The Hidden Problem in Your Clinic’s Business Strategy

I spoke to an owner this week who wanted to know how other clinic owners are surviving.

With clinician fee splits in the 60-70% range, it’s become a real challenge for owners. How can you run a profitable clinic?

Then, combine that with the difficulty of recruiting and hiring clinicians, and the question becomes even tougher—how do you not only survive but build a successful, sustainable practice? 

In the first case, the fee splits are what they are. There are macroeconomic forces you can't fight, so you have to work within them.

In the second case, you can implement a recruiting system that consistently generates clinician interviews, whether you're hiring or not. We’ll definitely be incorporating that into the plan.

But more fundamentally, her challenge comes down to how she has strategically set up her business.

There’s plenty of content on clinic systems and processes but very little discussion on clinic strategy. Yet, it’s one of the most important aspects of running a successful healthcare practice.

I could talk about clinic strategy for hours, but I’ll narrow it down to one critical move: clinic service strategy.

The Power of a Clinic Service Strategy

A well-defined clinic strategy is the backbone of clinic profitability. In an environment with high wage costs and a limited supply of clinicians, it can make or break your clinic's profitability.

Clinics that use an EMR & clinic management software with robust reporting tools can easily track performance trends, service gaps, and operational inefficiencies. A strong clinic strategy backed by data ensures that any financial or marketing leaks are identified early, protecting long-term profitability.

The first place I look? The weekly scoreboard.

A well-structured scoreboard should track each service and product offering with key behavior and outcome metrics. This helps identify operational leaks that directly impact revenue, allowing for immediate action to close those gaps.

Her issue? She only has one true service and product offering. In her clinic, she has:

• Four physical therapists (two of which are part-time)
• One full-time massage therapist
• One part-time chiropractor

Meanwhile, her clinic's product sales are nonexistent. With this clinic service strategy, the macroeconomic winds are going to blow away her ability to generate revenue. And, truly, this is further exacerbated if there are operational leaks in these services. For example: 

• Not enough weekly assessments (marketing leak) 
• Low average session prescribed (operational leak) 
• Low booked: prescribed ratio (operational leak) 
• Low patient visit average (operational leak)
• High patient drop-offs (operational leak) 
• Low patient graduations (operational leak)

Without a diversified approach, her clinic is vulnerable. The key question is—how can she strengthen her clinic service strategy?

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The Problem with Part-Time Clinicians

I often say that “part-time clinicians are clinic killers.” Why? Because they don’t offer enough appointment availability, patients can’t consistently book when they need to.

When a patient starts treatment, their plan of care is built on frequency and consistency. But if their provider is only available a couple of days per week—or worse, has inconsistent hours—scheduling appointments becomes difficult. Patients either stretch out their appointments too far apart, reducing the effectiveness of care, or they simply stop booking altogether.

Let’s put this into numbers. Suppose a patient requires 8-10 sessions for full recovery. However, due to scheduling limitations, they only end up attending 1-2 before dropping off. If the expected average was five sessions, but they only book one, that’s a $400 loss per patient (assuming $80 per session). 

Now, multiply that across all new assessments per week, month, quarter, and year. The result? Tens of thousands in lost revenue simply because the clinic couldn’t provide enough availability to meet patient demand.

Beyond the financial hit, this also impacts patient outcomes. Incomplete treatment plans lead to suboptimal recovery, which affects patient satisfaction, word-of-mouth referrals, and long-term retention.

The takeaway? Relying too heavily on part-time clinicians creates a scheduling bottleneck that directly undermines both clinic profitability and patient care.

Reducing Risk with Redundancy

Another key risk in this clinic’s setup—service gaps. With only one massage therapist and one chiropractor, the clinic is completely exposed. If either leaves, that service disappears overnight.

This isn’t just an operational inconvenience—it’s a major revenue and patient care issue. Consider the impact:

• Existing patients lose access to that service, potentially leading them to seek care elsewhere.
  
  
• Cross-referral opportunities disappear, reducing the clinic’s ability to maximize patient lifetime value.
  
  
• Recruitment takes time. Even if the clinic starts hiring immediately, there will be weeks (or months) of lost revenue before a replacement is found.

The solution? Always have at least two clinicians per discipline. This ensures continuity of care, prevents revenue loss, and provides a built-in buffer against turnover.

By addressing these risks—both the scheduling bottlenecks from part-time clinicians and the vulnerability of single-provider disciplines—the clinic can create a more stable, scalable, and profitable service model.

Diversifying Revenue Streams

Even with full-time coverage, her clinic is still at risk. It’s heavily reliant on assessments—if those decline, so does revenue. If your business hinges on one variable, you’re at extreme risk.

Revenue must be diversified.

Relying solely on one income stream is risky—especially when clinic profitability is already strained by rising costs. Leveraging your EMR & clinic software's reporting capabilities can help identify underutilized services and opportunities for additional revenue generation.

Diversification isn't about adding low-contributing services that make up 1-3% of revenue. Instead, clinics need four to five strong revenue streams that each contribute meaningfully and act as a hedge against downturns in core services.

Here are potential revenue streams:

• Clinician & Assistant model
• Cross-referrals
• Orthotics
• Off-the-shelf bracing
• Custom bracing
• Supplements
• Rehab product sales (foam rollers, bands, tubes, pulleys, weights, etc.)
• Technology product sales (Theragun, TENS, etc.)
• Lifestyle product sales (pillows, ergonomic tools, etc.)
• Custom programs (pickleball training, fall prevention, etc.)
• Employer services

Of course, these offerings must align with the clinic’s philosophy and patient care model.

Implementing New Revenue Streams: The Monthly Sprint

To implement these revenue streams effectively, some clinics use quarterly goals, Asana, or Trello. I don’t like any of those. Quarterly goals take too long—things get in the way, urgency fades, and momentum is lost. What starts as an ambitious plan turns into something that’s “in progress” for months without real results.

Instead, I prefer the monthly sprint approach—a fast, focused way to turn ideas into action. Why do I like this method? It helps me avoid this:

Here’s how it works:

1. Pick one revenue stream. Choose a single opportunity to implement that month.
2. Brainstorm every task required to set it up. Break it down into clear, actionable steps.
3. Set a four-week deadline. The goal is to go from planning to execution within a month.
4. Execute. Get it done, refine as needed, and move on to the next one.

Think of it like renovating a bathroom. You don’t just say, “I’ll redo the bathroom someday.” You decide on the changes—new lighting, mirror, wall color, mats, faucet—and commit to finishing them in a set timeframe.

This approach ensures momentum, accountability, and real results. Each month, the clinic builds another layer of revenue security. Do this consistently, and within six months, she’ll have multiple revenue streams reinforcing the business—protecting it from economic shifts, clinician turnover, and fluctuating patient volumes.

The key is speed of implementation. A strategy that sits on a to-do list for months doesn’t add value. The faster new revenue streams are integrated, the sooner they contribute to the clinic’s financial health and stability.

Final Thoughts & Next Steps

Running a clinic in today’s environment is tough, but with the right approach, it’s possible to not just survive but truly thrive. The key lies in clinic strategy, service diversification, and rapid implementation—not just improving day-to-day operations but ensuring long-term sustainability.

For this clinic owner, that means:

✅ Reducing reliance on part-time clinicians to eliminate appointment scheduling bottlenecks and improve patient retention.
✅ Ensuring redundancy in key services to prevent revenue loss and patient churn if a clinician leaves.
✅ Expanding into multiple revenue streams using the monthly sprint model to create financial stability.

By making these shifts, she’ll build a more resilient, profitable, and scalable practice—one that isn’t at the mercy of clinician availability or a single revenue source.

If you’re in a similar position, take a step back and evaluate: Is your clinic's strategy optimized for profitability, growth, and stability? Or are there hidden risks holding you back? Your clinic software’s reporting might have the answers—it’s time to take a closer look and rethink your strategy.

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