Your fractional CFO for owner-operated elective medicine practices.
Injectables. Body sculpting. Surgery. Skin rejuvenation. Cosmetic dental. Each modality has different consultation-to-procedure conversion, different patient LTV, different competitive set. Most practices run one funnel for all of them, and miss which modality the funnel is actually working for.
30 minutes. Free. No pitch, no obligation.
Five operational pains we hear most often
1. Patient acquisition cost has climbed and shows no sign of stopping
Allergan's Allē ecosystem, Galderma's ASPIRE, plus paid social and search platforms have, in our experience, driven acquisition cost for elective-medicine patients up significantly over the last 24-36 months. Practices winning the math are the ones who built referral and content-led acquisition strong enough to subsidize paid.
2. Consultation-to-procedure conversion is the lever most practices do not measure precisely
In our experience, top-quartile practices convert consultations to procedures at roughly 65-75%, while the median sits closer to 40-50%. The gap is usually a combination of consultation experience, pricing transparency, and follow-up cadence, none of which most practices can isolate from their own data.
3. Multi-modality reporting hides which modality is actually profitable
Practices running injectables + body sculpting + skin + surgery + sometimes cosmetic dental usually report one combined P&L. The injectables line might be carrying the practice while the surgery line bleeds time. Or the opposite. Without per-modality unit economics, pricing and capacity decisions get made on instinct.
4. Patient reviews and before/after content are the trust currency, and they decay fast
A prospect comparing your practice to the one two blocks over is reading reviews, looking at before/afters, and checking provider credentials. A single bad review hits conversion across the board. Most practices either over-rely on RealSelf without owning their Google + Yelp surface, or vice versa.
5. The geographic competitive set is real and the moat is real
Elective-medicine patients shop locally. The practice that wins the prospects within a five-mile radius of itself wins the market. Practices that try to compete on price across a 50-mile radius almost always lose to a locally-anchored practice with sharper trust signals.
Diagnose, monitor, advise
Most practice owners meet us one of a few ways, and you do not have to know which one fits today. Start with a finding or an Intro Call; the right depth becomes obvious from there.
Diagnose
Understand your own practice, in depth.
Exactly where patient attention and margin leak across injectables, body, skin, surgery, and cosmetic dental.
Website Audit: a three-layer read (classical search, answer-engine, generative AI) of your patient-acquisition surface, with state medical board ad-compliance awareness. Every finding carries severity, evidence, a recommendation, and the expected outcome. The punch list. You leave with a severity-ranked fix list and the order to work it, instead of piecing the problem together yourself from scattered agency opinions. View a sample (PDF) →
Website Audit Pro: the Audit plus the synthesized diagnosis. Fix-sequencing, the entity and citation problems the rules cannot reach, and a strategic read. The diagnosis, not just the list. You leave knowing which fixes to make first because they compound, the sequencing done for you rather than left as a list to prioritize on your own.
Buyer Alignment Audit: the patient your public properties actually attract versus the one your modality economics need, classified three ways, with the unit-economics implications of the gap. Usually the right entry point for elective-medicine practices. You leave able to name the patient mix you are actually drawing in and what the mismatch is costing you, without running that analysis yourself.
Full Business Diagnostic Pro: the whole-practice read for a practice competing across several modalities and several competitive sets at once. It decomposes into per-modality matrices, sizes the opportunity across five to seven levers, and lands a 90-day roadmap. It sizes any upside in your own numbers, and the whole-practice read is assembled for you instead of pieced together across a dozen spreadsheets and meetings.
Monitor
Keep an eye on it, every month.
Drift caught before it shows up in your schedule.
Monitor: a monthly scorecard on your own surface against the elective-medicine dimension framework, drift-watch alerts (search and AI, reviews and reputation, discoverability, schema), and a monthly digest with one to three actions, with state medical board ad-compliance awareness built in. It takes the monthly report off your plate, the data-pulls and the "how are we doing" write-up your staff now lose hours to, and catches drift the month it starts instead of at the quarterly review.
Monitor Plus: everything in Monitor plus the cohort overlay. Four named local peers, the practices in your geographic competitive set, tracked against you, with peer-movement and AI-visibility and pricing-drift alerts, written analyst commentary, a before/after visual-asset inventory, and the top three actions for the month. The richest read we sell without a retainer. It replaces the manual peer research your team would otherwise hand-build, and hands back the analyst read on the three things to do this month. View a sample briefing (PDF) → | Talk about Monitor Plus →
In our experience, elective-medicine practices that measure the consultation funnel tend to find a conversion gap of roughly 10-20 points they did not know they had, and many close it inside two quarters; results vary by practice. Monitor tells you which side of that you are on.
Advise
Put a CFO in the room.
The pricing, capacity, modality-mix, and capital decisions too expensive to make alone.
Engage: senior CFO judgment and the intelligence engine alongside your team, on a retainer. A monthly strategic-oversight call, a quarterly review with a refreshed 90-day roadmap, and Monitor Plus included. The work is structured around the decisions that move your practice, not just activity. It also lifts the data-pulls, the agency status reviews, and the "what does this mean" memos off the owner-provider's desk, the ten to fifteen hours a month that should go to clinical leadership and patient care. You keep your books; we are the CFO in the room.
Manage: we run the finance function outright. Close, cash, books, dashboard, and the finance-project library as recurring work, with Scott as your fractional CFO. Your finance function runs without you: the close, the cash, the dashboard, and the per-modality reconciliations, all handled. Every major pricing, capacity, and capital call gets CFO judgment before you make it. We own the books.
The line between Engage and Manage is who owns the books.
Ad hoc
Hand us the project, scoped to the work.
The one-off builds and analyses that do not fit a subscription. We scope the work, price it to the scope, and own delivery end to end.
Website builds: a new site engineered for the way patients actually find you now, classical search, answer engines, and AI. You leave with a property that converts consultations and wins the local answer, built and shipped for you instead of managed through an agency on retainer.
Modality pricing and mix analysis: what each service line, injectables, body, skin, surgery, cosmetic dental, earns per patient after acquisition cost and provider time, and which lines are priced below what they are worth. You leave knowing what to charge and where the high-margin slots are, the modeling done for you rather than guessed at over a spreadsheet.
Process redesign and automation: the manual, repetitive internal work, the reporting, the reconciliations, the hand-offs between systems, rebuilt and automated. You get hours back every month and a process that does not break when a key person is out.
Other project work too. If it has a defined scope, we can price it and own delivery.
Outcomes, including any time freed and any monetary gains, depend on your current business practices and your own execution. We size and pursue them against your real numbers; we do not promise a figure.
What another six months of waiting actually costs
In our experience, a consultation that does not convert to a procedure within 30 days is unlikely to ever convert, often on the order of a 70% chance of never closing. Typical practices convert in the range of 40-60% of consultations; the gap between you and the top quartile is usually a measurement gap, not a clinical one.
Every procedure-mix decision made on intuition rather than per-service-line economics costs you the high-margin slot. Injectables subsidize laser. Surgery subsidizes injectables. Without per-line P&L, you cannot see which one is the engine and which one is the drag.
Every quarter you are not in the AI-search consideration set for "best plastic surgeon in [your county]" or "best med spa near me" is a quarter your competitors close patients who never knew you existed. Elective medicine is one of the most AI-mediated buyer-decision categories in our scope. A Website Audit measures exactly where you stand in those answers.
Every retention cohort you do not segment is a retention cohort that may be funding the wrong service. Cash patients and insurance patients have wildly different LTV; lumping them in one CAC number hides the engine.
The patient who didn't book today rarely tells you why. The system does.
Visibility, acquisition, closing, servicing
Four operational layers, each with specific work we take off your plate.
Visibility
Three-layer audit (classical search + answer-engine + generative AI) calibrated to the elective-medicine vertical with state medical board ad-compliance awareness. AI-search query pack tuned to actual patient search behavior in your region and your modality mix. Monthly Monitor briefing tracking how you move against four named local peers, the practices within your geographic competitive set.
Acquisition
Public-surface channel diagnosis: where is your website, search, and AI visibility delivering patient attention by modality, and where is it underperforming? Buyer Alignment Audit if the patient mix you are attracting does not match the modality economics you need. Review-velocity and before/after content audit across RealSelf, Google, Yelp, and any modality-specific platforms.
Channel-economics analysis (injectables, body, skin, surgery, cosmetic dental) draws on your inside spend and attribution data and lives inside an Engage or Manage retainer. The Full Business Diagnostic reads the public-surface signal for each channel and names where patient attention is leaking.
Closing
Consultation-to-procedure conversion analysis by modality and by provider (from public surface plus the conversion data you supply). Pricing strategy review across injectables, body, surgery, and any modality-specific pricing models. Patient LTV + Cohort Model: retention curves, repeat-procedure rates, three-year value projections.
Servicing
Quarterly Buyer Alignment Audit (inside Engage and Manage) catches drift before it shows up in numbers. Monthly cohort intelligence on what peer practices are doing in modality mix, pricing transparency, follow-up cadence. The retainer tiers put a CFO-grade voice in monthly business reviews so the practice owner can focus on clinical leadership and patient care.
Take the Elective Medicine Assessment first
Five minutes. Tell us about your treatment mix, top challenges, and growth goals. We send back a written practice profile within one business day. No pitch.
What practice owners ask
Elective medicine runs on multi-procedure mix and the consultation-to-procedure lever. A facial-aesthetic patient may convert to injectables, then to surgery, over years. The CFO work is reading the funnel from initial consultation through lifetime procedure value, by service line, so the marketing spend and the schedule mix decisions both stop being guesses.
Cosmetic surgery, injectables, laser, dermatology, MedSpa, and adult cosmetic ortho all sit in one practice but they have different acquisition costs, lifetime values, and operational cadences. We separate them in the analytics so you can see which service line is actually paying for itself and which is being subsidized by the others.
The Website Audit benchmarks visibility, search authority, and AI-search citation rate against local and national peers. The Buyer Alignment Audit (usually the right entry point) diagnoses whether the patient mix matches the procedure economics you need. The Full Business Diagnostic adds the operational and capital read.
Pricing is set at the Intro Call, scoped to your modalities and goals. The Website Audit, Buyer Alignment Audit, and Full Business Diagnostic are fixed-scope diagnostic instruments; Monitor and the Engage and Manage retainers are quoted per client. The fastest way to a number is a 30-minute Intro Call.