of circumstances, including tax filings, estate and gift work, litigation, and certain government-backed loan programs. If your situation calls for one, we will say so before you spend money on the wrong document, and we will tell you who does them well.
One number worth explaining
Two practices can collect the same and keep very different money. The efficiency quotient is how we measure the difference, so you can see whether the problem is revenue or what happens to it.
Overhead as a single percentage hides too much. We break it into the categories that actually move, compare each against practices of similar size, specialty mix, and payer mix, and show which ones sit outside the range and by how many dollars a year.
Most practices are within norms on most categories and materially out on two or three. Those two or three are where the money is, and they are almost never the ones the owner suspected.
Each category is compared against practices of similar size, specialty mix, and payer mix. The shaded band is the normal range. What sits outside it is priced in dollars a year.
Your investment
One fee covers the full current-state review and valuation of the primary practice entity.
Additional entities include other practice locations and real estate holding entities under common ownership. Each one is reviewed and valued on the same basis as the first.
You own the findings whatever you decide next. Nothing in the Practice Review obligates either party to anything further.
The valuation is a professional opinion of value prepared for business decisions, not a certified appraisal issued under formal appraisal standards.
Where it leads
The Practice Review measures the current state. What you do with it is your call, and there is a defined path if you want one.
Measure the whole business. A valuation of the entity and a triage plan for the next ninety days.
Design the future state. What the practice must be worth at your exit, the gap from today, and the moves that close it.
Build it. The executive layer installed, with the owner keeping 100% of the equity and full clinical autonomy.
Most owners do one of these, not all three. The Review stands on its own, and plenty of owners take the findings and run them without us.
The questions everybody asks
It answers a different question, and the two work together. Your accounting work reports what the business did. The Practice Review measures operations, marketing, revenue cycle, capacity, and value at once, then puts the findings in the order you should act on them. Most owners have three or four people looking at pieces of the practice and nobody looking at all of it.
No. It is a fixed fee for a defined deliverable and it ends when we walk you through it. You own the findings whether you work with us afterward or hand them to somebody else.
Not really. We work from documents and reports you already have, plus a conversation or two with you. Nothing has to be announced to the team, and nothing disrupts the schedule.
Financial statements, tax returns, production and collections, aged receivables, marketing spend and reporting, and a staffing roster with roles and compensation. If something is missing or messy, tell us and we work with what exists.
Then you paid a fixed fee to find that out, which is worth knowing before you spend money solving a problem you do not have. That outcome is rarer than owners expect, but it happens, and we will say so.
Start here
Book a strategy call to scope the Review for your practice. Thirty minutes, no obligation, and you will know by the end whether it is worth doing.
Thirty minutes, no obligation. Nothing you share goes anywhere else.