The Second Practice Consulting
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A six-month minimum for independent practice owners who already know the work needs more than guidance. I don't just teach you how to build it. I help you build it, alongside your team, with real working capacity reserved between sessions.
I build with you.
You don't need another opinion.
You need someone who'll get in it with you.
You already know what's wrong. You've probably known for a while. What you don't have is the time, the bandwidth, or a team with the operational depth to architect the fix themselves, on top of running the practice!
Most consultants hand you a framework and a homework list, then leave you to figure out the rest between calls. Private Consulting is built for the practices that don't have room for that gap. I get in it with you, mapping the actual workflow, researching the real options, building the starting structure directly, so your team has something concrete to work with.
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The same independent physicians and nurse practitioners as Advisory, our other six-month option, concierge, direct primary care, aesthetics, dermatology, or menopause-care practices, already independent, already with a real patient base and reputation. The difference isn't the type of practice. It's what you already know you need: real hands-on building capacity, not guidance to build alone.
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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, this sharpens what's already built, it isn't built to launch a practice from nothing
You want someone to run your practice for you long-term, that's outsourced practice management, and it's not what this is
You're not sure yet whether you need this much, or whether Advisory would be enough, that uncertainty is normal, and it's exactly what the Assessment is built to resolve before you commit to either one
What working together looks like
I reserve dedicated working capacity between our sessions, not just time on a calendar.
Between meetings, I'm reviewing what your team has sent, researching real options, mapping the workflow that isn't working, and building the recommendation directly instead of describing and providing guidelines and leaving the building to you.
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Starts with mapping the practice directly alongside you, workflows, team conversations, the numbers, not a summary handed to me secondhand. Moves into finding the web myself, cross-referencing what your team says against what the calendar and the inbox show. Ends with your Practice Diagnostic, and the same real decision point every engagement starts with: agreeing on what's happening before either of us touches a fix.
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Starts with the same honest look at what you want, that part stays yours, I can't build a vision for you. Moves into deciding Stop, Slow, or Go together, this time knowing I'm the one who'll be building whatever comes next. Ends with your Practice Vision file, and a real decision that shapes everything I build after it.
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Starts with mapping where information lives today, pulled directly from your team, not just from you. Moves into designing and building the single source of truth that replaces it, drafted structures, not a diagram handed off for someone else to finish. Ends with a working 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, run and refined directly alongside the one person trying it first. Moves into building the backup plan for when a piece of it breaks, together with your team, not left for them to figure out alone. Ends with the whole team live on it, patient-facing pieces locked in without wavering, or a clear-eyed decision, made with you, to send a piece back to design.
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Starts with an audit of every decision still routing through you, done directly with your team's input, not guessed at from outside. Moves into the hard call, the conversation or decision you've been sitting on, where I help structure it and, where useful, sit in the room for it. Ends with your Leadership and Decision Guide, built with you, a real, tested line between what's theirs to decide and what's still yours.
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Starts with 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 we built holds without you watching it. Ends with your Owner Dashboard and Trust Plan, built together, and a return to Observation, with sharper eyes than the first pass had.
The Practice Files & AI Infrastructure
The same underlying asset Advisory produces, built more directly here. Operating knowledge gets pulled out of your head, your team's heads, old emails, half-finished documents, and organized into something real: what's been decided, who owns what, how a process should work, what keeps recurring without ever getting properly solved. I also set up your practice's AI infrastructure directly, deciding what each project should do, developing the instructions, teaching your team to work with it, refining it as what's useful becomes clear.
Working with your team, not around them.
A system doesn't work because you and I think it's well designed, it works because the people using it every day can run it without a manual open next to them. That can mean mapping what happens today with your team directly, testing a new workflow together, or saying plainly when an idea doesn't survive contact with how your practice runs.
Observation still comes first, the same as every other engagement, so the real problem gets found before any solution gets built on top of it.
A few examples of what this could look like in practice.
Not hypotheticals. Real problems, solved directly, the kind that sit on your desk waiting for time you don’t have.
PATIENT ENROLLMENT
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Mapping the current path end to end, finding where patients or staff get stuck, and designing a workflow your team can run, not just a diagram.
NEW EMPLOYEE ONBOARDING
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Building the checklist, access setup, and first-week structure once, so a new hire's first month feels organized instead of improvised. A practice that onboards well is a practice people talk about wanting to work for.
PATIENT EXPERIENCE
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Finding where a patient already feels cared for, and where they're just confused, then building the touch points that educate or delight without adding one more thing for your team to remember to send. Automating the ones that don't need a human voice, so the ones that do get more attention, not less.
TECHNOLOGY SELECTION
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Looking at the real problem, what's already in use, where information needs to move, and whether another tool helps at all. Sometimes the honest recommendation is a new tool. Sometimes it's an automation. Sometimes it's making better use of something you're already paying for and not using well.
MEMBERSHIP PRICING CHANGE
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Working through the operational side, timing, existing versus new patients, staff preparation, anticipated questions, what needs to change behind the scenes before the announcement goes out.
COMMUNICATION
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Pulling what's scattered across texts, EMR messages, and hallway conversations into one place everyone actually checks, so a question gets answered once instead of repeated to three different people, and nothing important gets lost between channels.
THE CLEAR NO
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Most businesses bury who they're not for, and what's excluded, somewhere in the fine print, if they mention it at all. I do the opposite. If you read the sections on this page telling you when Private Consulting isn't right, or when Advisory would serve you better, that's real information, not a tactic to make you second-guess a good fit. The same holds after you've paid for the Assessment: if the honest answer is Advisory instead, or neither, that's what you'll hear, not the version 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 CONSULTING IS…
NOT OUTSOURCED MANAGEMENT
I won't answer your phones, manage your employees, process patient requests, or maintain systems indefinitely. The goal is the same as Advisory, less dependence on me over time, just with more of the early building done alongside you instead of taught to you.
NOT A SUBSTITUTE
Not a substitute for clinical, legal, privacy, security, or regulatory expertise. I'll flag where that's needed. I won't make those decisions for you or pretend operational experience replaces them.
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 SHARING PHI WITH AI
The AI infrastructure built here runs the business, scheduling, staffing, systems, internal communication, not patient care or clinical decision-making. That boundary stays in place regardless of how useful it would be to cross it.
NOT BILLING OR REVENUE CYCLING MANAGEMENT
Outside the scope of this work entirely.
What's included - $5,000/month Minimum 6 months
Weekly working sessions with me across the full six-months, plus dedicated working capacity reserved between them, not just time on a calendar and a dedicated Slack channel for daily communication.
Direct research, mapping, and building of starting structures for the real operational problems your practice runs into, not a generic checklist
Practice Files, SOP library, automations and AI infrastructure, including your I Projects setup, built alongside you rather than taught for you to build alone
Direct involvement with your team: mapping what's happening today, testing new workflows, and building the pieces that need building
Clear flags on where specialized clinical, legal, privacy, security, or regulatory expertise is needed, so nothing gets built on ground it shouldn't stand on
I reserve dedicated working capacity between our sessions, not just time on a calendar.
Between meetings, I'm reviewing what your team has sent, researching real options, mapping the workflow that isn't working, and building the recommendations directly instead of leaving the building to you.
There's no separate application for Private Consulting. 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.
Which six-month options fits, if either, depends on what the Assessment surfaces and how much hands-on building capacity your practice needs. If Private Consulting turns out to be the right call, that determination comes stated plainly in your Practice Audit.
If you join within 14 days of receiving it, the full $750 you already paid gets credited toward your first month.
Questions worth asking before you start
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In Advisory, I teach you how to build it, and your team builds it with guidance. In Private Consulting, I help create the starting architecture directly, alongside your team, with dedicated working capacity between sessions. Both end with you owning the work, this option just gets further inside it along the way, and costs more because of the hours it reserves.
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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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By capping how many clients I take on, two in Consulting at any given time, and by being upfront about exactly how my time splits between meetings and dedicated working times. 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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The same Observe-again checkpoint as Advisory: a return to Observation, what changed, what held, what didn't. Then you choose, keep going in Private Consulting at the same rate, move into the lighter Alumni Cycle, or stop. All three are real outcomes, not a contract quietly rolling over.
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That uncertainty is common, and it's exactly what the Assessment is built to resolve. You don't need to arrive already knowing which of the two fits, the honest answer comes from what the Assessment finds, not from guessing on your own first.
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No. I won't answer phones, manage employees, or maintain systems indefinitely. The goal is still for your practice to need me less over time, just with more of the early building done directly instead of taught.
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No. The AI infrastructure built here stays scoped to business and operational context, not anything patient-identifiable or clinical, unless a dedicated privacy and compliance environment gets built specifically for that.