The Second Practice Advisory
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A six-month minimum, hands-on intensive for independent practice owners who've already built something real, and are ready to stop being the only person who can run it. I teach you how to build the systems and leadership underneath your practice.
You and your team build it.
You didn't get this far by accident. You also can't get further alone.
You built a real practice. Patients trust you enough to pay you directly for their care. Your reputation carries weight in your market, and you didn't need a franchise or a management company standing behind you to earn it. Most of what you set out to build is already here.
What's left is the part nobody trained you for. Delegation that sticks instead of bouncing back to you. Systems that hold up when you're not the one holding them together. A team that can make a real decision without checking first. A version of quiet that feels like relief instead of a warning sign.
That's not a clinical problem. It's an operational one, and it's the specific kind Advisory exists to close.
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Independent physicians and nurse practitioners already running a concierge, direct primary care, aesthetics, dermatology, or menopause-care practice. Already small, already independent, no franchise or management company behind you. Already have the patient base, the clinical reputation, and years of relationship capital in place, often most of the way to the practice you originally set out to build. Still stuck on the operational last mile: delegation, systems, leadership capacity, and a real plan for what happens if you step back.
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You're still employed by or under contract to a hospital or a large medical group
Your practice runs through an active franchise or management-company relationship with real control over how it operates
You don't have a patient base yet, Advisory sharpens what's already built, it isn't built to launch a practice from nothing
You already know you need someone in the weeds with you ,building alongside or for you directly, not teaching you to build it yourself. This would be a strong case for the Second Practice Consulting.
What 6 months looks like
This is intensive, on purpose. For six months, you're learning how I work and I'm learning your practice from the ground up, not from a summary.
Here's roughly how it breaks down. The pacing below is typical, not fixed, some owners move faster through one month and slower through another, depending on where the real work turns out to be.
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Starts with an unstructured walkthrough of how the practice runs day to day, no fixing yet, no agenda. Moves into finding the threads that connect what looks like three separate problems, and naming what nobody's said out loud. Ends with your Practice Diagnostic and the real decision point: agreeing on what's happening before either of us touches a fix.
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Starts with an honest look at what you want without the white coat on, most physicians never got asked. Moves into deciding whether to climb the next peak or stay at this one, on purpose, not by default. Ends with your Practice Vision file and a real decision, Stop, Slow, or Go.
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Starts by mapping where information lives today, scattered across email, texts, and whoever happens to remember. Moves into designing the single source of truth that replaces it. Ends with a drafted Operating Manual and SOP Library, and one decision left open on purpose: what gets tested with one person before it goes live to everyone.
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Starts with that pilot test, one person, real patient days, before anyone else touches it. Moves into building the backup plan for when a piece of it breaks, a good system isn't one that never fails, it's one you can fix fast when it does. Ends with the whole team live on it, patient-facing pieces locked in without wavering, or a clear-eyed decision to send a piece back to design.
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A strong look at every decision still routing through you that doesn't need to anymore. Moves into the hard call, the conversation or decision you've been sitting on, and teaching your team to own a process, not just execute a task. Ends with your Leadership and Decision Guide, a real, tested line between what's theirs to decide and what's still yours.
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Naming what's still driving you to check in, evidence or habit. Moves into a real test of disengagement, phone off, a genuine stretch of time where you find out whether what you built holds without you watching it. Ends with your Owner Dashboard and Trust Plan, and a return to Observation, with sharper eyes than the first pass had.
What's included - $2,500/month - Minimum 6 months
Bi-Weekly 60-minute Zoom sessions (pre-scheduled)
Ongoing slack and and voice-note access in between sessions with defined response expectations.
Guidance on the recurring issues nearly every independent practice runs into: team communication, patient communication, scheduling, patient membership intake and outreach, and the patient experience
Direct tool and vendor recommendations, explained clearly enough for your team to act on, not just a list of names
A guided AI sequence that helps you build five practical files and AI projects as you move through the cycle: a Diagnostic File, a Vision File , Operating Manual and SOP Files, a Leadership and Decision Files, and an Owner Dashboard and Trust File, each one building on the last
I explain what to build and how the pieces fit together. Your team builds it, with my guidance. That's the actual difference between this and hiring someone to fix it for you: you and your team walk away able to run and adjust what you built, not dependent on a call to me every time something needs to change.
A few examples of what this could look like in practice. Real problems, with the recommendation, the how-to guide, and the homework that gets you and your team building the fix yourselves.
PATIENT ENROLLMENT
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A guide walking the enrollment path end to end, showing where patients typically stall and what a clean version of the workflow looks like.
NEW EMPLOYEE ONBOARDING
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A framework for the checklist, access setup, and first-week structure a new hire should walk into. You build it once with your team, ideally before your next hire, and it's yours to update every time a role changes.
PATIENT EXPERIENCE
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A guidebook on where patients already feel cared for, where they're just confused, and which touch-points are worth automating so education and delight don't add to your team's workload.
TECHNOLOGY SELECTION
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A clear recommendation on what tool, if any, solves the real problem, and how to weigh it against what you already have.
MEMBERSHIP PRICING CHANGE
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A checklist covering timing, existing versus new patients, staff preparation, and the questions to expect before anything gets announced.
COMMUNICATION
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A guide for pulling what's scattered across texts, EMR messages, and hallway conversations into one place your team checks without a second thought.
THE CLEAR NO
Some businesses hide who they're not for, what's excluded, what won't work for you, somewhere in the fine print. I do the opposite. Every place on this page where I tell you this might not be right for you sits in plain sight, not a page you'd have to go looking for. If you read one of those sections and recognize yourself in it, that's real information, not a tactic to make you second-guess a good fit! I'd rather you find that out in thirty seconds of reading than six months into a commitment. The same holds after you've paid for the Assessment: if the honest answer is that you don't need ongoing help, that's what you'll hear, not a version of the truth that's easier to sell. Neither of us has time to waste, and I'd rather spend mine being straight with you than spend it convincing you.
THE SECOND PRACTICE ADVISORY IS…
I don't build the SOPs, configure the CRM, or set up the phone system myself, that's your team's work, guided by what I've shown them. If you know you need someone building alongside you directly, that's Private Consulting, a separate, more hands-on six-month option.
NOT IMPLEMENTATION
NOT MARKETING OR LEAD GENERATION
I'm not a marketing consultant. I can help you think through panel growth as part of the broader work, but bringing in new patients isn't what this delivers.
No promised revenue, no promised conversion rate, no fixed timeline independent of your own execution and your market. Some owners move through their first full Practice Cycle in six months, some take eight or longer, it depends on where you start and how much time you can give it. I'd rather tell you that plainly than oversell what any six months can promise.
NOT A GUARANTEE
NOT ACCESSING PATIENT DATA
The AI tools used throughout Advisory stay scoped to business and operational context, scheduling, staffing, systems, communication, not anything patient-identifiable or clinical, unless a dedicated privacy and compliance environment gets built specifically for that.
NOT BILLING OR REVENUE CYCLING MANAGEMENT
Outside the scope of this work entirely.
Questions worth asking before you book
There is no separate application for Advisory. The way in is the same $750 Practice Assessment used to read any independent practice: a pre-assessment questionnaire, a 60-minute call, a written Practice Audit within three business days, and a 30-minute follow-up call to talk through what it found.
If Advisory turns out to be the right fit, that determination comes stated plainly in your Practice Audit, not as a sales pitch. And if you join within 14 days of receiving it, the full $750 you already paid gets credited toward your payment.
If Private Consulting or nothing at all turns out to be the more honest answer, you'll hear that instead. The Assessment is built to say what your practice needs, not to steer you toward the option that's easiest to sell.
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No. This is built for any independent medical professional working in direct patient care, physicians and nurse practitioners both, running concierge, direct primary care, aesthetics, dermatology, or menopause-care practices. What matters is that the practice is independent and does direct patient care, not the specific credential behind it.
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Not on its own. Advisory helps you build the systems and leadership behind a practice that already exists, it isn't built to launch one from nothing. If that's where you are, the Assessment will tell you plainly, and point you toward what fits instead.
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By capping how many clients I take on, five in Advisory at any time, and by being upfront about exactly how my time splits between meetings and Slack response windows. Most of the work between calls is done in writing, in Slack, and in the guided work you're doing on your own practice. I have spent years working with multiple clients and my organization and structure allows me to deliver the time and dedication promised to you.
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We come back to Observation. What changed, what held, what didn't, what you want now. Then you choose: keep going in Advisory at the same rate, move into the lighter, less frequent Alumni Cycle, or stop. All three are real, legitimate outcomes, not a contract quietly rolling over because nobody said otherwise.
If you finish this work and don't need me anymore, that's not a loss. It's the actual goal. The whole model is built so the longer you stay, the less you need, not the more you get sold.
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No. No revenue guarantees, no promised conversion rate, no fixed timeline independent of your own execution and your market. That's a deliberate choice, not a gap. I'd rather tell you the truth than oversell what six months can promise.
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Then Private Consulting is worth a direct conversation, it's built for owners who need real building capacity, not just guidance. The Assessment will tell you plainly which one your practice needs.