Comprehensive Practice Review
Know what to fix first.
Before you spend a dollar
fixing the wrong thing.
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
Most owners already know something needs to improve.
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 answer may be right about one piece. Nobody has measured the whole business.
The Comprehensive Practice Review measures the whole business at once. Five areas, one review, a valuation, and a triage plan for the next ninety days.
Financial performance
- Practice valuation and normalized EBITDA
- Overhead, margin, production, and capacity utilization against industry norms
- Collections, cash flow, and profitability trends
- P&L review and expense categories
Marketing and new patient flow
- Current marketing strategy and spend
- Website, lead flow, call conversion, and campaign performance
- Reputation, local positioning, and acquisition opportunities
Front office and revenue cycle
- Insurance participation and reimbursement mix
- Billing workflow, accounts receivable, and collections
- Financial policy and case acceptance
- Scheduling systems, call handling, and patient conversion
- Reactivation and unscheduled treatment
Team and operating systems
- Staffing structure, role clarity, and cost against norms
- Hygiene capacity and provider utilization
- Daily operating rhythm and accountability
- Training needs and workflow gaps
Growth readiness
- Current practice capacity and the systems needed to support growth
- Highest-impact opportunities over the next 30, 60, and 90 days
- Owner goals, lifestyle priorities, and long-term optionality
- Where the practice sits ahead of a future capital event
What you walk away with
Three answers,
in plain English.
The Vitals
Valuation, the priced gap, and benchmarks against industry norms. Where the practice actually stands today, in numbers rather than impressions.
The Triage
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.
The Prognosis
A straight answer on what happens next, and whether broader support is worth pursuing, before you commit a dollar to anything.
How the Review works
Four steps.
No disruption to the schedule.
Nothing here requires you to close a day, pull the team off the floor, or announce anything.
Share
You provide financials, marketing reports, practice metrics, and staffing details. One upload, one conversation.
Review
We assess the business across all five areas, normalize the earnings, and value the entity.
Prioritize
We identify the highest-impact opportunities and put them in the order you should act on them.
Walk through
We review the findings and the recommended action plan together, page by page, and you ask whatever you want.
The deliverable
A working document,
not a binder of ideas.
You receive a written report and a live walkthrough. The report is short enough to read and specific enough to act on.
What is inside
Delivered as a PDF and walked through live
- Executive summary, the entire practice read on one page
- Valuation and normalized EBITDA, with every adjustment documented
- The priced gap against industry norms
- Financial performance and expense analysis
- Marketing and new patient flow findings
- Front office and revenue cycle findings
- Team, capacity, and operating systems findings
- Growth readiness and capital event positioning
- The triage plan, ordered across the next 30, 60, and 90 days
- What we would do first if this were our practice
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 your team, accountant, or another advisor can execute the recommendations without us. That is deliberate. A plan that requires our help is a subscription, not a plan.
You keep the document and the findings regardless of what you decide next. There is no version we hold back.
The marquee component
A number you can defend,
backed by the analysis.
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 shows the work, and no two agree. The Review replaces those shortcuts with one supported number you can hand to another professional and defend.
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.
- Lender conversations. An underwriter wants normalized earnings and a supported range when a practice is being financed.
- Pricing an offer. Buying, selling, or fielding an unsolicited letter, you negotiate against a number rather than a feeling.
- Partner and associate buy-ins. Both sides work from one set of numbers built by someone who sits on neither side of the table.
- Buy-sell and insurance funding. You learn what the agreement should be funded at rather than relying on a figure set years ago.
- Planning ahead. You see what the practice is worth today against what you need it to be worth, which is where the Blueprint picks up.
Where the line sits. This is a valuation prepared by a transaction advisor with experience across more than one hundred practice transactions on both sides of the table. 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.
Where the money goes
The priced gap.
Two practices can collect the same and keep very different money. The priced gap shows where the difference goes, including capacity the practice pays for and does not use, in dollars a year.
Overhead as a single percentage hides too much. We break overhead 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 outliers are where the money is, and the biggest outliers are almost never the categories 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
A fixed fee that pays for itself in clarity.
One fee covers the full current-state review and valuation of the primary practice entity.
Complete review and valuation
Under common ownership
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.
Add the Blueprint and the Review becomes a package at $6,950.
The valuation is a professional opinion of value prepared for business decisions, not a certified appraisal issued under formal appraisal standards.
Where the Review leads
The front door, not the whole house.
The Practice Review measures the current state. What you do with the findings is your call, and there is a defined path if you want one.
Comprehensive Practice Review
Measure the whole business against one published standard.
Practice Review and Blueprint
Decide what matters most for the business and for the life it funds.
Operations Management
Run the business side on a fixed weekly, monthly and quarterly cadence.
Groups, acquisitions and associates
Add locations, providers and partners on the same standard.
Sale and Transition Advisory
Strengthen value and change ownership when you choose to.
The Review stands on its own, and plenty of owners take the findings and run them without us. Operations Management always starts with one.
The questions everybody asks
Fair questions.
Straight answers.
The Practice Review 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 the whole business.
No. The Review is a fixed-fee, defined deliverable and ends with the live walkthrough. 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 the Review will say so when the business is performing well.
Start here
Evaluate first.
Then decide what deserves action.
Book a strategy call to scope the Review for your practice. Thirty minutes, no obligation, and you will know by the end whether the Review is worth doing.
Thirty minutes, no obligation. Nothing you share goes anywhere else.