7. Conclusion to Operational Module

Operational excellence is paramount for the growth and success of private healthcare practices, as it directly impacts every aspect of service delivery, financial performance, and practitioner productivity. By optimizing service delivery models, practices can ensure that client care is delivered in a timely, efficient, and cost-effective manner, enhancing client engagement and loyalty, while maximizing revenue opportunities. Additionally, reducing labor spend through strategic workforce management initiatives enables practices to allocate resources more efficiently, freeing up capital for investment in growth initiatives such as technology upgrades, practice expansion, or service diversification.

Improving schedule efficiency is a critical aspect of operational excellence in private healthcare, as it directly impacts client access, practitioner productivity, and resource utilization. By implementing automated scheduling systems, streamlining appointment booking processes, and optimizing practitioner schedules, practices can reduce wait times, minimize client no-shows, and maximize practitioner productivity, ultimately driving revenue growth and improving overall operational performance. Moreover, enhancing practitioner productivity through targeted training, performance metrics, and workflow optimization initiatives enables practices to deliver higher-quality care, increase client throughput, and achieve better clinical outcomes, further enhancing their competitive position in the market.

Practice Owners-always more skilled at their professional craft v. business acumen.

Practice owners often excel in their craft or field of expertise, possessing a unique passion, creativity, and dedication that drives their success. However, when it comes to managing the business aspects of their practice, many owners struggle. One reason for this disparity is that entrepreneurial + leadership skills and business acumen are distinct competencies that require different sets of knowledge and expertise. While owners may possess a deep understanding of their services, they may lack the necessary knowledge of finance, operations, human resources, marketing and other critical business functions.

Practice owners are typically driven by passion and optimism, traits that fuel their creativity and ambition, but may also cloud their judgment when it comes to making strategic business decisions. They may underestimate the risks of overpaying their clinicians to keep them from leaving or, overestimate potential benefits of bringing on poor revenue services or, overlook warning signs of impending challenges created with the chronically high cost of borrowing. This optimism bias can lead entrepreneurs to take on excessive debt, make rash investment decisions, or pursue growth opportunities without adequate planning or preparation, ultimately jeopardizing the success of their practices.

Furthermore, your practice journey is inherently challenging and unpredictable, requiring resilience, adaptability, and a willingness to learn from failures and setbacks. While entrepreneurs may possess a strong drive to succeed and a willingness to take risks, they may lack the patience, discipline, and humility necessary to navigate the complexities of business management effectively. Without a solid foundation of business knowledge, skills, and experience, entrepreneurs may find themselves struggling to overcome obstacles, manage resources efficiently, and sustainably grow their ventures in the long run.

At ELEVATE, we understand the best way to compete and grow your practice is to be a great storyteller.  Imperative to this, is an understanding of two things: clients don’t buy what you do, they buy why you do it, and a client can never love your brand until your team members love it first.  When considering how to start your story, be mindful that we are not in the business of healthcare; in fact, we are in the people business delivering healthcare.  Also, at the end of each day, if you strip away your technical skills and business acumen, you are left with relationships.  Said another way; in the end, we are people, people caring for people in communities where we have a privilege to serve. 

As a practice owner, you must understand what it feels like to be in service of something bigger than yourself. To give freely with no expectation of receiving anything in return.  To serve is an amazing leadership gift that embraces humility, empathy, humanity, self-awareness, and interpersonal relationships.

Shared purpose, shared impact, and shared values all deserve a great story.  Stories that are rooted in your competitive advantage and your brand’s ability to drive a world-class client experience. As an owner, when you talk with your clients host a town hall with your team members, or have 1:1 with a practitioner, you always lead with purpose and impact.  You never bring the need to grow revenue or profit into any conversation unless you are with your business advisory team.

At ELEVATE, we spend an inordinate amount of time with practice owners crafting their ‘why’.

ELEVATE-Nexus of Practice Purpose and Execution:

The symbiotic relationship between your practice purpose and operational execution is a cornerstone of successful practice operations. Purpose provides the guiding vision, values and impact that informs every aspect of a company’s activities, from strategic planning to day-to-day operations. Purpose, paired with the client experience, also known as your culture, serves as the practice’s North Star. This star aligns the efforts of team members, funders, vendors and partners toward a common goal and imbues their work with meaning and significance. Purpose and impact inspire passion, commitment, and resilience, driving individuals and teams to overcome challenges, pursue innovation, and strive for excellence in pursuit of a shared vision.

Execution, on the other hand, is the tangible manifestation of purpose in action. It involves translating strategic goals and objectives into concrete plans, tasks, and initiatives and implementing them with precision, discipline, and accountability. Execution is about turning ideas into reality, making tough decisions, allocating resources effectively, and delivering results in line with practice aspirations and expectations. It requires focus, determination, and attention to detail to ensure that projects are completed on time, within budget, and to the highest standards of quality and excellence.

Together, purpose and execution form a symbiotic relationship that drives practice success. Purpose provides the overarching direction and motivation that inspires action and guides decision-making, while execution translates purpose into measurable outcomes and tangible achievements. Without purpose, execution lacks direction and meaning, leading to aimless activity and wasted effort. Conversely, without execution, the purpose remains an abstract ideal, disconnected from reality and unattainable in practice. When purpose and execution are aligned and integrated seamlessly, businesses can achieve their full potential, realize their aspirations, and create enduring value for all stakeholders.

At ELEVATE, we will always be generous with our knowledge.

The development of this operational learning module for healthcare practice owners represents a significant milestone in ELEVATE’s journey to empower practices to achieve their full potential. Through comprehensive research, strategic planning, and collaboration with industry experts, we have crafted a resource that addresses the unique challenges and opportunities facing healthcare practice owners today. By equipping practice owners with the knowledge, skills, and tools they need to succeed in business, we are not only driving individual practice growth but also contributing to the overall advancement of the private healthcare industry in Canada. As ELEVATE moves forward, we remain committed to supporting practice owners on their path to success and fostering a culture of continuous learning and improvement within the healthcare community. Together, we can ELEVATE the brand agency of owners in the conversion from practice valuation to personal wealth.



5. Case Studies: Real World Examples

Operations Module: Case Study-ELEVATE Practice Intelligence


The optimization of Financial, Operational, and People performance is paramount to the growth and sustainability of healthcare practices. This case study delves into the transformative journey undertaken by an ELEVATE health management consultant that was engaged by a network of 5 practices to bolster their net income from operations. Cash will always be King.

Faced with the real macroeconomic disruptions where 50%-60% of Canadians with mortgages, have renewed at rates often 5% higher than their previous term. The impact of less disposable household income has had a dramatic impact on healthcare practices that derive >60% of revenue from B2C (Business to Consumer).   Canadians are saving money at a rate not seen in decades and

clients are more likely than not, spending only what is covered by their employer-funded healthcare plan and not a penny more.  

The ever-present challenge of delivering a world-class client experience paired with a high-quality care plan, while maintaining operational excellence, continues to exhaust and frustrate practice owners across Canada.  In this case study, the owner sought the expertise of the consultant to navigate these complexities and chart a course toward enhanced operational efficiency, clinical performance, clinical productivity, and a culture of accountability.

As this case study unfolds, we will explore the collaborative efforts between the health management consultant, the owner, and a network of 25 practitioners (Employee and IC) across 5 practice locations. We will delve into multifaceted ‘needs assessment’ tactics like a 30-day listening tour, what is our collective ‘why’, what is our competitive advantage, understanding ‘how we play’, our ‘right to win’, and the team’s ‘capacity for change’. 

Starting with the end in mind and having a full 360 view of where the Buyer would place value made the starting point for this engagement relatively straightforward, but never easy. Through a combination of data-driven analysis, understanding the strengths of the team, creating opportunities to lower the cost of every transaction across the business units, creating compelling clinic and practitioner scorecards, and driving an execution/accountability culture, the consultant embarked on a comprehensive initiative to enhance gross margin by 5+%.  Winning on driving down costs related to your practice’s greatest expense-LABOR is the journey we are on it this case study.

Problem Statement:

A sobering thought…roughly 80% of all healthcare practice owners in Canada have little to no value in their practice and at the end of the day-all they own is their job.

Despite the network’s substantial revenue, the practice owner identified a pressing need to enhance free cash flow to ensure long-term sustainability and facilitate strategic growth initiatives. The consultant’s engagement was prompted by the practice owner’s recognition that: paying practitioners 65-75% fee for service splits was too high, longer wait times for clients to access care because schedule efficiencies dropped below 70% and the owner was operating the practices without a strategic plan, budget or monthly P&L statements. All of which were impeding the network’s ability to generate surplus funds necessary for reinvestment and expansion.

The problem statement revolves around the imperative to drive GM% growth/lower labor spend across the network of clinics.  The majority of practices this consultant has engaged with over the last several years, all have one common fault. The owner has given away the value in the practice by overpaying practitioners just to keep them from leaving for a slightly better offer. The practice owner felt a need to pay practitioners more just to keep their practice doors open.  The second part to this broader labor issue, stems from overpaying for administration support that is required to operate the practice units.

The labor challenge was further compounded by the fact that the practice network had a disengaged work force. The transactional nature of the practitioner’s relationship with the owner was reflected in little to no goodwill; the owner was forced trade on the only currency desired by the practitioners—a higher fee split. 

The healthcare consultant’s intervention was thus necessitated by the imperative to identify and address root causes of team dysfunction which was a disengaged leader. 1:1 Leadership training, creative story-telling connected to purpose, impact and values were established; upgrading talent commenced and labor reduction plans were identified.  All tactics were aligned to unlock the owner from ‘labor hostage’ and pave the way for sustainable growth and success across the network.


  1. Facilitate team-building exercises and 1:1 meetings to address team dysfunction and improve collaboration, communication, and cohesion between owner and team members.
  2. Provide 1:1 leadership coaching and development specific to being present in the clinic, finding purpose and impact in their leadership role and to reimagine living the brand values that were established years ago.
  3. Implement communication strategies and channels to ensure transparent and effective communication throughout the organization, fostering trust, transparency, and alignment.
    • Understand our collective ‘why.’
    • Understand purpose, impact, and values.
    • Understand our competitive advantage and how we create a world class client experience.
  4. Implement and execute the administrative team have full control of the clinical schedule, not the practitioners.  The story must be one of creating greater access to care for our clients. Must win of schedule efficiency by removing all practitioner white spaces and have all Ax and Rx time aligned to the same number (30 min Ax, 15 min. Rx or 20 min. Rx)
  5. Create clinic scorecards for every location: complete with lead and lag measures.
    • Themes:
      • Lower direct labor spend from 70% to 60%
        • All Employees transitioned to IC’s
        • IC’s with lower FFS splits had their schedules filled first v. higher FFS split IC’s.
        • Implement a 3% administrative fee on all IC contracts.
      • Lower the administrative labor spend from 14% to 8%
        • Cut existing administrative team members.
      • Increase EHB prices by 5%
      • Schedule efficiency gains of 15% to a target of 85%
      • Increase intakes/day by 10%
      • Lower Cx./NS from 16% to <12%
      • Lower G&A expenses (not including rent) from 12% to 8%
      • Grow higher value MVA/EHB revenue streams from 46% to 66% while lowering government and WCB service stream volume by 10+%
  6. Upgrade our talent via implementation of a practitioner scorecard, complete with productivity, referrals and Google review targets
  7. Facilitate tactical planning sessions to define near-term goals, priorities, and action plans aimed at driving sustainable growth and success for the practice.
  8. Monitor progress, track key performance indicators, and provide ongoing support and guidance to the practice owner.


Improving the overall operational excellence of a healthcare practice requires a multifaceted approach that addresses various aspects of high value revenue growth, reduction in both practitioner and administrative labor spend, accountability to both clinical and practitioner scorecards and amazing story telling. Here are the methodologies used by this healthcare consultant to drive operational efficiencies:

  1. Right brain Leadership training: we are in the people business delivering healthcare. EQ training for the leader + redefining your purpose and impact within the business.  Need to be a present leader.
  2. Right brain Leadership training related to story telling: celebrating amazing customer experiences through greater access to care stories; celebrating a practitioner achieving FCAMP credentialling; celebrating a new hire chiropractor that was referred by an existing team member.
  3. Right brained leadership training related to authenticity, transparency, and fun.  Create opportunities to have fun at work and outside work with team building events.  As the owner, you must build your currency in terms of culture so a team member won’t leave for a 2% fee increase from a competitor.  At the same time, they won’t ask you for a 2% increase because the intangibles in your practice are more often than not, priceless.
  4. Create greater access to care: Enhance patient access by optimizing scheduling efficiency, improving hours of operations, reducing appointment wait times, and implementing strategies to minimize patient no-shows and cancellations. 
  5. Labor Reduction Initiatives (practitioner): identify and calculate highest value service streams and highest value practitioner. 
  6. Labor Reduction Initiatives (administrative): identify areas of opportunity for process automation specific to transactional tasks; which ultimately lowers the cost of administrative labor.
  7. Clinical scorecard development: create a set of 5 lead measure KPI’s and a set of three lag measure KPI’s.
  8. Practitioner scorecard development: create a set of 5 lead measure KPI’s and one lag measure KPI related to productivity.
  9. Create a culture of accountability and execution.  Learn how to manage your daily whirlwind of things that are just busy work (80%) which leaves only 20% for the really important stuff.  Create a tactical plan that switches these ratios.

By implementing these methodologies and working collaboratively with the healthcare practice owner, the consultant helped optimize schedule efficiency, improve gross margin%, and position the practice for long-term success and sustainability through a cadence of execution and accountability.


The healthcare consultant embarked on a comprehensive initiative to enhance gross margin for the network of 5 clinics, leveraging a multifaceted approach that addressed various aspects of high-value revenue generation, labor expense reduction, maximizing schedule efficiency, and creating a monthly P&L statement and clinical and practitioner scorecards. Important to keep in mind that reducing labor spend is a lag measure and we won early on by identifying lead measure KPIs and the processes required to win on those measures.

To begin, an extensive operational analysis was conducted across all clinics to identify areas of improvement and potential cost-saving opportunities (daily billing accuracy, payroll accuracy, bad debt reduction, employee and IC contracts). This involved scrutinizing billing processes, schedule efficiencies and schedule consistency across clinics, and assessing service delivery models. 

Concurrently, the consultant implemented tactics to create a culture of accountability, execution, and negative consequences.  The RACI (Responsible, Accountable, Consulted, and Informed) model was used to create operational role clarity.  The consultant lead the clinical scorecard development and P&L statement development, while the owner created a practitioner scorecard that focused on client experience and productivity. This included revamping scheduling procedures (limiting blocking schedule by practitioners) to minimize patient wait times, and ongoing coaching with practitioners to learn to be comfortable asking clients for friends and family referrals and Google reviews.

As the assignment progressed, significant milestones were achieved, demonstrating tangible improvements in the network’s GM% gains (5% GM gains in the first 90 days). Winning early on ‘administration’ controls the schedule was critical for achieving the 85% target.  The owner created opportunities to work with the clinical team to ensure 100% of clients received a full-service care plan; this expertise created amazing Google reviews from clients. Both scorecards were launched within 60 days.

The implementation process was not without its challenges. Two IC practitioners quit because referrals were redirected to IC’s with lower FFS splits in their contracts. Relationship challenges were felt on the government contracts where patients waited longer to receive care, while higher paying customers were prioritized. One FTE administrative team member was deemed redundant and was let go.  Through proactive communication and a collaborative approach, these challenges were effectively addressed, paving the way for sustainable improvements in culture and operational efficiencies.

Results: goal-enhance GM% from 30% to 40% (net income gain of $500,000) in 12 months.


  • Revenue mix adjustment to higher EHB/MVA ratios: $60K
  • Labor spend reduction on practitioners and administrative team member: $110K
  • Schedule efficiency gains of 15%: $200K
  • Bad debt reduction: $40K
  • Payroll and Billing accuracy $40K
  • Pricing adjustment $50K


  • Engaged, passionate leader. High performance, high impact, and fun returned
  • Right team member in the right seat, on the right bus, moving in the right direction.
  • P&L statement finalized 5 days post month end
  • Accountability, execution and understanding negative consequences to poor performance.


  • Always start with the end in mind-who do you want to sell your business to. A National Strategic company, A Private Equity firm, to your team members (Employee Owner Trust)
  • Find a consultant that understands the full 360 view of where a Buyer places value. Laser focused tactical decision making on things that will and will not create value for the Buyer.
  • Implement a culture of execution and accountability to both clinical and practitioner scorecards.
  • EQ coaching and development of the leader will always be the #1 competitive advantage a practice will have.
  • Leader to understand that you are in the people business delivering healthcare and upskilling your team members capabilities to become better humans is a wise investment.
  • Story telling in the context of putting the enhancement of the client experience at the centre of every decision your practice makes.
  • Get control of your own personal whirlwind (your busy work); 80% of your time should be spent on the top 3 practice priorities.


In conclusion, the partnership between this healthcare consultant and the $5M enterprise has yielded remarkable results in maximizing net income from operations growth by $500,000 and enhancing the practice’s overall ability for tactical growth. Through tactical operational initiatives and diligent execution, the consultant successfully navigated the complex landscape of healthcare management and the importance of engaged and present leadership. Operational excellence is the cornerstone to bolstering the financial health of the practice but also positions it as an attractive investment opportunity for potential buyers in the future. Moreover, the collaborative efforts between the consultant and the practice owner have cultivated a culture of continuous improvement on metrics that are critically important to a Buyer. 

The positive outcomes achieved through this partnership underscore the importance of understanding just how challenging it is to become a great operator. There is nothing in your university training that prepares you for this role and it is difficult for practices to be successful without this leadership strength.  Operational excellence must always pair culture with growth as both are driven from the strategic plan.  By leveraging data-driven insights, implementing and winning on clinical and practitioner scorecards becomes just a little easier.  As the practice continues its journey of growth and evolution, the lessons learned and successes achieved through this collaboration with the healthcare consultant will serve as a roadmap for future success and prosperity.


Based on the successful collaboration between the healthcare consultant and the healthcare practice to maximize operational efficiencies, several recommendations can be made to further enhance the practice’s financial health and prepare it for a successful sale:

  • Leadership development has no finish line: we recommend that Leaders spend an inordinate amount of time working on 4 core themes: leaders are authentic, leaders lead themselves, leaders lead others and leaders are clear thinkers.  I’ll say it again, the number one competitive advantage a practice can have is its leadership.

Leaders must continue to work on their EQ; skills like empathy, self efficacy, self awareness and interpersonal relationships.  Leaders must create the ability to become great story tellers—clients don’t buy what you do, they buy why you do it.  Understand the ‘why’ behind your practice’s existence.  Always lead through the lens of creating a world class client experience, and always trade on your currency of purpose, impact and values.

  • Never, ever, over pay for your clinical labor: I can’t count the number of times I’ve heard an owner state, I didn’t have a choice-I had to pay my practitioner a higher fee split or they would have left.  Data suggests a disengaged IC or employee will leave their current place of practice for a 2% fee increase; conversely, a highly engaged team member won’t leave their existing place of practice unless the compensation is 20% higher.  Don’t ever get stuck with the ‘sucker’s choice’.  As a leader, you must win on culture every day.  Culture is intentional and the dosage is daily.

Said another way, do not give the value of your practice away to your practitioners. Most practice owners are paying 10% higher fees than they need to pay.

  • Operational lessons from the movie ‘Moneyball.’
    • The first one through the door gets bloodied- operational excellence is a messy, but necessary undertaking.
    • Trust the process, Trust the process.  See your plans through on 100-day cycles and course correct after you have 100 days of data trends to analyze.
    • You are only as good as your last month-which always begs the question, what have you done for me lately?
    • Anything worth doing is hard…And ELEVATE will teach you.

Closing Leadership Nugget:

I continue to believe the greatest leadership character is that of COURAGE.  My favorite Courage passage comes from a BMW excerpt:

Courage and why we need it more than ever.

Courage is independent and disruptive.

It questions, shatters, and awakens.

We need bold creative voices, all of us.

We need fresh thinkers with optimism.

We believe in the front runners, the avant-garde,

Those who fight stagnation and backwardness.

Courage knows only moving forward,

Driving the pioneers of our culture to inspire tomorrow,

To create a sublime kind of now

And reach a superior level of excellence.

This is where a new kind of value is born.

Citations & Acknowledgments:

  1. CBV Institute Program of Studies Level One-Introductory Business Valuation 2020
  2. Gandz, J. Developing Leadership Character. New York NY Routledge Publishing
  3. Excerpt from The Art of Owning the Moment, BMW
  4. Mainardi, C “The Essential Advantage”2011 Booz and Company Inc.
  5. McKinsey & Company-Four Interrelated Trends are Poised to Unwind the Old Rules of Mgmt. 
  6. McKinsey & Company-Rewired Consumer Enterprises Adhere to Six Imperatives
  7. Heffernan, M. “Beyond Measure” TED Books 2025
  8. Ron Price, The Complete Leader 2014 Aloha Publishing.

I would like to express my sincere gratitude to my colleagues and mentors at CBI Health who have provided invaluable guidance and support throughout my development as a Healthcare executive, especially in the areas of Operational Excellence and Leadership. Special thanks to the late Christopher Szybbo (CEO), David Maxwell (COO) and Avi Barkin (CFO) for their expertise, belief and insights that spanned the best 15 years of my career.

Additionally, I extend my appreciation to all the healthcare practice owners that have trusted ELEVATE’s insights and expertise to achieve shared goals. 

Lastly, to the healthcare practice owners that ELEVATE will engage with in the future…I am excited to share what gets me up every morning.  I continue to be amazed at ELEVATE’s ongoing impact to eradiate entrepreneurial healthcare poverty across Canada.  Our competitive advantage of being able to 2x the profit of healthcare practices is a powerful statement. Empowering practice owners to win on Brand Agency is an impactful ‘why’.  We collaboratively achieve this by converting practice valuation into greater personal wealth. 



4. Fusion of Right and Left Brain Themes

Healthcare practice management is complex as there is often a divide between the analytical, left-brain themes of efficiency and optimization and the creative, right-brain themes of humanization and communication of a practice owner. However, the true magic happens when these two seemingly disparate sides come together in harmony. Let’s explore how we can integrate both right and left-brain themes to create a holistic leadership approach to operational excellence.

Humanizing Operational Efficiency

In the quest for operational efficiency, it’s easy to get lost in spreadsheets, data analysis, and optimization strategies. However, at the heart of every successful practice are the people – the clinicians, team members, and most importantly, the patients. Humanizing operational efficiency means recognizing the human element in every process and decision.

Imagine a scenario where you’re optimizing your scheduling system to minimize wait times and maximize practitioner utilization. While it’s essential to crunch the numbers and analyze appointment data, it’s equally important to consider how these changes will impact your clients. Will shorter wait times improve their experience and engagement? Will practitioners feel overwhelmed or rushed? By incorporating empathy and understanding into our efficiency efforts, we can create systems and processes that not only improve the bottom line but also enhance the overall client experience.

Aligning Communication Strategies with Operational Goals

Effective and timely communication is the lifeblood of any successful practice. Whether it’s conveying treatment plans to patients, coordinating schedules with staff members, or aligning strategic goals with stakeholders, clear and concise communication is essential. However, communication isn’t just about conveying information – it’s about fostering connection, understanding, and trust. When aligning communication strategies with operational goals, it’s crucial to consider both the content and the delivery method.
When introducing changes to practice workflows or policies, framing the message in a way that emphasizes the benefits to both team members (purpose) and clients (experience) can help garner buy-in and support. Additionally, choosing the right communication channels – whether it’s face-to-face meetings, email updates, or team huddles – can ensure that information is effectively disseminated and understood by all stakeholders.

By integrating right brain themes of empathy, creativity, and connection with left brain themes of efficiency, analysis, and optimization, healthcare practice owners and clinicians can create a practice environment that not only operates smoothly and efficiently but also prioritizes the well-being and engagement of both clients and team members. Through this balanced approach, we can achieve our operational goals while staying true to our core values and mission as healthcare providers.




Tailored solutions to address your unique challenges & ELEVATE your Practice.

3. Left Brain Themes: Operational Efficiency

Lower The Cost of Every Transaction in your Practice

Lowering the cost of every transaction is a strategic approach aimed at reducing the overall expenses associated with conducting practice operations. The primary objective is to optimize processes, enhance efficiency, and ultimately decrease the human resource spend allocated to each transaction within your practice.  Cut costs to grow stronger and create a more sustainable and competitive operational model.

Outlined below are several ways a practice owner can work towards achieving tangible cost savings and creating a sustainable and competitive operational plan.

Streamlining Processes for Cost Effectiveness

Reducing risk to fixed costs is likely to be the practice owner’s number one strategic initiative aimed at minimizing the potential negative impact of excessive fixed expenses on your practice’s financial stability.  Examples of fixed costs, direct labor (practitioner), indirect labor (administration), rent, and G&A expenses.

Key Tactics:

  • Understanding labor ratio benchmarks as a percentage of sales (revenue)
  • Identify full labor costs associated with employee and independent contractor contracts. Hiring a practitioner as an employee on a 50% fee split has a total labor cost of 59% to the clinic. 
  • Optimizing other fixed cost to industry benchmarks: occupancy rate: >$400/sqft, bad debt: <0.5% of revenue, and general administrative expenses: <8% of revenue.

A key aspect of reducing risk to fixed costs involves understanding labor ratios as a percentage of sales (revenue), in combination with the full cost of the employee and Independent Contractor contracts. Let’s unpack these two parts:

  • Understanding Cost of Goods Sold (COGS) and Labor Allocation:
    1. Direct Labor Allocation: Direct labor costs (represent expenditure on practitioners) should ideally range between 48%-52% of total sales.
    2. Indirect Labor Allocation: Indirect labor costs (covers administrative team expenditure) should be kept below 8% of total sales.
    3. Total Labor Spend: The combined spend on direct and indirect labor should fall within the range of 55% to 60% of total sales.
    4. Gross Margin Management: Gross margin, calculated as sales minus COGS, should ideally be maintained between 40% to 45% for optimal profitability.
      • If total labor = 55%, then GM% = 45%
      • If total labor = 60%, then GM% = 40%
  • Other Fixed Costs Metrics:
    1. Rent: <10% of total sales.
    2. Occupancy Rate: Based on an average of $400 per square foot, a practice occupying 2,500 square feet should aim for revenue between $1M to $1.3M
  • Additional Considerations:
    1. Administration Fees: Consider implementing a 3-5% administration or facility fee on ALL independent contractor chiropractors, physical therapists, and registered massage therapy as a way to cover a portion of the overhead costs. Think of it a rent. CRA endorses IC’s should pay rent.
    2. Payment Terms: Evaluate the option of paying on receivables rather than payables.

Summary: Profit and Loss Statement

Sales: $400,000

Costs of Goods Sold: 

  • Direct: 50% or $200,000
  • Indirect: 8% or $32,000

Rent: 10% or $40,000

G&A: 8% or $32,000

Net Profit from Operations: $400,000 – $304,000 = $96,000 or 24%. 

Ultimately, the goal is to create a financial framework that minimizes your vulnerability to fixed costs, allowing businesses to better withstand economic fluctuations and remain adaptable in dynamic market conditions.

Maximizing Operational Efficiency

Key Strategies:

  1. Avoid adding quasi-personal expenses to your practice for the sole reason of lowering your tax liability. Stop treating your practice as a hobby.
  2. Increase prices strategically to preserve margin and adapt to market conditions.  EHB or Private rates are services where you can adjust upward. Strongly consider shifting prices 5%-8% at the start of your next calendar year.
  3. Shift revenue mix towards high-value services to optimize profitability. More EHB and Auto services are better than government and WCB services (an exception would be WSBC).

Stop Treating Your Business Like a Hobby
As the saying goes: Treat your business like a business and it will pay you like a business. Treat your business like a hobby and it will cost you like a hobby.

Treating your practice like a business means not writing off quasi-personal expenses just to lower your tax liability. This is a rookie mistake many owners make, and it’s important to stop doing this for several reasons:

  • First, accurate accounting is essential for sound decision-making in your practice, and rules are rules – meaning the CRA may audit you. 
  • Second, it’s difficult to have a clear picture of profit when it’s clouded with personal expense write-offs.
  • Finally, doing so could harm your valuation if you decide to sell. Cash flow is highly important in a business valuation and running personal expenses through your business moves the needle the wrong way. 

Increase Price to Preserve Margin
In recent years, economic shifts, such as inflation, rising operational expenses, and supply chain disruptions, have prompted owners to reassess their pricing strategies (often increasing prices by 8% or more.) By implementing price adjustments, affords practices to remain agile in response to shifting market dynamics, preserving their competitive advantage and fostering long-term success and resilience.

The second part to increase prices, is the inherent compensation gain for your FFS practitioners.  If you raise prices by 8%, your practice keeps 4% and 4% is passed along to your 50% FFS IC’s.  As an owner, this should buy you a year or two from having IC’’s coming to you for fee split increases.

Shift Your Revenue Mix to The Highest Value Service
Strategically shifting a business’s revenue focus toward its highest-value services is a key tactic for optimizing profitability and ensuring long-term business sustainability. By prioritizing high-value services, a company can leverage its core competencies and areas of expertise, resulting in higher profit margins compared to lower-value offerings. This deliberate pivot not only maximizes revenue but also strengthens the business’s market position and competitiveness.

Service streams, such as EHB and Auto (both at $80+/Rx), which typically yield the highest fee-for-service rates and should ideally constitute over 75% of your practice revenue, while WCB and Government related care (both around $40/Rx) should make up <25% of you practice revenue.

Operational Scorecards/KPIs: Navigating Healthcare Practice Success

Setting wildly achievable goals aligns a healthcare practice with both the operational and strategic vision. Wildly Achievable Goals (WAGs) are high-impact, quantitative indicators that demand a team’s full attention and dedication. These goals could range from improving client outcomes (like access to care and return to work) to creating a world-class client experience to operational efficiencies (like gross margin). WAGs provide clarity, rallying the entire healthcare team around a shared mission, fostering a sense of purpose and contribution, as well as a clear sense of the impact the practice has on the community where they have the privilege to serve.

Developing KPI’s: Building Your Roadmap to Success

A great KPI scorecard gives you the tools you need to communicate up and down your practice, including owners, team members, patients, and investors. They can also provide insight into successes, risks, and opportunities.  Keep in mind that your scorecards must be a living, breathing, dynamic document and require ongoing attention and energy from you and your team. Without the proper energy dosage, clinical operations will default to chaos and chance or in other words Entropy.

Using quantifiable metrics in your scorecard makes tracking and understanding progress easy, but also requires leadership and accountability from the entire team. The scorecard allows you to objectively see which areas of your practice are making progress and which are lagging. It is important when using scorecards, to clearly define who (individual) is accountable for each key performance indicator and address the success and opportunity as they outline.   

As a busy healthcare practice owner, your time is valuable. You know it’s important to operate your practice efficiently, while also providing the best client experience possible. A KPI scorecard can be designed for many different functions. When it comes to tailoring it to your healthcare practice, there are two key areas you should consider:

  • Operational 
  • Practitioner 

The operational scorecard is a management tool that provides a visual representation of a practice’s key performance indicators. It serves as an easily digestible snapshot of the practice’s performance, allowing both owner and practitioners to quickly assess the health and effectiveness of various practice functions. The components of an operational scorecard are carefully selected to align with the owner’s 100-day plan and further up to the practice’s annual strategic goals. By tracking these KPIs in real-time or through regular reporting intervals, practices can identify trends, measure progress, and make informed decisions to drive continuous improvement. 

The practitioner scorecard is a performance measurement tool specifically tailored for evaluating the effectiveness and efficiency of practitioners.  This scorecard is designed to capture key performance indicators that reflect the practitioner’s contribution to client experience, care plans, and overall impact on the practice’s success. Ultimately, the healthcare practitioner scorecard serves as a valuable tool for fostering accountability, driving excellence in client care, and ensuring that practitioners are aligned with the organization’s mission and values.

Tracking and Improving Operational Metrics: The Lead and Lag Dynamics

Lead and lag measures are commonly used in the context of key performance indicators and compelling scorecards. Practice objectives are often created across two scorecards: operational and practitioner.  Understanding the difference between lead KPIs and lag KPIs is critical as you create your scorecard. Leading KPIs indicate where you want to go and lagging KPIs show what you’ve achieved. Here’s an explanation of lead and lag measures:

Lead Measures:
Lead measures are proactive and predictive indicators that have a direct influence on achieving a specific goal. They are the actions and activities that, if executed successfully, are expected to drive the desired outcome. Lead measures are typically within the control of individuals or teams and provide early signals of progress. For example, to generate more referrals to your practice, lead measures might include: the practice, this month, will source 40 new Google reviews, 20 net new friends and family referrals this month, and generate 15 new patients through cross referrals between clinicians. By focusing on driving and improving lead measures, organizations increase the likelihood of achieving their broader objectives.

Lag Measures:
Lag measures, on the other hand, are the outcomes or results that indicate the success or failure of past activities. They are retrospective and measure the actual achievement of a goal after the fact. In the weight loss example, a lag measure would be the total weight lost over a certain period. Lag measures reflect the end results of the efforts put into lead measures. While lag measures are important for assessing overall success, they are often influenced by various factors and may not provide timely insights into the effectiveness of current actions. Examples include: gross margin, revenue/month, net income from operations.

ELEVATE has provided an example of Lead and Lag measures for both operational and practitioner scorecards.


Lead/Lag Indicator
TargetAction Plan
Clinic Productivity
Schedule Efficiency>85%
Cancellation/NS rate<12%
Revenue per case by service stream (EHB, WCB)Dependent on pricing/contract vs EHB
Gross Margin
% GM> 40%
Revenue per monthAs per the annual plan
Intakes per day1.2 Intakes per 1.0 FTE
Labour (Direct)< 52% of sales
Labour (Indirect)< 8% of sales
Bad debt<1% of sales
Client Experience and Brand
Google Reviews> 4.8
Direct Referrals (F&F/GP)50-70% of intakes
Client Experience Q90% score 9 or 10
% clients with No next visit< 10%
Talent Engagement
Buckingham SurveyFor your interest
Turnover< 20% annually
Vacancy time to fill< 3 weeks


Lead IndicatorTargetAction Plan
Access to Care/Productivity
Schedule Efficiency>85%
Cancellation/NS rate< 12%
Revenue per monthDependent on pricing (22,000-28,000)
Clinical Excellence
<20% cases have < 4 visits< 20%
Revenue per caseDependent on pricing/contract vs EHB
Client outcomesCan assess RTW/RTADLs
Client Experience and Brand
Google Reviews> 4.8
Direct Referrals (F&F/GP)50-70% of intakes
Client Experience Q90% score 9 or 10
% clients with No next visit< 10%

Now that we’ve defined what a KPI scorecard is, let’s examine why creating one can help your business. In a busy practice, no one wants to take on extra administrative work. But, when updated daily, a KPI scorecard provides valuable insights into your practice’s performance and highlights elements of your business that require attention.

Reasons Why Every Practice Should Have Operational and Practitioner KPI scorecards:

Facilitates Agile Decision Making
Amidst the hustle and bustle of daily patient care and administrative tasks, it’s easy to lose sight of the bigger picture. Your KPI scorecard acts as a compass, providing standardized metrics to focus on, areas of growth and identify potential obstacles. Whether seizing new opportunities or navigating unexpected challenges like shifts in market dynamics, your scorecard enables swift and informed decision-making, ensuring your practice remains resilient and adaptable.

Enhances Client Experience
In a competitive healthcare landscape, offering an exceptional client experience is key to retaining clients and attracting referrals. By evaluating metrics such as client engagement rates, and referral volumes, your client experience KPI scorecard helps you understand your target audience and outshine your competitors. After all, who doesn’t love a practice with rave reviews and a steady stream of referrals from friends and family?

Streamlines Internal Processes
Well-documented internal processes and procedures are the backbone of a smooth operating practice. Your scorecard ensures that everyone on your team is aligned and informed, preventing disruptions caused by unexpected absences or transitions. With clear protocols in place, your practice can maintain its momentum even during challenging times.

Drives Practice Growth
Your practice holds vast growth potential, and regular evaluation is the key to unlocking new opportunities and addressing obstacles. By tracking metrics like new referrals per day, average revenue per treatment, patient visit average, and overall revenue, your growth-focused KPI scorecard empowers you to seize opportunities, expand your services, and attract new clients. Whether it’s hiring additional staff or tapping into new referral sources, your scorecard provides valuable insights for strategic decision-making.

Optimizes Financial Performance
While revenue is important, profitability and cash flow are crucial for the long-term success of your practice. Your financial performance KPI scorecard evaluates metrics like revenue growth, profitability, and resource utilization, ensuring that your practice remains financially healthy and attractive to investors or potential buyers. By maximizing revenue streams and managing expenses effectively, your practice can thrive financially while delivering exceptional care to your patients.

A Culture of Execution and Accountability—action and results

Cultivating a Culture of Execution and Accountability
The whirlwind of ‘busy work’ often consume a healthcare practice’s daily operations. However, the the critical tasks necessary for future sustainability of your practice can easily slip through the cracks. Leaders/owners should spend 80% of their time on the 3-5 most critical KPI’s. However, ‘busy work’ consumes the owner daily, and at best, 20% of their energy goes into driving practice success. It’s like owners are driving their car while looking in the rear-view mirror.  Said another way, nothing stops the growth of a practice faster than owners/team members who believe the way you worked yesterday is the best way to work tomorrow.  Instilling a culture of execution and accountability might be the hardest thing you do as an operator/owner and it will make all the difference to your bottom line growth.

Leadership’s Role
Leadership sets the tone for accountability within the practice. By clearly communicating expectations, defining key performance indicators (KPIs), creating a compelling scorecard, and sharing the strategic vision, leaders create a framework for success. Regular team meetings and one-on-one check-ins provide opportunities to discuss progress, address challenges, and reinforce accountability.

Systematic Processes and Workflows
Integration of accountability into daily operations involves implementing systematic processes and workflows. This includes setting SMART goals, tracking performance, and providing constructive feedback. Recognition and rewards for achievements contribute to a positive culture of execution.

Empowering team members to take ownership of their roles fosters a proactive mindset. When team members understand how their contributions impact the practice’s success, they are more likely to identify opportunities for improvement and actively contribute to achieving shared goals.

Establishing Accountability Measures

To ensure clarity and alignment of roles and responsibilities within the practice, implementing tools like RACI (Responsible, Accountable, Consulted, Informed), can be immensely beneficial.

RACI Matrix:
The RACI matrix clarifies roles and responsibilities for specific tasks and outcomes. It designates individuals or groups as Responsible (doers), Accountable (decision-makers), Consulted (providing input), or Informed (kept in the loop). Assigning these roles ensures transparency, accountability, and effective alignment towards the practice’s goals.

Key Components of RACI
Responsible: Directly responsible for completing tasks or delivering outcomes.
Accountable: Ultimately responsible for ensuring tasks are completed and standards are met.
Consulted: Provides input and feedback on tasks.
Informed: Kept informed of project progress without direct involvement in decision-making.

Implementation and Evolution:
Regular review and refinement of the RACI matrix are essential as the practice evolves. Roles and responsibilities may shift, requiring updates to ensure continued effectiveness.

Practical Application
As a practice owner or clinician, imagine the impact of clearly defined responsibilities and accountability measures on your day-to-day operations. With a culture of execution and systematic accountability measures in place, you can confidently navigate challenges, drive continuous improvement, and elevate the success of your healthcare practice.

RACI application to 4 CORE metrics-how/who

TaskAdmin. TeamPractitionerOwner
Schedule efficiencyAcct.Resp.Consulted
Cancel/No Show ManagementAcct.Resp.Consulted
Drop off listAcct.Resp.Consulted
Care planningAcct.Resp.Consulted

Automation bias/Owner Complacency to Tech Driven Data

Our Team at ELEVATE are experts in practice management.  Our five decades of experience has developed our deep understanding of practice finance, operations and clinical data intricacies and the story it should be telling you.  This may shock you, but over 80% of the time we look at monthly or quarterly data generated by a PMS or EMR, the first thing out of our mouths…this can’t be accurate.  Knowing when your data doesn’t seem accurate and finding ways to solve the problem creates a very different narrative vs. the practice owner who takes EMR data at 100% face value and creates tactical operational plans from it.

Be aware of your automation bias and complacency to trust data just because your PMS generated it.  When operational efficiency data from an EMR/PMS fails to align with your expectations, it can be a frustrating experience for owners. One of the primary reasons for this discrepancy may stem from the quality and accuracy of the data being captured by the EMR system. Inaccuracies in data entry, coding errors, and inconsistencies in recording practices can all contribute to unreliable data outputs. Without clean and reliable data, it becomes challenging to derive meaningful insights or make informed decisions to improve operational efficiency.  As an owner, can you tell the difference between clean and dirty data.

Another factor that can complicate the interpretation of operational efficiency data is the complexity of healthcare workflows and processes. Healthcare practices often involve numerous interconnected activities that make it difficult to isolate specific metrics or identify areas for improvement. Additionally, EMR systems may not always capture the full scope of these workflows, leading to gaps or oversights in the data collected. Without a comprehensive understanding of the entire operational system, it becomes challenging to accurately assess performance or identify opportunities for accuracy.

To address these challenges, healthcare practitioners must prioritize data integrity and invest in strategies to improve the accuracy and reliability of the information captured by their EMR systems. This may involve implementing standardized data entry protocols, providing training to staff members responsible for data input, and regularly auditing data quality to identify and rectify errors. By ensuring that their operational efficiency data is accurate and actionable, healthcare practices can leverage this information to drive meaningful improvements in patient care delivery and practice performance.

Importance of Radical Candor in Operational Success (attributed-Kim Scott)

The value of communicating with radical candor cannot be overstated. Clear is kind, serves as a feedback mechanism for steering practitioners towards operational excellence and success. Let’s delve into how embedding radical candor into our daily operations can elevate our practice to new heights.

Performance Management: Nurturing Growth and Development
At the heart of operational success lies performance management—the ongoing dialogue between employees and leaders aimed at achieving success in their roles. Our goal is to enhance this communication, fostering a culture of continuous improvement and development. Here’s how we do it:

  • Stop with the ruinous empathy and learn how to communicate with radical candor.
  • Frequent, Two-Way Communication: We believe in open, transparent communication, where team members and owners engage in regular discussions about performance and development. By understanding each other’s perspectives, we can work together to overcome challenges and seize opportunities.
  • Support Development Aspirations: Every member of your team has unique talents and aspirations. We’re committed to identifying and supporting these aspirations, providing opportunities for growth and advancement. When our team grows, our practice flourishes.
  • Establish Baseline Performance Criteria: To facilitate meaningful conversations and assessments, we’ve developed team member dashboards and performance tools. These tools provide a common language for evaluating performance, setting goals, and recognizing achievements.

Operational challenges often present formidable obstacles to success within your practice. From streamlining client flow to optimizing revenue mix, each hurdle requires a strategic approach to conquer. By harnessing left-side brain themes focused on lowering transaction costs, maximizing operational efficiency, and cultivating a culture of execution, healthcare practices can navigate these challenges with confidence.

Exercise: Reflective Questions

  1. How can you apply the concept of lowering the cost of every transaction to the top three practice challenges?
  2. What tactics can you implement to reduce fixed costs related labor and rent?
  3. What is your direct labor spend as a % of revenue including employees and independent contractors? 
  4. What are some practical steps you can take to reduce bad debt to <0.5%?
  5. How can you strategically adjust pricing to preserve margin and adapt to changing market conditions without compromising on service quality or client experience?
  6. What high-value services can you focus on in your practice to maximize profitability and differentiate yourself from competitors?
  7. How can you develop and implement operational scorecards and KPIs to better track and improve the performance of your practice and practitioners.
  8. What are some lead and lag measures you can identify and track to drive progress toward your practice’s goals?
  9. How can you leverage technology, like practice management software, to enhance efficiency, effectiveness, and engagement.
  10. What steps can you take to cultivate a culture of execution and accountability within your practice, ensuring that everyone is aligned and focused on achieving our goals?


Need Further Help?

Book A FREE CONSULTATION with Gary Thorne, ELEVATE’s Founder!

Tailored solutions to address your unique challenges & ELEVATE your Practice.

2. Right Brain Themes: People-Centric Strategies

Remember, you are in the People Business Delivering Healthcare

In healthcare, one fundamental truth stands out: at its core, it’s a people’s business. When you strip away every strategic plan, every P&L statement, and every operational scorecard from your business you are left with one thing – relationships. Relationships with clients, team members, referral sources, and investors. My hope—if you take one nugget away from this module, please take this one–We are people, people caring for people.

Beyond the clinical skills and diagnostic tests, it’s the human connection that defines the essence of healthcare. Thus, it becomes imperative for both healthcare owners and practitioners to not only excel in their technical competencies but also to nurture and grow skills that allow you to become a better human.

Fostering Humanity in Practice (EQ eats IQ for breakfast) 
The hallmark of a successful practice lies not just in their technical prowess of the clinical team but in their team members ability to empathize, create trust, listen to understand, meet the client where they are at, communicate effectively, and remain self-aware. This blend of human skills, often termed emotional intelligence, plays a pivotal role in forging strong clinician-client relationships. A blend of caring and clinical competency is a great way to create a moment with your clients. Don’t forget, you win on the emotional and lose on the transactional.

Winning by upskilling team member’s EQ will have a greater downstream impact on all you Key Performance Indicators (KPI’s) vs. adding another technical tool to your clinical toolbelt. Here are a few lead measures, KPI’s:  lowering your no show/cancellation rate <12%, improving net promoter score >85%, fewer private pay clients with three or fewer visits, and increasing friends and family referrals. A client cannot love a brand until its team members love it first.

Winning on Emotional Connection
In the competitive world of private healthcare, winning solely on technical skills is no longer a winning formula. Understanding the profound impact of emotional connection with your clients is essential for fostering a culture of empathy, trust, reciprocity, and human connection. Clients won’t remember what you did, or how you did it, but they’ll remember how you made them feel.

1. Defining Your Practice’s Purpose

Understanding your purpose or “WHY” behind launching a healthcare practice is paramount as your practice’s purpose serves as its North Star.  It shapes every decision and action. It’s more than just the services you provide; it’s the deeper reason behind why you do what you do. Defining and understanding this purpose provides clarity to both internal team members and your clients. 

Internally, a well-defined purpose fosters a sense of direction and pride among team members, aligning their efforts with a shared mission. This alignment contributes to a more engaged and motivated workforce, as team members see their roles as integral to achieving the broader purpose. 

Externally, a clear practice purpose enhances your brand identity and how it resonates with clients and referral sources. When clients connect with the values and impact of your practice, it creates brand loyalty and fosters a deeper, more meaningful relationship. A well-articulated purpose acts as a guiding light during times of practice start-up or change. Whether navigating challenges or pursuing opportunities, a clear understanding of the “why” enables owners to make decisions that are not only strategic but also reflective of the practice’s core values.

2. Making a Meaningful Impact in Your Community

Your healthcare practice is not just a business—you have a responsibility to make a difference in the communities where you have a privilege to serve. Steward leadership is a concept rooted in the idea that leaders are entrusted with the responsibility to manage and cultivate resources for the benefit of others, rather than solely for their own gain. At its core, steward leadership emphasizes service, integrity, and accountability. Steward leaders view themselves as caretakers or stewards of the practice they lead, acknowledging they are responsible for the well-being of their team members and the community at large.

By actively engaging with residents and organizations, you can become a catalyst for positive health and wellness change. This involvement can manifest in various ways, from organizing health awareness programs and preventive care initiatives to offering educational workshops on relevant health topics. By tailoring services to address specific community needs, your practice can become an integral part of the community’s overall well-being. Providing accessible healthcare services, not only enhances the overall health of the community but also strengthens social bonds. As your practice becomes a trusted advisor for health and wellness, it contributes to the community’s resilience and sets a positive example of brand responsibility. 

3. My True North – A Values-Driven Practice Model

Aligning your practice’s core values with your personal values is essential for establishing authenticity and trust. When your values are reflected in your practice, it creates a sense of purpose and integrity that resonates with both clients and team members. Clients and team members alike are drawn to healthcare practices that demonstrate a commitment to values beyond profit margins. This alignment fosters a genuine connection between you, your team, and the community you serve.

As a healthcare owner, your core values must mirror your commitment to client well-being, evidence-based practices, and a compassionate approach to healthcare. Having congruent core values provides a guide, not only to your actions as an owner but also those of your team members. It helps cultivate a shared sense of purpose among your team members, promoting a positive work environment, and contributing to higher team member engagement. Clients can feel the sincerity behind your services, leading to increased trust, loyalty, and likely word-of-mouth referrals.


Owner Driven Communication Tactics-every word matters

In the complex world of healthcare practice management, purpose driven communication is essential for success. As an owner, when engaging with your team, ensure that your communication is consistently rooted in enhancing the client experience and delivering best practices. Avoid framing your communication to team members in terms of the practice’s need for increased revenue or greater profit. When you frame your communication to team members in terms of the practice’s need for increased revenue or greater profit, it can lead to demotivation, a focus on individual gain over collective goals, reduced morale, and a potential decline in teamwork and collaboration. Stay aligned with a common purpose that drives the collective team.


Building Trust through Effective, Timely, and Frequent Communication
Imagine a scenario where financial metrics take a back seat, and the spotlight shines on the impact of your actions on the client experience. Shifting the narrative from financial figures to tangible client interactions can ignite a powerful transformation within your practice. By emphasizing how specific behaviors positively influence client engagement and experience, practitioners are more likely to connect emotionally, driving meaningful change. Your financial metrics will follow suit as a result. 


At ELEVATE, we believe there are two masters in every conversation. You are the Master of your INTENT while your conversation partner is the Master of your IMPACT. Always check back with your team members to ensure they heard what you intended for them to hear.  Never leave communication to chance as your intent will inevitably get lost in translation.

Influential Communication: 1:1 with Team members or a Team huddle (daily/weekly)

Here are some of the essential components of effective communication with your team:

  • Establish a Purpose

Effectively articulating the overarching purpose of your healthcare practice is fundamental. It helps your team members understand the bigger picture and their integral role in achieving collective success. It also allows you as the leader, and your team members, to align short term action plans to the larger goals and purpose of your practice. 

  • Share Success Stories

Sharing client and community success stories is the best way to illustrate the positive impact of the team’s efforts. This will help foster a sense of pride and motivation among team members.

  • Express Gratitude/Recognition

Express gratitude for the hard work and dedication of the team to create a world-class client experience in your practice. Recognizing individual team members and collective contributions reinforces a positive and collaborative work environment. There are several ways to recognize team members. Make sure to check with your team to identify how they prefer to be recognized individually. Team recognition goes a long way in fostering a strong and cohesive culture.

  • Create opportunities to ‘stretch’ your team’s performance

Encourage team members by setting achievable yet challenging goals. This instills a sense of purpose, encourages continuous improvement and creates a can-do attitude.

 Collaborative Communication: usually best for staff meetings (30 minutes)-monthly basis

  • Interactive Meetings

Conduct interactive meetings that encourage active team member participation. Allow team members to share their insights, experiences, and suggestions, fostering a collaborative and fun environment. As a leader, be sure to follow up on any unaddressed questions or suggestions. It can be harmful to not close the loop leaving team members feeling unheard and disengaged.

  • Team-building Activities

Incorporate team-building activities or exercises into communication sessions. This helps strengthen interpersonal relationships, promotes teamwork, and enhances overall collaboration. A team that plays together, stays together.

  • Feedback Mechanism

Establish a constructive feedback mechanism where team members feel comfortable sharing their opinions. Actively listen to their feedback, address concerns, and incorporate valuable insights into decision-making. A great owner always listens to understand v. listens to be understood.

  • Encourage Front End/Back End Communication

Facilitate communication across the front end (business administration) and back end (practitioners) within the practice. This ensures that information flows seamlessly and promotes a broader understanding of the practice’s operations.

By incorporating these communication tactics, you, as a healthcare practice owner, can cultivate an environment where team members feel informed, inspired, and motivated to contribute positively to the practice’s success. Together, let’s elevate communication and propel your practice to new heights of excellence.


Crafting a World Class Client Experience

In a world where clients are overwhelmed with the multitude of healthcare options, creating a world-class client experience stands as the ultimate competitive advantage. Beyond clinical expertise, it’s the personalized care and lasting impressions that leave an indelible mark on clients. Here’s how to elevate the client experience to exceptional levels and master the art of creating lasting impressions.

Elevating Client Experience to Exceptional Levels

Imagine a practice where every interaction is a testament to personalized care and genuine concern for the client’s well-being. It’s more than just a transaction; it’s a journey tailored to meet individual needs and preferences. Practitioners who understand how their actions influence the overall client experience tend to have a differentiating factor, a sense of purpose and pride in their work that becomes a competitive advantage. 

By placing clients at the heart of every decision, a client-centered mindset spreads within the practice, fostering improved teamwork and a positive work environment. We are in the people business serving healthcare. When this becomes the foundational belief, it can create a positive change building an engaged client-oriented healthcare team, setting the stage for unparalleled client engagement and customer loyalty.

The Art of Creating Lasting Impressions

To create a world-class client experience, three key themes should be woven into the fabric of your practice:

Personalized Care
Your brand identity hinges on personalized service that anticipates and fulfills the unique needs of each client. From remembering names and your client’s interests and special events, to accommodating a care plan and appointment requests. Attention to detail is paramount. This means paying attention to what it feels like to walk into your clinic and interact with your team. Every touchpoint contributes to a highly personalized experience your clients will consistently choose over your competitors.

Attention to Care Plan Details:
Care planning plays a crucial role in shaping the client experience. Completing and reviewing a care plan with a client influences the quality and effectiveness of patient care. It creates a sense of collaboration and partnership between practitioners and their clients. Through involvement of the client, it empowers them to participate in decisions regarding their treatment goals, preferences, and expectations. This leads to greater satisfaction and engagement in their healthcare journey. Care planning provides the opportunity for a personalized approach demonstrating empathy and fostering trust and rapport. Furthermore, effective care planning promotes continuity and consistency in the delivery of care, which is essential for optimizing the client experience and care outcomes. 

Highly Trained and Empowered Team Members:
Invest in the ongoing training and professional development of your team members to uphold the highest standards of both clinical and personalized care. Beyond technical skills, empower your staff to embody the brand’s dedication to exceptional client service. From answering every phone call to delivering customer service education to your team.  Empowering your team members to make decisions that create amazing experiences is critical especially when some sort of ‘hiccup’ has occurred in your practice. For example, a client was upset because their practitioner was running 30 minutes behind. The front desk team member was empowered and chose not to charge the client for the treatment as a small amends for a poor experience. 

By embracing these principles, you can transform your practice into a beacon of client-centric care, where every interaction leaves a lasting impression of warmth, compassion, and professionalism. Let’s embark on this journey together and ELEVATE your practice to new heights of success. Empower Your Team Members to Make Great Experience Decisions!

Exercise: Reflective Questions

  1. How does the concept of “We are in the People Business Delivering Healthcare” resonate with the experiences you create within your practice?
  2. Reflect on a time when the human connection played a significant role in your interactions with patients. What impact did it have on establishing trust?
  3. Why is it important for healthcare practitioners to excel not only in technical competencies but also in nurturing their human skills?
  4. In what ways do you currently upskill the emotional intelligence of you practitioners?
  5. Reflect on a memorable experience where you felt your EQ abilities were more impactful than your technical abilities. What made it stand out? Did you share this story with your team?
  6. The power of reciprocity fosters a sense of trust and interdependence between team members. Reflect on how you have used reciprocity to enhance the overall dynamics in your practice.
  7. How do you define the purpose of your healthcare practice? Reflect on how understanding the “why” behind your practice’s existence can guide decision-making.
  8. Share examples of how your practice has made a meaningful impact in the community it serves. How has this involvement contributed to its overall success?
  9. Reflect on the current state of communication within your practice. How can you enhance collaborative communication during staff meetings and interactions?


Have Questions?

Book A FREE CONSULTATION with Gary Thorne, ELEVATE’s Founder!

Tailored solutions to address your unique challenges & ELEVATE your Practice.

1. Introduction to Operational Module


Welcome to ELEVATE’s Launch Operational Learning Module, where we begin on a journey to empower you as a healthcare practice owner and practitioner to find your starting point on the road map to operational excellence. At ELEVATE, our mission is to upskill you with the insights, tactics, and tools needed to operationally position your practice for growth.

Understanding the operational benchmarks that create value for national strategic buyers or financial investors can be the difference between seizing opportunities and missing out. With ELEVATE’s firsthand experience sitting in the role of strategic buyers, we bring invaluable insights into what resonates with potential acquirers, enabling you to highlight your operational strengths from day one.

A quick caveat, ideally, a functional strategic plan (Launch Financial Module) should precede operational excellence. Operational excellence focuses on optimizing day-to-day processes and activities, while a strategic plan provides the overarching framework that guides and aligns these operational efforts with the long-term goals and vision of the practice. 

Operational excellence lies at the heart of our approach, serving as the cornerstone for quality client care, regulatory compliance, and streamlined workflows. By prioritizing operational efficiencies, your practice can:

  • gain a competitive edge
  • reduce costs
  • enhance client experience 
  • lay a foundation for sustainable growth

Our objective is clear: To empower you with practical and actionable insights that will revolutionize your approach to practice management.


  • Launch Operations will equip practice owners with new communication skills and theme insights for talking with practitioners and administration team members.
  • Launch Operations will deliver the framework for clinical scorecards and practitioner scorecards.
  • Launch Operations will highlight the urgency to create a culture of execution, accountability, efficiency, and consequences for non-performance.
  • Launch Operations will unpack the importance of lowering the cost of every transaction in the practice.
  • Launch Operations will highlight an ongoing priority to always be on the lookout to upgrade your talent. 

As we dive into the Launch Operations learning module, remember that the journey to operational excellence is not just about optimizing processes—it’s about transforming your practice into a beacon of quality care, innovation, and success. Are you ready to elevate your practice to new heights? Let’s begin!

Exercise: Reflective Questions:

Before delving into Launch Operations, it would be beneficial to start with reflective questions as a pulse check. These questions serve as a valuable tool to gauge current knowledge, understanding, and readiness for change and growth. By taking a moment to reflect on what is already known, past experiences, what gaps exist, and what questions may arise, you can better prepare for the upcoming learning experience. These reflective questions will not only help to set the stage for deeper learning but also encourage active engagement and critical thinking, ultimately enhancing your overall learning process.

  1. Reflect on a recent experience in your practice where operational inefficiencies impacted client engagement. What was the root cause of the inefficiencies and what steps did you take to address them?
  2. Consider the long-term goals and vision you have for your practice. How does winning on operational excellence align with these goals? What strategy and steps have you implemented to ensure alignment between day-to-day operations and your overarching vision and goals?
  3. As you envision preparing to engage with potential strategic buyers or investors for your practice, which aspect of your current operations management do you think would resonate most, and why?
  4. Consider the current relationship between your practice’s operational excellence and client engagement. How do you currently measure operational efficiency and what improvements can you make to enhance the overall client experience?
  5. Think about a time when you faced communication challenges within your practice. What were the consequences of these challenges? 
  6. To win at operational excellence, you must create a culture of execution, accountability, and efficiency within your practice. What steps have you taken to foster this culture among your team and how would it positively impact the overall success of your practice?
  7. What is your current approach to training and development of your team members? What strategies can you implement to ensure high performance and compliance to your key operational targets?
  8. Imagine you are evaluating the cost-effectiveness of every transaction within your practice. What areas of your operations could benefit from cost-reduction efforts, and what strategies could you implement to lower transaction costs while maintaining effectiveness, efficiency and engagement?
  9. Reflect on the overarching goal of elevating your practice to new heights of success. What specific actions as a leader can you take, starting today, to begin this journey toward operational excellence and transformative growth?
  10. More revenue, with the same revenue mix, won’t solve your operational inefficiencies.


Book A FREE CONSULTATION with Gary Thorne, ELEVATE’s Founder!

Tailored solutions to address your unique challenges & ELEVATE your Practice.