Crush Q4 Smarter: The Pre-Purchase Inspection for 2027, EP 279

Tracy Cherpeski 8/28/26 Tracy Cherpeski 8/28/26

Stop, Hand Off, or Automate: The Framework Practice Owners Actually Need – A Special SNACK Episode, EP 278

Physicians work nearly 58 hours a week, but only 27 involve actual patient care. The rest? Administrative tasks that do not align with why they went into medicine. For practice owners, this burden is yours to own, often by accident. In this SNACK episode, Miranda Dorta and Tracy Cherpeski break down the admin burden, explore the difference between moral distress and moral injury, and share the framework that works: stop, hand off to a person, or automate.

Physicians work nearly 58 hours a week, but only about 27 of those hours involve actual patient care. The rest? Documentation, administrative tasks, and systems management that have nothing to do with why anyone went into medicine in the first place. For practice owners, this burden lands differently than for employed physicians. When you own the system, the admin work becomes your responsibility, often by accident. And when a highly-paid clinician spends hours on tasks that could be delegated, stopped, or automated, it is not a productivity gap. It is a values conflict.

In this SNACK episode, Miranda Dorta and Tracy Cherpeski break down the admin burden that practice owners absorb and, more importantly, what to do about it. They explore the real difference between moral distress (frustration at the system) and moral injury (the deeper disillusionment that creeps into burnout). And they share a framework that actually works: stop, hand off to a person, or automate. Most practice owners get the second bucket wrong, and it costs them both time and money.

If you are a practice owner caught between knowing you should not be doing administrative work and feeling like you are the only one who can do it right, this conversation is for you.

Key Takeaways

The admin burden problem is a values conflict, not a productivity gap. When practice owners recognize that certain tasks do not align with their clinical role or their values, the reframing shifts from "I am inefficient" to "this is not mine to do."

Moral injury lurks beneath burnout. The frustration of spending 12+ years in training only to spend half your week on documentation and admin tasks is not just annoying, it is a deep, corroding sense of betrayal that feeds burnout.

Delegation is the most common failure point. Solo practitioners especially struggle with handing work off because they just know how to do it faster. But that habit costs them time, sanity, and the ability to scale.

Not every task can be automated. Before buying a tool, identify what is actually broken: Is it a tool problem, a process problem, or a people problem? The wrong diagnosis here amplifies the original pain.

Automation takes time and buy-in. If you implement a tool without team alignment and realistic expectations (90 days to 6 months for larger systems), you are setting yourself up to blame the tool instead of examining the actual problem.

Q&A

What is the difference between moral distress and moral injury for practice owners?What is the difference between moral distress and moral injury for practice owners?

Moral distress is the immediate frustration: this is heavy, and something needs to change. It is the signal that your current situation is not working. Moral injury goes deeper. It is the sense of incredulity and disillusionment that creeps in when you realize you spent 12+ years in training only to spend half your week on documentation. Over time, this frustration calcifies into the burnout symptoms many practice owners recognize.

How do practice owners distinguish between tasks they should delegate and tasks that genuinely need their attention?How do practice owners distinguish between tasks they should delegate and tasks that genuinely need their attention?

Start by asking: How do I want my patients to experience my practice? What is most important about their journey from the moment they schedule to when they leave and refer others? Then map every recurring task into one of three buckets: stop, hand off to a person, or automate. The mistake many practice owners make is thinking like a control freak when really they are operating on habit. But there is a difference between a task that is hard to let go of and one that genuinely requires your clinical judgment or human voice.

What happens when practice owners buy a tool before naming the actual problem?What happens when practice owners buy a tool before naming the actual problem?

They make the problem grow faster. Tools amplify whatever system is already in place, good or bad. If you have not taken time to understand whether you are facing a tool problem, a process problem, or a people problem, the tool will accelerate your existing dysfunction. Before any new software, ask: Do I have the right process in place? Do I have the right people? Do I have team buy-in? Am I prepared to tolerate 90 days to 6 months of learning before this tool is functional? If the answer to any of those is no, the tool is not your solution.

Episode Highlights

The admin burden: why 31 hours a week of physician time goes to non-clinical work

How a values conflict shows up differently than a productivity problem

The psychology of I am just faster at this, and why that thinking traps solo practitioners

The three-bucket framework: stop, hand off, or automate (and why delegation is where most owners fail)

How to tell the difference between a task that is hard to delegate and one that needs your hands

Thinking like a hospitality professional: designing the full patient experience from scheduling to referral

The three questions every practice owner must ask before buying a new tool

Why automation requires patience: 90 days minimum before you see real results

Sometimes the answer is not a tool, it is another human (the virtual medical assistant option)

Memorable Quotes

There is a real misconception about being a control freak. I do not think it is all of what it is. I think there is an element of control. I do not think it is an ego thing. I think it is a needs-must thing. And then it just becomes habit. - Tracy Cherpeski

You need to ask three questions: Is this a tool problem, a process problem, or a people problem? - Tracy Cherpeski

If you have not named the actual problem, a tool will make it grow faster. - Tracy Cherpeski

Sometimes the answer is not automation at all, it is another human. - Miranda Dorta

Leaning back, pausing, and asking for support: that is how you take ownership without blame. - Tracy Cherpeski

The admin burden is not inevitable. It is a choice, one that most practice owners make by default, not by design. But once you name it for what it is, a values conflict, not a productivity problem, you have options. You can stop certain tasks entirely. You can hand them off to a person (and yes, hiring sometimes makes more sense than automating). Or you can automate what is truly automatable. The key is naming the real problem before you try to solve it. If you are ready to reclaim those admin hours and build a practice that actually aligns with why you went into healthcare, share this episode with a colleague. Visit practicesuccess.co to learn more about coaching and practice optimization, or explore thrivingpracticecommunity.com for resources on building a thriving, sustainable practice.

Miranda’s Bio:

Miranda Dorta, B.F.A. (she/her/hers) is the Manager of Operations and PR at Tracy Cherpeski International. A graduate of Savannah College of Art and Design with expertise in writing and creative storytelling, Miranda brings her skills in operations, public relations, and communication strategies to the Thriving Practice community. Based in the City of Oaks, she joined the team in 2021 and has been instrumental in streamlining operations while managing the company's public presence since 2022.

Tracy’s Bio:

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Tracy Cherpeski 8/26/26 Tracy Cherpeski 8/26/26

The Hidden Cost of Chaos: How One Question Can Fix Your Healthcare Operations Featuring Srikar (Sam) Yeruva, EP 277

Sam Yeruva, founder of PYCUBE, Inc., spent decades as a data center architect before stepping into healthcare. What he discovered was striking: hospitals and health systems look like five-star hotels on the surface but operate like disconnected departments held together by duct tape. His solution isn't flashy technology—it's connecting the data you're already collecting so you can actually see what's broken, where it's broken, and how to fix it.

Your healthcare practice feels organized. Your team is skilled. Your systems exist. But somewhere between the billing department, the lab, the clinical floor, and the vendors, something breaks. Samples disappear. Orders get lost. Your best clinicians spend time hunting for things instead of treating patients. This episode explores why—and reveals how operational intelligence is changing healthcare from the inside out.

For practice owners wrestling with how to scale sustainably, how to keep clinicians at bedside instead of doing admin work, and how to build a solid foundation before growing, this conversation is essential. Because operational efficiency isn't just about cost—it's about capacity, and capacity is what allows you to serve more patients without burning out.

Key Takeaways

• Operational intelligence means connecting data across your entire workflow so you can see bottlenecks, waste, and inefficiency in real time. You can't improve what you don't track.

• Healthcare is a service industry like any other repair shop. The "repair" requires purchasing, coordination, and dozens of moving parts. When departments don't communicate, patients feel the chaos—even if they can't pinpoint why.

• The four pillars of any workflow are people, process, tools, and training. If all four are aligned, workflow happens. If one breaks, everything else strains.

• AI is an assistant, not a replacement for clinical judgment. Use it for predictable tasks (billing, transcription, process support) while keeping human judgment for diagnosis and complex decisions.

• Practical expansion beats idealized solutions. Build a solid foundation, find inefficiencies, subtract before you multiply. Strategic focus on one question at a time is more effective than trying to solve everything at once.

Q&A

What is operational intelligence?

Operational intelligence connects data from across your workflows—where patients move, how samples flow, what you're purchasing, who's doing what work—so you can see the full picture instead of isolated department views. It reveals hidden waste, bottlenecks, and opportunities for improvement that HR systems, finance systems, and EMRs alone can't show you.

Why do healthcare systems struggle with efficiency even when they're well-funded?

Healthcare systems have many moving parts: clinicians, support staff, vendors, labs, pharmacies, couriers. Each department has its own systems and priorities. When they don't communicate smoothly, time is lost—nurses spend 15% of their time looking for assets; samples sit in loading docks; billing takes months to process. Operational intelligence maps these workflows so the breakpoints become visible.

How does this apply to independent healthcare practices?

For smaller practices, the chaos is often hidden in billing, purchasing decisions, and patient experience bottlenecks. Start with one strategic question—like "How can I serve more patients per day?"—and use operational intelligence tools to track progress. Build your foundation with clear processes and good data before trying to scale to multiple locations.

How should we think about AI in healthcare?

AI is a powerful assistant for predictable, data-heavy work (billing, transcription, sample tracking). It's not ready to replace clinical judgment. The real opportunity is agentic AI—multiple AI agents working in sequence to handle complex workflows while human clinicians remain the decision-makers.

Episode Highlights

• Sam's origin story: data center architect to healthcare operational specialist

• The "repair shop" metaphor for healthcare systems

• A heartbreaking story: biopsies lost in a loading dock for 10 days

• The three-pronged answer: why AI adoption is exploding now

• How AI works as assistant, not replacement, in healthcare workflows

• The four pillars: people, process, tools, training

• Why clinicians want to spend 99% of their time at bedside, not hunting for assets

• Practical vs. idealized solutions: why foundation matters before scaling

• Sam's one-liner: "Respect the problem"

• The power of one strategic question and the discipline to stick with it

Memorable Quotes

"Hospital is nothing but a repair shop. You go in sick, hopefully the doctor fixes you and sends you back." — Sam Yeruva

"You can't improve anything that you don't track. When you don't track, you're blind sometimes." — Sam Yeruva

"Three months to a half day—that's what operational intelligence and workflow automation can do." — Sam Yeruva

"If you ask any clinician where they want to spend their time, 99% of them say bedside." — Sam Yeruva

"Respect the problem. Don't blame the problem, but start respecting it. That's where you get depth." — Sam Yeruva

Operational intelligence sounds technical, but at its heart, it's about visibility. You can't fix what you can't see. For practice owners who feel the tension between what systems demand and what patients actually need, this episode offers both a diagnostic framework and practical next steps. Start with one question. Respect the problem deeply enough to understand it. Build your foundation before you scale. Find the time your clinicians are losing to chaos and give it back to bedside care. If this conversation resonated with you, share it with a colleague facing similar operational challenges. You can connect with Sam on LinkedIn (search Srikar Yeruva or Sam Yeruva) and explore PYCUBE, Inc.'s resources to learn more. For more on building sustainable, scalable healthcare practices, visit thrivingpracticecommunity.com.

Guest Bio:

Srikar "Sam" Yeruva is the Founder & CEO of Pycube, Inc., transforming how hospitals operate behind the scenes. With a background in electrical and computer engineering and executive training from Harvard Business School, Sam spent his early career designing mission-critical systems for organizations like Delta Air Lines and Dell EMC. Motivated by a personal experience where critical biopsy samples were lost for 10 days, he launched Pycube to bring true operational intelligence to healthcare—helping hospitals track assets, specimens, equipment, and supplies in real time. Pycube has been recognized twice on the Inc. 5000 list and featured on ABC7 News for its impact on reducing burnout and improving patient care.

Find Sam:

Website: PyCube.com

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Tracy Cherpeski 8/19/26 Tracy Cherpeski 8/19/26

[REPLAY] From Pajama Charting to Month-Long Vacations: Practice Management Software That Actually Understands Healthcare Featuring Damien Adler, EP 276

What if the biggest threat to your practice is not a lack of patients, but administrative burden? In this episode, Tracy Cherpeski sits down with Damien Adler, a psychologist and co-founder of Zanda Health, who solved this problem by building systems instead of hiring more staff. For 14 years, Damien ran his psychology practice while creating the infrastructure that would eventually become Zanda Health. He automated scheduling, invoicing, documentation, and patient communication - so thoroughly that he and his wife could take month-long vacations to Europe while the practice ran itself. In this episode, Damien breaks down the three admin tasks that drain the most time and energy from healthcare practices, why automation actually frees your brain to think and lead, and how to incorporate AI safely without compromising patient privacy. You'll also hear about the hospitality mindset that transforms patient experience, why your brain works on open loops even when you're resting, and exactly where to start if you're overwhelmed by the idea of automating your practice.

What if the biggest threat to your practice is not a lack of patients, but the administrative burden eating your evenings and weekends? In this episode of The Thriving Practice Podcast, Tracy Cherpeski sits down with Damien Adler, a psychologist and co-founder of Zanda Health, who learned this lesson the hard way. After running his own thriving psychology practice into the ground with admin work, Damien built systems. He automated. He engineered the practice so it could run without him. Then he took month-long vacations to Europe while his practice kept humming along. This conversation is essential listening for any healthcare practice owner drowning in scheduling chaos, invoicing headaches, and documentation overload.

Damien's story is not unique - it's the story of nearly every solo or small-group practice owner who's charted in pajamas or worked weekends to keep up. But his solution is. Rather than accepting administrative burden as the cost of doing business, he did something about it. What emerged is a practitioner-led approach to practice management software that prioritizes practitioner wellbeing, patient experience, and sustainable business practices. For practice owners struggling with burnout, staff turnover, or the feeling that you're working harder than ever but seeing no growth, this episode offers both a framework and hope.

Whether you're a solo practitioner overwhelmed by manual scheduling, a small practice owner watching admin consume your team's clinical time, or a healthcare leader asking how to build systems that actually work, this conversation reveals why automation is not about being lazy - it's about being strategic. It's about reclaiming your time, reclaiming your energy, and reclaiming the reason you started your practice in the first place.

Key Takeaways

The system runs the practice - not your memory, late nights, or survival mode.

Your brain is a problem-solving machine. Open loops - undocumented sessions, unpaid invoices, scheduling gaps - drain your mental energy subconsciously, even when you're trying to rest.

The top three admin pain points are scheduling/patient management, invoicing and financial management, and documentation/communication. Solving these frees up the most time and energy.

Automation is not about becoming less human. It's about freeing your brain so you can actually think, lead, and rest.

Small touches - fresh flowers, beverage preferences on file, proper parking directions - matter more to patient experience than clinical excellence alone. But you only have bandwidth for these when you're not drowning in admin.

AI can be integrated thoughtfully: data protection first, policies before code, separate environments protecting patient data from commercial platforms.

Q&A

What are the biggest admin tasks draining time and energy from healthcare practices?

The top three are scheduling and ensuring patients actually show up, invoicing and financial management (critical for cash flow), and documentation and communication. These vary slightly by practice type, but addressing these three creates the biggest time and energy return.

How does automation reduce practitioner burnout?

When systems handle repetitive tasks, your brain stops holding open loops about things that still need to be done. Instead of subconsciously working on documentation or invoicing even during rest, your brain relaxes. This frees mental bandwidth for actual thinking, strategic leadership, and recovery - allowing you to work less and accomplish more.

How did Damien scale his practice while maintaining work-life balance?

By building systems first, not people. Rather than hiring staff to handle admin, Damien automated the admin itself. This meant the practice could grow without proportional administrative burden. His team spent time with patients, not drowning in paperwork. Eventually, the practice ran so smoothly he and his wife could take month-long vacations annually while the practice maintained revenue and patient care quality.

What's the role of AI in practice management, and how do you protect patient privacy?

AI can transcribe sessions, write clinical notes, and summarize patient history - reclaiming significant clinician time. The key is architecture: rather than sending patient data to external AI platforms, systems should run AI models in isolated environments with no feedback to the AI company. Patient data stays encrypted within your practice management system, not in the cloud with third parties.

Episode Highlights

Damien's burnout story: charting in pajamas, weekends consumed by invoicing and scheduling, everything done manually; The turning point: deciding to build systems instead of hiring more staff; Scaling the practice for 14 years while maintaining sustainability and team satisfaction; How month-long vacations in Europe became possible because the system ran the practice; The hospitality mindset: why small touches (fresh flowers, beverage preferences, parking tips) matter more than clinical excellence alone; Patient surveys reveal the truth: people care about atmosphere and feeling known, not technical clinical details; Building a practice that attracts and retains great practitioners through low-admin environments; How to incorporate AI safely: data protection officer first, policies before code; AI features that save real time: automatic transcription, note-writing, session summaries, patient history snapshots; The real lesson: pick one friction point and fix it this week. Don't overwhelm yourself trying to solve everything at once.

Memorable Quotes

"The system runs the practice. Not Damien. Not his memory. Not his late nights. The system." - Damien Adler

"Your brain is a problem-solving machine. The more open loops you have - undocumented sessions, unpaid invoices, scheduling gaps - the more your brain works on those things subconsciously, all the time." - Damien Adler

"Automation is not about becoming less human. It's about freeing your brain so that you can actually think, you can actually lead, and you can actually rest." - Damien Adler

"We used to go to Europe for a month every year for many years whilst running the practice. And the practice ran just as well without us there." - Damien Adler

"The best practitioners like to stay in environments where they don't have to do a lot of administration, where all of those things are happening automatically." - Damien Adler

Damien Adler built Zanda Health because he refused to accept that administrative burden was the price of running a practice. For healthcare practice owners tired of charting in pajamas, working weekends, or sacrificing family time, this episode is permission and a practical roadmap. The system does not have to be you. If you're ready to explore how practice automation can reclaim your time, energy, and passion for patient care, start small - pick one friction point and fix it this week. Visit zandahealth.com to learn more about Zanda, download their free resource "The Nine Secrets of Successful Health Practices," and explore whether their platform is right for your practice.

To request the replay of the Roundtable: AI & Automations for the Smart Practice, click here.

Resource Mentioned: “The 9 Secrets of Successful Health Practices” http://zandahealth.com/ThrivingPracticePod

Guest Bio:

Damien Adler is a registered psychologist, practice owner, and co-founder of Zanda, an all-in-one practice management platform used by thousands of health practices across Australia, the UK, Ireland, New Zealand, Canada, the US, and beyond. He spent 15 years building and running Mind Life Clinic, a large private psychology practice in Central Victoria — so he knows firsthand how administrative complexity can quietly compete with a clinician's original purpose.

That experience led him and his brother Paul to co-found Zanda (formerly Power Diary), now one of the most widely used practice management systems in the Allied Health space. Damien brings both the clinician's perspective and the operator's eye to conversations about sustainable practice-building, smart systems, and using technology in ways that actually serve practitioners and their clients.

Find Damien:

Website: ZandaHealth.com

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Tracy Cherpeski 8/14/26 Tracy Cherpeski 8/14/26

From Idea to Live: How to Plan an Event Your Practice Actually Enjoys, a special SNACK Episode, EP 275

Launching an event or retreat for your practice can feel daunting—from the first spark of an idea all the way through registration going live. In this SNACK episode, Tracy Cherpeski and Miranda Dorta turn the mic around and walk through the entire event-planning process, revealing what systems they built, what they reuse versus rebuild, and the critical mistakes that taught them how to do it better.

If you are mapping out your first event or retreat—or refining your approach to hosting—this conversation cuts through the noise. Tracy and Miranda share their operational flow, how they use data to decide whether an event idea is worth pursuing, and the specific systems that prevent small details from falling through the cracks. Most importantly, they will show you where practice owners typically get stuck and how to avoid the chaos that can derail even the best intentions.

Whether you are planning your first roundtable, masterclass, or retreat, the principles they share here will save you time, reduce stress, and help you show up fully present for your attendees.

Key Takeaways

• Planning comes before execution. Spend time anticipating contingencies and mapping out every task before you launch. This "slow down to speed up" philosophy applies to events, new services, systems implementation, and everything else in your practice.

• Use data to decide which events are worth your time. Track which LinkedIn posts get engagement, monitor email open rates and click-through rates, take field notes on the topics people bring up repeatedly, and look for patterns. This is how you decide whether to host a masterclass or a roundtable.

• Templatize your operational flow and creative assets. If something works well the first time, you can duplicate it. Develop templates for your artwork, social media posts, and—most importantly—your task management so the same operational flow scales across multiple events.

• Keep everything in one project management system. Avoid exporting to spreadsheets and importing into separate tools—information gets lost in translation. Find a system that works for your team (Tracy and Miranda use Notion) and keep all tasks, reminders, and communication centralized.

• The most common mistake is rushing forward without pausing first. Most operational misses happen when entrepreneurs dive in excited and skip the setup phase. Taking a moment to verify everything is in working order before launch prevents costly scrambles later.

Q&A

How much time should you spend planning an event versus promoting it?

Tracy and Miranda typically allocate 8–10 weeks for planning and another 3 weeks for promotion. The planning phase is where the real work happens—anticipating what could go wrong, mapping out every task, and setting up systems that prevent details from slipping through the cracks. This ratio protects your ability to actually enjoy the event when it is live.

What should you do immediately when you notice something feels off during event planning?

Stop and check your checklist. If emails are not where they should be, if social media posts have disappeared, or if a task got buried, it is a sign your system has a gap. Rather than powering through the chaos, pause and identify what got missed so you can recover quickly and correct it for next time.

How do you choose between a masterclass format and a roundtable discussion?

Let your data guide you. Look at which topics your audience engages with most—both in organic content and in private conversations. If you are seeing consistent interest in a topic where you are the expert, a masterclass with interactive elements works well. If the value is in bringing together multiple perspectives and peer learning, a roundtable is the right call.

Episode Highlights

• From the first spark to registration live: what happens at each stage of event planning

• How to templatize operational flows, creative assets, and social media posts

• Using data to decide whether an event is a "yes" or a "maybe"

• The CSV export-import mistake that taught them a hard lesson (and how they are fixing it)

• Why project management tools like Notion beat spreadsheets for team coordination

• The postmortem process: how they forensically review each event to improve the next one

• The "pause before running" principle that prevents 90 percent of their operational mishaps

• Building systems that allow you to be fully present at your own event

Memorable Quotes

"The planning is where you anticipate as much as you can possibly anticipate and plan for as many contingencies as you can." — Tracy Cherpeski

"It is the slow down to speed up philosophy applied across the board." — Tracy Cherpeski

"I personally will not remember unless there is a reminder in front of my face. Notion, we can tag ourselves and put reminders in it." — Miranda Dorta

"Don't just put on your shoes and start running. You put on your shoes, you do some calisthenics, you warm up, and then you walk a bit before you run." — Tracy Cherpeski

"When push comes to shove or you are coming to crunch time, the likelihood that important but maybe seemingly small details go begging is real." — Tracy Cherpeski

Hosting an event does not have to be chaotic. What Tracy and Miranda demonstrate in this episode is that the difference between a stressed, scrambling experience and a present, enjoyable one comes down to systems. When you plan before you launch, use data to guide your decisions, templatize what works, and keep everything in one place, you reclaim the space to actually connect with your attendees and enjoy the fruit of your labor. If you are planning your first event for your practice or refining your approach to the ones you are already hosting, apply one system from this conversation and watch how it changes your experience. For more resources on running a thriving practice, visit thrivingpracticecommunity.com.

Miranda’s Bio:

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Tracy Cherpeski 8/12/26 Tracy Cherpeski 8/12/26

Stop Overpaying Taxes: A Tax Strategist Reveals the Strategies Doctors Are Missing Featuring Rachel Michaelov, EP 274

Here's a question that might make you uncomfortable: How much of your hard-earned income are you handing to the IRS every quarter? For many healthcare practice owners—doctors, dentists, psychiatrists—the answer is: too much. In this episode of The Thriving Practice Podcast, Tracy Cherpeski sits down with Rachel Michaelov, an Enrolled Agent and tax strategist who works exclusively with high-earning healthcare professionals. Together, they unpack why so many brilliant, busy practice owners are overpaying their taxes blindly, sometimes by hundreds of thousands of dollars per year.

Rachel is the founder of Empire Tax Advisors and Practice Wealth Partners, firms that serve doctors, dentists, and healthcare providers nationwide. She's licensed by the IRS and holds credentials in all 50 states. But here's what makes her different from your typical CPA: she doesn't just file your returns after the year is over. She works with you proactively throughout the year to implement strategies that legally reduce your tax liability—strategies many practice owners have never even heard of.

If you're a practice owner who feels like financial stress is stealing your time, your peace of mind, and your ability to reward your team—this conversation is essential. Because the money you save in taxes isn't just a number on a spreadsheet. It's time with your family. It's the ability to build real wealth. It's the freedom to work less and serve your patients better. Let's talk about how to make that real.

Key Takeaways

• Most healthcare providers are working with CPAs, not tax strategists. A CPA often handles bookkeeping, payroll, and tax prep. A tax strategist works proactively throughout the year to implement strategies that reduce your liability before you owe it.

• Entity selection mistakes are expensive. Many practice owners end up as sole proprietors or single-member LLCs instead of S-corps, which means they pay 15.3% more in payroll taxes and face higher audit risk.

• Reasonable compensation is misunderstood. Doctors paying themselves $60,000–$70,000 a year while making $1+ million in revenue aren't protecting themselves; they're setting themselves up for audit and overpaying in taxes.

• Cost segregation and R&D credits are real strategies available right now. Most doctors have never heard of them. A cost seg study on a $1 million building can give you a $400,000 deduction with zero additional tax liability.

• Fragmented service providers cost you money and stress. When your bookkeeper, payroll processor, and CPA don't communicate, you end up with wrong numbers, wrong liability projections, and wrong strategies.

Q&A

**What's the difference between a CPA and a tax strategist?** A CPA (or dental/medical CPA) is typically reactive. They wait until year-end, gather your information, and file your return. They tell you how much you owe. A tax strategist is proactive. They review your numbers throughout the year, project your liability, and implement strategies during the year to reduce that liability before it comes due. The best situation is having someone who does both: tax strategy AND tax preparation under one roof.

**Why do so many doctors overpay in taxes even though they have a CPA?** Most CPAs are trained in bookkeeping, payroll, and return prep. They aren't trained in advanced tax strategies like cost segregation, R&D credits, accountable plans, and strategic entity selection. It's not that they're bad CPAs—it's that they specialize in a different area. The problem is that doctors often assume their CPA is handling strategy, when they're really only handling the basics. Ask your CPA directly: "Are you going to present me with specific strategies to reduce my liability?" If they don't have a clear answer, it's time to find someone who does.

**What are the three biggest tax mistakes Rachel sees practice owners making?** First: Payroll mistakes, especially reasonable compensation. Doctors often guess at their own salary or let a payroll provider decide, resulting in either overpayment through excess W-2 wages or underpayment that triggers audit risk. Second: Wrong entity selection. Many practice owners end up as sole proprietors or single-member LLCs, paying 15.3% more in self-employment taxes and facing higher audit risk. Third: Fragmented services. When your bookkeeping, payroll, and tax strategy are handled by different people who don't talk to each other, information gets lost, numbers are wrong, and strategies can't be properly implemented.

**What is cost segregation, and why haven't I heard of it?** Cost segregation is a strategy used when you buy or build a property (like your practice building). Normally, commercial buildings depreciate over 39 years. But with a cost seg study, you can accelerate certain components of that depreciation into 5 and 7 years instead. On a $1 million building, this might give you a $400,000 deduction in year one—with zero additional cost. Most doctors haven't heard of it because many CPAs don't specialize in it. It requires working with a specialist, but the payoff is significant.

Episode Highlights

• Rachel's origin story: why she specializes in healthcare professionals and why she's passionate about this work

• The real-life example: A doctor with a $1.2 million tax liability who walked away with a $24,000 refund

• Why doctors are "slaves to their job" even though they started a practice for freedom

• The hidden cost of overpaying taxes: time with family, inability to reward your team, delayed retirement

• Rachel's personal story: her father and why she's so emotionally invested in helping doctors

• Three common myths: "Successful people just pay taxes," "You can't reduce taxes if you're a W-2 employee," "If my CPA hasn't mentioned it, it must not be available"

• The framework: How to interview a tax strategist and ask the right questions

• The mindset shift: From passive ("tell me what I owe") to active ("show me my options")

Memorable Quotes

"That's reactive. And that's how people stay poor."—Rachel Michaelov

"You have a CPA all year round. How do you have a $500,000 tax liability? How does that make sense?"—Rachel Michaelov

"Don't be afraid of your CPAs. Ask questions. Where are my numbers? Can we get on a Zoom? Can you show me QuickBooks live?"—Rachel Michaelov

"I could save a client $200k in taxes in my sleep."—Rachel Michaelov

"Saving taxes is easy. You just need to go to the right specialist, and they can help you."—Rachel Michaelov

"If you're overpaying in taxes by $300,000 or $500,000 a year, what happens in retirement?"—Rachel Michaelov

"You don't have to overpay in taxes. You don't have to be reactive. And you don't have to do it alone."—Tracy Cherpeski

Rachel Michaelov doesn't believe in accepting overpayment as the cost of success. She believes that high-earning healthcare professionals deserve to keep more of what they earn, to have more time with their families, and to have the financial freedom to run their practices the way they want to. For practice owners who are tired of writing big tax checks every quarter and wondering "is there a better way?"—the answer is yes. The question isn't whether you can reduce your taxes legally. The question is whether you're willing to be proactive instead of reactive. If you're ready to find out, head to cfocall.com and schedule a consultation. Whether you work with Rachel's team or not, the conversation alone might change the way you think about your money. And that's worth the call.

Guest Bio:

Rachel Michaelov is an Enrolled Agent and founder of Empire Tax Advisors and Practice Wealth Partners, where she specializes in proactive tax strategy for healthcare professionals. With over a decade of experience—including years managing a team of accountants at a prominent CPA firm—Rachel has developed deep expertise in helping doctors, dentists, and practice owners legally reduce their tax burden through advanced strategies like cost segregation and R&D credits. As an NTPI Fellow, she's mastered IRS correspondence and complex tax scenarios. Rachel is licensed to practice before the IRS in all 50 states. Outside work, she's devoted to her family and draws inspiration from helping high-earning professionals reclaim their time and financial freedom.

Find Rachel:

Website: https://www.practicewealthpartnersco.com/

Instagram: @practicewealthpartnersinc

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Tracy Cherpeski 8/5/26 Tracy Cherpeski 8/5/26

Infrastructure for Readiness: The Missing Foundation of Sustainable Practice Growth, EP 273

In this episode, Tracy walks through what "infrastructure for readiness" actually means, why bottlenecks are diagnostic, not failures, and how thinking strategically about systems, delegation, and decision-making can transform a practice from overwhelmed to sustainable. For practice owners wrestling with how to grow without burning out, how to delegate without losing control, or how to implement new tools (like AI and automation) without creating more chaos—this episode offers both the philosophy and the practical framework to think differently about building your practice.

What if the thing blocking your practice growth isn't ambition, intelligence, or work ethic—but infrastructure? Tracy Cherpeski attended the American Association of Medical Society Executives conference and returned with a crystallized insight: sustainable growth in independent healthcare practices depends entirely on the deliberate, measurable foundation you build before (and while) you scale. In this episode, Tracy walks through what "infrastructure for readiness" actually means, why bottlenecks are diagnostic, not failures, and how thinking strategically about systems, delegation, and decision-making can transform a practice from overwhelmed to sustainable. For practice owners wrestling with how to grow without burning out, how to delegate without losing control, or how to implement new tools (like AI and automation) without creating more chaos—this episode offers both the philosophy and the practical framework to think differently about building your practice.

Key Takeaways

Infrastructure is foundational to sustainable growth. Readiness isn't about having all the answers—it's about having the right foundation so that when things change, you don't crumble. Without it, growth becomes exhaustion.

Bottlenecks are diagnostic tools, not character flaws. Every practice has friction points—delegation, systems clarity, financial literacy, communication, or leadership capacity. Identifying where you're actually blocked is the first step to building deliberately.

AI and automation are infrastructure, not strategy. If you don't know what you're trying to solve for, automation just makes you faster at doing the wrong things. Tools become leverage only when they sit on top of solid foundations.

Message discipline and shared values unlock possibility. The Georgia physicians story shows what's possible when people across disagreement find common ground and build power together—same principle applies to your practice and your team.

Readiness is a choice, not a destination. You don't need everything perfect. You need to be willing to look at where you're blocked, and then deliberately build the infrastructure to move through it.

Q&A

What does Tracy mean by "infrastructure for readiness"? Infrastructure for readiness is the deliberate, thoughtful, measurable foundation that lets you grow alongside your practice instead of becoming a prisoner to it. It includes your systems, your team's clarity, your decision-making frameworks, your communication patterns, and your own leadership capacity—the things that actually enable sustainable growth.

How do you identify what infrastructure your practice actually needs? Tracy introduces the Bottleneck Diagnostic—a framework for identifying the specific friction points blocking your growth. It might be delegation, systems clarity, financial literacy, communication culture, or your own capacity. Once you see where you're blocked, you can make a deliberate choice about what to build next.

Why is AI and automation considered infrastructure, not strategy? Without the foundations to support it—mapped workflows, clarity on who decides what and why, understanding of what you're trying to solve—automation just makes you faster at doing the wrong things. Tools become real leverage only when they sit on top of solid systems and decision-making clarity.

How does this apply to burnout prevention? Burnout often isn't about working harder; it's about working on top of nothing. When you lack the infrastructure to delegate effectively, have unclear systems, or haven't defined decision-making frameworks, you end up prisoner to your practice. Building infrastructure is actually how you create breathing room and sustainability.

Episode Highlights

Tracy's AAMSE moment: What a room full of medical society leaders taught her about infrastructure

The succession planning insight: It's not about replacing yourself—it's about sustainability

The Georgia physicians story: How shared values enable people to work across disagreement

The three conversations that were actually one: Bench strength, ethics, and coalition-building all point to the same foundation

Why 'methodical' isn't the same as 'strategic about sequence'—and why asking people to hold too many balls in the air at once isn't progress

The Bottleneck Diagnostic: How to identify the specific friction points blocking your growth

AI and automation as infrastructure: Why having tools without foundations just makes you faster at the wrong things

The August 18th roundtable: AI, Automation, and the Smart Practice

Memorable Quotes

"You don't struggle because you're lazy or incompetent. You struggle because you tried to build something sustainable on top of nothing." — Tracy Cherpeski

"Infrastructure. Not in the boring, checkbox sense. I mean the deliberate, thoughtful, measurable kind of infrastructure that lets you actually grow alongside your practice instead of becoming a prisoner to it." — Tracy Cherpeski

"Readiness isn't about having all the answers. It's about having the right foundation so that when things change — and they will

"If you don't know what you're trying to solve for, if you haven't mapped your workflows, if you don't have clarity on who makes decisions and why — then AI is just going to make you faster at doing the wrong things."

"You don't have to have everything figured out. You have to be willing to look at where you're actually blocked, and then build the infrastructure to move through it." — Tracy Cherpeski

The difference between a practice that exhausts you and a practice that sustains you often comes down to one thing: infrastructure. Tracy's insight from AAMSE isn't about adding more to your to-do list—it's about being strategic about what you build so that growth becomes possible, not just harder. If this episode resonated with you, share it with a colleague who's feeling the weight of growth without the foundation. And if you're ready to get clear on your specific bottlenecks, mark August 18th for our roundtable on AI, Automation, and the Smart Practice. Visit thrivingpracticecommunity.com for registration, resources, and episodes that help you build the practice you actually want to run.

Join us August 18, 2026 (or request the replay after): AI, Automations & The Smart Practice: A Private Roundtable

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Tracy Cherpeski 7/29/26 Tracy Cherpeski 7/29/26

Before You Buy AI: The Smarter Way to Cut Admin Burden and Grow Your Practice Featuring Clark Van Oyen, EP 272

How much of your team's day disappears into phone calls, faxes, and data entry? In this episode, Tracy Cherpeski sits down with Clark Van Oyen, founder of Cortico Health — a company that has helped nearly 10,000 healthcare professionals reduce administrative burden through smart automation and better workflow design.

How much of your team's day disappears into phone calls, faxes, and data entry? If you're like most practice owners, the honest answer is: more than you'd like to admit. In this episode of The Thriving Practice Podcast, Tracy Cherpeski sits down with Clark Van Oyen, founder of Cortico Health — a company that has helped nearly 10,000 healthcare professionals reduce administrative burden through smart automation and better workflow design.

Clark's path into healthcare began with a single pediatric clinic buried under 800 phone calls a day. He built them an online booking system, brought those calls down to nearly zero, and discovered a problem shared by practices everywhere. His company's mission today: isolate, understand, and eliminate anything that pulls healthcare professionals away from patient care.

Whether you're exploring medical practice automation for the first time, trying to run a successful medical practice without burning out your team, or wondering whether AI is worth the hype, this conversation offers a clear-eyed, outcomes-first framework for deciding what your practice actually needs.

Key Takeaways

Booking is the single biggest time drain. Roughly 40 percent of clinical support staff time goes to scheduling — far more than billing, reminders, or fax management — which makes online self-booking the highest-impact fix for most practices.

Admin burden has a visible side and an invisible side. Pain points are only the part you notice; a time-and-motion review of where hours actually go reveals the burden your team has stopped seeing.

AI is a tool, not a strategy. Voice AI phone systems fully resolve only about half of patient calls, while online booking can approach 90 to 100 percent. Use AI only where it's genuinely the best tool for the job.

Hold vendors accountable for outcomes, not methods. Define the result you want — more booked appointments at lower cost, fewer phone calls — and measure whether your vendor actually delivers it.

Your website is your practice's front door. Mobile-friendly design, posted patient handouts, and a clear path to online booking cost little and quietly remove entire categories of phone calls.

Q&A

How much time do physicians spend on administrative tasks?

Clark cites an average of about 11 hours per week per physician from the Canadian Medical Association — and notes that between after-hours paperwork and the hidden work of delegating, admin can consume a large share of a clinician's working life, especially in the U.S., where billing complexity multiplies the load.

What is the biggest source of admin burden in a medical practice?

Scheduling. About 40 percent of all support staff time goes to booking patients by phone, based on Cortico Health's studies across its customer base. Billing, reminders, fax management, patient inquiries, and follow-ups each account for roughly 10 percent.

Should my practice use AI to answer the phones?

Not necessarily. Current voice AI systems fully contain only about 50 to 60 percent of patient calls — the rest still escalate to your staff. Online booking, by contrast, can handle 90 to 100 percent of scheduling without a phone call at all, which is why Clark recommends starting there.

How can I reduce admin burden without buying new software?

Start with your website. Make sure it works on a smartphone — where roughly 80 percent of patients visit from — post your patient handouts, and point visitors clearly to online booking if you offer it. These basics eliminate whole categories of routine calls at essentially no cost.

Episode Highlights

Clark's origin story: a Harvard-trained clinic founder, 12 doctors, and 800 phone calls a day

From one clinic's proprietary tool to nearly 10,000 healthcare professionals served

Visible versus invisible admin burden — and why pain points don't tell the whole story

Slicing staff admin into buckets: booking, billing, reminders, faxes, inquiries, and follow-ups

Tracy's client story: the orthodontic practice whose automations made daily huddles possible — and kept staff for five years on average

The clinic that grew from 12 to 22 physicians in 18 months after moving booking online

IVR containment: the metric that exposes the limits of AI phone systems

Where AI genuinely earns its keep: fax parsing and clinician-side tasks like chart prep

The path toward near-zero admin overhead — and the vision of a clinician fully present with every patient

Clark's parting advice: your website is the mouth of the funnel

Memorable Quotes

“Our mission is to isolate, understand and eliminate anything that's taking healthcare professionals away from helping patients.” — Clark Van Oyen

“How do you ever carve out space to be proactive in a medical practice? It's the most chaotic business on the planet.” — Clark Van Oyen

“Hold your vendors accountable for outcomes, not for their methods.” — Clark Van Oyen

“AI should be used if and only if it's the best tool for the job, for every little point in the workflow.” — Clark Van Oyen

“Ideally a clinician just shows up and spends all their time fully present with their patient, and everything else is taken care of.” — Clark Van Oyen

Clark Van Oyen offers a refreshing counterweight to the AI hype cycle: technology should serve outcomes, and outcomes should be measured. For practice owners who feel buried under phone calls and paperwork, the way forward isn't the flashiest tool — it's an honest assessment of where the time is going, a fix for the biggest lever first, and vendors who own results alongside you. If this conversation resonated, share it with a colleague who's still charting in their pajamas.

Want to keep the conversation going? Join us for a free AI roundtable featuring Dr. Sarah Baldwin, a physician who has used automation to reshape her own practice. We'll talk through how to decide which tools actually earn a place in your practice — and which ones don't. Save your spot on August 18, 2026, Register here at PracticeSuccess.co/SmartPractice

Guest Bio:

Clark Van Oyen grew up on a farm in British Columbia, spending his childhood writing code — a combination he credits with making him both resourceful and methodical. After studying physics at UBC and building a career in tech, his connection to healthcare through his wife and colleagues opened his eyes to an industry running on software 20 years out of date — costing providers time, causing frustration, and worst of all, harming health outcomes. Then a clinic owner buried under 800 phone calls a day asked him a simple question: why can't patients just book online? Clark built the answer, watched the calls all but disappear, and Cortico was born. Today the platform serves 400+ clinics across Canada, the U.S., and beyond, automating up to 84% of repetitive administrative tasks with one mission: isolate, understand, and eliminate anything that pulls healthcare professionals away from patient care.

Find Clark:

Website: Cortico.Health

Cortico LinkedIn

Instagram @CorticoHealth

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The Alchemy of Change: What Burnout Is Really Telling You About Your Practice, EP 260

Miranda Dorta 7/24/26 Miranda Dorta 7/24/26

Why Practice Growth Isn't a Straight Line (And What To Do When It Cycles Back) - A Special SNACK Episode, EP 271

You survive a hard season of practice ownership and assume smooth waters are ahead. Then a new stage of growth arrives — a bigger team, a new location, more patients — and suddenly you're right back in the messy middle. In this SNACK episode, Miranda Dorta turns the tables on Tracy Cherpeski to ask why practice growth cycles instead of moving in a straight line.

Every practice owner has been there: you push through a brutal season, finally catch your breath, and assume the hard part is behind you. Then a new stage of practice growth arrives — a bigger team, a second location, a jump in patient volume — and suddenly you're back in the messy middle, wondering what you did wrong. In this SNACK episode of The Thriving Practice Podcast, Operations Manager Miranda Dorta turns the tables on Tracy Cherpeski to unpack why growth isn't a straight line, and what that means for healthcare practice owners trying to build a sustainable practice without burning out.

This conversation builds on Tracy's solo episode, “The Alchemy of Change” (EP260), where she introduced a three-stage framework for understanding why the hardest seasons of practice ownership real growth in progress, not failure. Here, Miranda pushes Tracy further: how do you tell the difference between cycling back through a hard season and actually losing ground? Why does every new chapter of practice growth seem to restart the whole process? And what does it look like to make peace with a cycle that may never fully end?

Tracy answers with real client stories — including a solo practice that grew into a two-location group with a full clinical and admin team — plus a personal story about getting knocked around by ocean waves that turned into an unexpectedly useful metaphor for resistance versus surrender. If you're a healthcare practice owner in the middle of a hard season and wondering if you're doing something wrong, this episode is your reminder: you're not failing, you're cycling.

Key Takeaways

Growth is not a straight line. The two-steps-forward-one-step-back pattern practice owners experience isn't a sign of doing it wrong — it's the normal shape of the “messy middle.”

Repeating patterns are information, not regression. When a hard season resurfaces, the useful question is “what am I learning right now?” rather than treating it as a step backward.

New growth exposes old gaps. Adding a bigger team, a new location, or more patient volume will reveal any process, structure, or expectation that wasn't fully built out the first time.

Structure beats “we're all adults here.” Clear expectations and documented processes matter more as a practice scales — informal culture that worked with a small team often breaks down with a bigger one.

Expecting the cycle reduces its impact. Practice owners who anticipate that hard seasons will recur are less likely to be thrown off guard by the next one, even if they can't predict exactly what it will look like.

Q&A

Why does growth in a healthcare practice rarely feel like a straight line?

Tracy explains that practice owners are often sold an unrealistic picture of success as a clean, linear climb. In reality, growth looks more like a tangled ball of yarn: two steps forward, one step back, with a “messy middle” that can feel brutal and endless while it's happening — much like the transition phase of childbirth, or the itch of a wound that's almost, but not quite, finished healing.

What's the difference between cycling back through a hard season and actually losing ground?

According to Tracy, cycling back usually means there's unfinished business — a pattern repeating because there's still something to learn from it. The useful move is to ask, “what am I learning right now?” instead of treating a dip as failure. A single hard moment isn't a regression; a sustained downward trend in the numbers is the real signal to address.

Why does hiring a bigger team or opening a new location restart the hard parts of practice ownership?

Any unhandled issue or undocumented process gets magnified by growth. Tracy shares the story of a solo neuropsych practice that grew over 20 years into a two-location group with 10–11 doctors, techs, and admin staff — where the informal “we're all adults here” culture that worked at a small scale stopped working entirely. The fix wasn't a full overhaul, just a pause to identify what structure and expectations were actually needed.

How can practice owners make peace with cycles that may never fully end?

Tracy points to the pace of change in healthcare — regulatory shifts and fast-moving technology — as a reason to expect ongoing cycles rather than resist them. Her framework: acknowledge the reality, ask “now what?”, and build the systems, people, and support that let the practice adjust without a full pivot every time.

Episode Highlights

Why “success is a straight line” is a myth, and what practice growth actually looks like on the ground

The messy middle as a transition, and the childbirth metaphor Tracy uses to describe it

How to tell if you're cycling back through old patterns versus actually regressing

A real client story: growing from a solo neuropsych practice to a two-location, 20+-person team

The ocean-wave metaphor: what resisting change costs versus what surrender makes possible

Why healthcare's pace of regulatory and technological change means the cycle may never fully stop

How to prepare for the next cycle without bracing against it

Memorable Quotes

"Whatever you expand in your practice will also expand your problems." — Tracy Cherpeski

"We're all adults here is good, but that's not actual guidance." — Tracy Cherpeski

"If you resist, it's going to hurt. It actually hurts." — Tracy Cherpeski

"It's kind of like it is what it is. Now what?" — Tracy Cherpeski

"What am I learning right now?" — Tracy Cherpeski

Growth won't ever hand you a permanently smooth season — but knowing that the messy middle can resurface doesn't have to knock you off balance. If you're in the middle of a hard season right now, remember Tracy's reframe: it's not regression, it's information. To go deeper on the three-stage framework behind this conversation, listen to EP260, The Alchemy of Change. And if you're ready to build a practice that can handle its own growth, visit practicesuccess.co.

Episode Referenced

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Tracy Cherpeski 7/22/26 Tracy Cherpeski 7/22/26

Don’t Wait for the Audit: Three Compliance Gaps Hiding in Your Practice Featuring Dr. Natasha Guess, EP 270

What if the biggest risk in your practice is the one sitting quietly in a policy binder you haven’t opened in two years? In this episode, Tracy Cherpeski talks with Dr. Natasha Guess, founder of Guess Compliance Consulting, about why healthcare compliance is an operational system — not a legal checkbox.

What does it actually take to run a successful medical practice that can withstand an audit, a breach, or a surprise records request? For most independent practice owners, compliance lives in a binder — a set of policies downloaded years ago, signed, and never opened again. In this episode of The Thriving Practice Podcast, Tracy Cherpeski sits down with Dr. Natasha Guess, a healthcare compliance consultant who believes compliance belongs in your daily operations, not your filing cabinet.

Natasha is the founder of Guess Compliance Consulting, serving small and mid-sized healthcare practices across the U.S. and Canada. Born and raised in Guyana, South America, she witnessed preventable illness and loss in a country without strong healthcare structure — an experience that led her to fall in love with the rules and regulations that protect patients. Today she helps practice owners navigate HIPAA, CMS, Medicare and Medicaid requirements, state regulations, and vendor relationships without the fear-based messaging that dominates the compliance world.

If you’re a practice owner focused on practice growth, profitability, and building a private practice without burnout, this conversation reframes compliance as something that protects all three — because a practice that collapses under an OCR investigation isn’t thriving, no matter how full the schedule is.

Key Takeaways

Compliance is an operational system, not a legal checkbox. A policy document means little if your team doesn’t know who to report a breach to, how to report it, and what happens next.

Three gaps show up in nearly every practice: not knowing where your gaps are (and assuming silence means safety), outdated template policies that describe a practice that no longer exists, and no ongoing system to stay compliant as you grow.

Your vendors are your responsibility. Business Associate Agreements matter — and many owners have never read theirs, or never received one at all. Regulators hold the covered entity accountable.

Growth creates new compliance gaps. Adding providers, staff, or technology — or moving a team member into a new role without retraining — changes your risk profile, often invisibly.

Don’t wait for an audit. The practices that hold up best are the ones with systems already in place. Waiting until something happens is when you have the fewest options.

Q&A

What are the most common compliance gaps in small medical practices?

Natasha consistently sees three, regardless of specialty: owners who don’t know where their gaps are and assume everything is fine because nothing has gone wrong yet; outdated template policies downloaded at startup and never updated; and the absence of any ongoing system that keeps compliance current as the practice grows and changes.

What is a Business Associate Agreement, and why does it matter?

A BAA defines who is responsible for what between your practice and third-party vendors that touch patient information — EHRs, schedulers, AI-enabled tools. If something goes wrong, OCR and OIG hold the covered entity (your practice) accountable, so you need to know what your agreements actually say. Natasha recommends reviewing vendor agreements quarterly.

Do small practices really get audited or investigated?

Yes — small and mid-sized practices are not exempt from enforcement, and in some ways they’re more vulnerable because they lack the resources of large systems. A common trigger is patient records access: if a busy practice misses the required response window, a single patient complaint to the Office for Civil Rights can open an investigation.

What’s one compliance step a practice owner can take this week?

Reach out to your vendors, request your Business Associate Agreements, and read them. Know what your vendor is responsible for and what falls to you — and repeat that review quarterly, since vendors change and services get added.

Episode Highlights

Natasha’s path from Guyana, South America to healthcare compliance — and why patient protection is at the heart of her work

The difference between having a policy and having a workflow: her breach-reporting example

Why OCR enforcement should be on every small practice’s radar — without leading from fear

Patient records access requests: the quiet trigger behind many investigations

Vendor management in the age of AI: BAAs, responsibility allocation, and reading the contract

The three compliance gaps Natasha finds in nearly every practice

How growth creates new exposure: new providers, new roles, and retraining

Inside Natasha’s compliance risk diagnosis process

Her new service line for Canadian practices — and why province-by-province rules add complexity

Why hhs.gov — not an AI chatbot — should be your primary source for HIPAA guidance

Memorable Quotes

"While I work with providers and it’s about protecting their business, it’s really about protecting the patients that trust them." — Dr. Natasha Guess

"The gap between where you are and where you need to be never closes on its own — and it doesn’t get smaller with time." — Dr. Natasha Guess

"You really cannot fix what you don’t know or what you haven’t named yet." — Dr. Natasha Guess

"Every time they grow without updating their compliance structure, they’re creating new gaps — and a lot of times they don’t even realize it." — Dr. Natasha Guess

"Winging it is not a very good business plan." — Tracy Cherpeski

Dr. Natasha Guess offers a rare thing in the compliance world: reassurance backed by rigor. Her message to practice owners is simple — do not wait. Start with an honest assessment, name your gaps, and you’ll find that closing them is far less overwhelming than living with the unknown. Begin this week by pulling your Business Associate Agreements and reading them. Then explore Natasha’s free consultation, HIPAA template kit, and free compliance assessment (linked below), and visit thrivingpracticecommunity.com for more resources to help you build a practice that’s not just busy, but protected and thriving.

Resource Mentioned:

Practice Risk Check

Compliance Assessment

Guest Bio:

Dr. Natasha Guess is the founder of Guess Compliance Consulting LLC, where she helps small and midsize healthcare practices build compliance programs that work in the real world — not just on paper. Born and raised in Guyana, South America, Natasha saw firsthand what happens when healthcare structure is missing, an experience that shaped her decade-plus career in regulatory compliance. Today she specializes in HIPAA privacy and security, vendor and Business Associate oversight, and audit readiness, translating complex regulations into clear operational systems. She's known for a practical, non-fear-based approach that lets practice owners meet regulatory expectations while staying focused on patient care.

Find Dr. Natasha:

Website: GuessComplianceConsultingllc.com

YouTube @GuessComplianceConsulting

Podcast: Guess What? Compliance Can Be Simple! Apple Podcasts

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Tracy Cherpeski 7/15/26 Tracy Cherpeski 7/15/26

30 Seconds to Connect: What Healthcare Practices Get Wrong About Patient Communication Featuring Danny Bobrow, EP 269

What’s the single most costly communication breakdown in your practice? Chances are it’s happening before a patient ever walks through your door.

In this episode, Tracy Cherpeski sits down with Danny Bobrow, a healthcare marketing consultant who has spent more than 35 years helping dental and medical practices grow — not just by generating leads, but by helping teams turn those leads into loyal, kept appointments.

What if the single biggest obstacle to your practice’s growth isn’t your clinical skills, your location, or even your marketing budget — it’s what happens during the first 30 seconds of a phone call? In this episode of The Thriving Practice Podcast, Tracy Cherpeski sits down with Danny Bobrow, a healthcare marketing consultant with more than 35 years of experience helping dental and medical practices grow. Danny’s work doesn’t stop at generating leads — it picks up right where most marketing efforts leave off: at the point of first contact.

Danny is the creator of the Persuasion Blueprint, a communication coaching framework built around three core principles: caring, connection, and collaboration. After years of tracking what he calls “missed moments” — the small communication breakdowns that quietly cost practices new patients every day — he developed a systematic approach to closing the gap between how caring a team intends to be and how caring they’re actually perceived to be. For independent practice owners focused on patient retention, front-office communication, and sustainable practice growth, this episode is both practical and genuinely eye-opening.

Whether you’re a private practice owner working to strengthen your team’s patient communication skills, a clinician-turned-CEO still figuring out the business side, or someone building a profitable healthcare practice without burning out your staff, Danny’s framework is a strong place to start.

Key Takeaways

The “care gap” costs practices real money. The difference between your team’s intention to be caring and how they’re actually perceived by patients is where missed moments — and missed revenue — live.

The first 30 seconds of a phone call can make or break a patient relationship. Patients scan for caring before competence, and how your front desk answers sets the tone for everything that follows.

Persuasion isn’t manipulation — it’s the most honest form of communication. Danny reframes persuasion as empowering people to make decisions that are genuinely in their best interest, not coercing them.

Enthusiasm is a tool, not an opener. Using enthusiasm responsively — building from what matters to the patient — is far more effective than leading with it before you know what they need.

Clinical training doesn’t include business communication. Medical and dental schools train clinicians, not entrepreneurs. That gap in patient communication and team leadership is exactly what the Persuasion Blueprint addresses.

Q&A

What are “missed moments” and how do they affect practice revenue?

A missed moment is any communication breakdown that prevents a prospective patient from converting into a kept appointment. Danny explains that practices often track their marketing leads without measuring how effectively their team handles those leads. When front-desk staff fail to demonstrate caring quickly — or prioritize efficiency over connection — potential patients disengage before they ever schedule.

What is the Persuasion Blueprint?

The Persuasion Blueprint is Danny’s communication coaching framework built around three Cs: caring, connection, and collaboration. The approach teaches teams to demonstrate caring first, build genuine connection with the patient, and then move toward aligned action where the patient feels like a partner in their own care — not a transaction to be processed.

How do practice owners improve front-desk communication without making staff feel criticized?

Danny recommends starting with the complimentary Persuasion Scorecard to establish a baseline, then framing coaching as an investment in the team’s success — not a critique. He also emphasizes that practice owners need to lead by example, modeling what relational communication looks like before expecting it from their teams.

Why do some teams resist improving their communication skills?

Many team members welcome AI-assisted phone answering because they’re uncomfortable with patient calls. But Danny points out that discomfort is a signal, not a solution. With the right coaching, most people discover that relational communication actually reduces friction — making their job easier and their results measurably better.

Episode Highlights

Danny’s origin story: family ties to dentistry and 35+ years in healthcare marketing

The attract, convert, deliver framework for sustainable private practice growth

“Missed moments” explained: what they are, why they’re hard to measure, and what they actually cost

The care gap: why good intentions don’t automatically translate into perceived caring

The First Four Minutes — and why phone calls can compress that window to 30 seconds

Why Danny says enthusiasm should be responsive, not introductory — the “building a fire” metaphor

The three Cs: caring, connection, and collaboration as a sequence, not a checklist

What mountaineering and adventure racing taught Danny about team dynamics and patient persistence

Viktor Frankl’s distinction between toxic positivity and tragic optimism, and why it matters for practice leadership

Listening as a skill: the habits that undermine it and how to build it deliberately

The one mindset shift listeners can implement immediately

Memorable Quotes

“Getting the phone to ring or getting people to your website is necessary but not sufficient. You’ve got to connect with the prospective patient to convert them into a solid kept appointment.”

— Danny Bobrow

“On the telephone, it can be closer to 30 seconds — because people are scanning for caring. They want to know that the person at the other end of the phone is not just competent, but concerned.”

— Danny Bobrow

“People don’t care about your vision until they know that you care about theirs.”

— Danny Bobrow

“If you want to be interesting, be interested.”

— Danny Bobrow

“View your connection with everyone as relational as opposed to transactional. The money will follow.”

— Danny Bobrow

Danny Bobrow is proof that the most sophisticated marketing strategy in the world can’t outpace a missed connection at the front desk. For practice owners who want to attract more patients, retain the ones they have, and build a team culture that reflects the care they deliver clinically, this conversation is a strong place to start. Visit dannybobrow.com to access the complimentary Persuasion Scorecard and request a complimentary strategy call — he’ll even send you the Persuasion Blueprint primer in advance. And for community, resources, and support in building a practice that genuinely thrives, explore thrivingpracticecommunity.com.

Guest Bio:

Danny Bobrow is the creator of the Persuasion Blueprint, a communication framework he developed after decades running a marketing consultancy for dental and healthcare practices. An ultra-endurance mountaineer who has climbed 20 of the world's highest peaks, Danny draws on lessons in reading subtle signals under pressure to help practice teams turn first impressions into lasting patient loyalty and referrals.

Find Danny:

Websites: DannyBobrow.com AmericanDentalMarketing.com

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Tracy Cherpeski 7/10/26 Tracy Cherpeski 7/10/26

Two Websites, One Brand: What Our Site Merger Taught Us – A Special Snack Episode, EP 268

What happens when a growing practice launches a second website to give a new offering room to breathe? In this SNACK episode, Miranda Dorta turns the mic around on host Tracy Cherpeski to unpack why they built the Thriving Practice Community its own separate website, why it didn't perform the way they hoped, and why they recently merged everything back into one unified brand.

What happens when a growing practice launches a second website to give a new offering room to breathe? In this SNACK episode of The Thriving Practice Podcast, Miranda Dorta turns the mic around on host Tracy Cherpeski to unpack why they built the Thriving Practice Community its own separate website, why it didn't perform the way they hoped, and why they recently merged everything back into one unified brand. For healthcare practice owners weighing whether to split a program, service line, or community into its own site, this candid conversation is a real-time case study in brand identity and website strategy for independent practices.

Tracy and Miranda walk through the original thinking behind giving the Thriving Practice Community its own front door, what the analytics actually showed once the site was live, and the moment Tracy realized that trying to keep her personal body of work separate from the community she built was working against her instead of for her.

Whether you're a practice owner debating a second website for a new program, wondering if your current site setup is sending mixed signals to visitors, or simply curious how two seasoned entrepreneurs test and course-correct a business decision, this episode offers a transparent look at what didn't work, why, and what Tracy and Miranda are doing instead.

Key Takeaways

Multiple websites can dilute brand clarity instead of protecting it. Splitting a new offering into its own site felt strategic on paper, but it created a "wait, what is this?" moment for visitors instead of building trust.

Data drives the decision, not guesswork. Tracy and Miranda tracked analytics for months before concluding that a standalone site for the community wasn't generating meaningful organic traffic or conversions.

Separate isn't always safer. Tracy initially wanted distance between her personal brand and the community, but came to see the community as an extension of her own body of work rather than something that needed its own identity.

A single scrolling landing page is a tough way to build SEO. A standalone site without a fuller content structure struggled to rank or generate organic visits.

Give a change roughly eight weeks before judging it. Tracy and Miranda's rule of thumb is to test one variable at a time and hold for about eight weeks before deciding whether it worked.

Q&A

Should I build a separate website for a new program or offering?

Not necessarily. Tracy and Miranda found that a standalone website for the Thriving Practice Community created confusion rather than clarity, since visitors weren't sure how it related to Tracy's main brand and business.

How do you know when two websites are hurting your brand instead of helping it?

Watch the data, not just the design. For Tracy and Miranda, the tell was consistently weak organic traffic and slow conversions on the standalone site, even after testing several changes.

What does it cost a business when people can't tell how the pieces fit together?

Mostly slower, harder-to-track progress. When visitors are confused about how two offerings relate, interested people pause instead of taking the next step, even when they like what they see.

How long should you test a website or marketing change before deciding it isn't working?

Tracy and Miranda's rule of thumb is about eight weeks per change, testing one variable at a time so they can actually tell what moved the needle before pulling a different lever.

Episode Highlights

Why the Thriving Practice Community originally got its own website and URL

The moment Tracy realized separating herself from the community wasn't protecting either brand

What the site analytics revealed after months of running a standalone community website

Why a single scrolling landing page is a hard way to build SEO and organic traffic

The eight-week testing rule Tracy and Miranda use before pulling a new lever

What practice owners should ask themselves before splitting a brand across multiple sites

Memorable Quotes

"I really need to embrace what I have built and what we have built around the body of work that I've created over all these years." — Tracy Cherpeski

"Trying to keep them separate is actually not on brand for us, which I think that was the biggest takeaway for me." — Tracy Cherpeski

"A scrolling one page doesn't perform very well for SEO and AIO." — Tracy Cherpeski

"Slow down, take your time, consult with people who get it." — Tracy Cherpeski

If you've ever wondered whether a new offering in your practice deserves its own website, or if your current setup might be quietly confusing the people you're trying to reach, this conversation is worth the listen. Tracy and Miranda's biggest lesson: don't be afraid to test, track, and change course when the data tells you something different than your instinct did. Visit practicesuccess.co/community to learn more about the Thriving Practice Community, or practicesuccess.co to schedule a consultation with Tracy.

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Tracy Cherpeski 7/8/26 Tracy Cherpeski 7/8/26

“I Take What I Get” — And Other Costly Myths About Your Payer Contracts Featuring Brett Spark, EP 267

Most private practice owners have a feeling they're not being paid what they're owed by insurance payers — but very few can prove it. In this episode, Tracy Cherpeski talks with Brett Spark of Aroris Health about why payer underpayment is so common, and why visibility into your payer contracts might be the most overlooked lever for practice profitability.

Most private practice owners have a feeling that they're not being paid what they're owed by insurance payers — but very few can prove it. In this episode of The Thriving Practice Podcast, Tracy Cherpeski talks with Brett Spark of Aroris Health about why payer underpayment is so common, why almost no practice has its own contracts organized, and how visibility into the payer relationship can directly impact the profitability of a medical practice.

Brett's path is a unique one: he spent the first half of his career climbing the ladder inside a large regional health system before being recruited into a private practice CEO role. That shift exposed him to just how differently independent practices operate — with more autonomy, more speed, and far less red tape, but also far less infrastructure for managing complex payer relationships. Aroris Health grew out of that gap, evolving from a peer negotiation service into a software platform that digitizes contracts and tracks every claim against what a practice is contractually owed.

For practice owners thinking about time management for healthcare practice owners, running a profitable medical practice, or building private practice without burnout, this conversation reframes payer contract management from an overwhelming back-burner task into one of the highest-leverage things a practice owner can do.

Key Takeaways

Most practices don't have their own contracts organized. Brett notes that in six years of business, Aroris Health has yet to have a client who could produce all of their payer contracts, amendments, and fee schedules in one place.

Underpayment is rarely simple fraud — it's often complexity and drift. Rate changes, coding complexity, and contract amendments create frequent opportunities for errors to creep in undetected, sometimes for years.

Visibility, not just negotiation, is the real lever. Many practices assume their only option is to renegotiate rates, but Aroris Health often finds that practices are simply being paid incorrectly relative to their existing contract — a fixable error, not a negotiation.

Independent practices preserve choice in the healthcare ecosystem. Brett argues that empowering private practices to stay independent — rather than being absorbed by health systems or private equity — protects patient access to a different, often more personal, care model.

Doing something is better than doing nothing. Brett's parting advice: practice owners have a fiduciary responsibility to understand what they signed, whether they tackle it internally or bring in outside support.

Q&A

Why are independent practices losing money on payer contracts without realizing it?

According to Brett, most practices have never had full visibility into their own contracts — many can't even produce a complete copy of what they originally signed, let alone every amendment since. Without that visibility, it's nearly impossible to know whether a payer is reimbursing according to the terms that were actually agreed upon.

Is payer underpayment usually intentional?

Brett is careful not to assume bad intent across the board. He points to the sheer complexity of coding, modifiers, site-of-service rules, and contract terms that change year over year as a major driver of errors — alongside cases where payers simply aren't held accountable for catching their own mistakes.

How much revenue can be recovered once a practice gets visibility into its contracts?

Brett shares that Aroris Health has uncovered cases where a practice was paid the wrong rate for an entire year, resulting in six-figure and even million-dollar corrections — revenue that would have otherwise been permanently lost.

What's the first step a practice owner should take if they suspect they're being underpaid?

Brett's advice is to start by simply gathering the actual contracts, amendments, and fee schedules — something most practices have never done. From there, even a basic comparison between what's billed and what's paid can reveal discrepancies worth pursuing.

Episode Highlights

Brett's path from a large regional health system to private practice CEO — and what it taught him about autonomy and speed

Why Aroris Health evolved from a peer negotiation service into a payer-contract software platform

The six-year track record: no client has ever shown up with a complete, organized contract file

How the software digitizes contracts and flags discrepancies between contracted rates and actual claims paid

The Netflix subscription analogy: how reimbursement rates quietly shift without practices noticing

Why timely filing windows for correcting payer errors vary contract by contract

The case for preserving independent, private practice as a vital part of the healthcare ecosystem

Brett's parting advice: doing something is better than doing nothing

Memorable Quotes

“Don't buy into the narrative that has existed of, I just signed the contract, I take what I get.” — Brett Spark

“Visibility will lead to revenue opportunities.” — Brett Spark

“Doing something is better than doing nothing.” — Brett Spark

“I think to be successful, the practices that we're seeing really growing and evolving are taking a more focused approach: I need to essentially start right, to end right.” — Brett Spark

“Our mission is to preserve the spirit of medicine.” — Brett Spark

Brett Spark's conversation with Tracy is a reminder that the most overlooked opportunity in a private practice's finances might not be a new patient acquisition strategy or a pricing change — it might be the contract that's already been signed and never fully read. For practice owners who've ever had the nagging feeling that they're not being paid what they're owed, this episode offers a concrete, fiduciary-minded path forward: get visibility first, then decide what to do with it. Share this episode with a colleague who manages the business side of their practice and visit ArorisHealth.com to learn more about Brett's work. Explore ThrivingPracticeCommunity for additional resources to help you build a practice that truly thrives.

Guest Bio:

Brett Spark has spent his career inside the business of healthcare — first climbing the ranks of a large regional health system, then taking the leap into private practice as a CEO. That shift changed everything. Seeing firsthand how payer contracts shape both financial performance and patient care, Brett co-founded Aroris Health to give independent practices the clarity and tools they need to navigate those relationships with confidence. Today, Aroris combines negotiation expertise with a purpose-built software platform that helps practices understand exactly what they're owed — and actually get it.

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Website: ArorisHealth.com

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Tracy Cherpeski 7/1/26 Tracy Cherpeski 7/1/26

Still Doing It Yourself? What That's Really Costing Your Practice, EP 266

Are you the one still writing every patient email, every social post, every practice announcement? In this solo episode, Tracy Cherpeski asks the question most practice owners don't want to answer: is that actually your job?

Are you still writing your own patient emails? Still drafting every social post, every newsletter, every practice announcement — and quietly wondering why it still lands on your plate? If that question landed uncomfortably, you're in the right place. In this solo episode of The Thriving Practice Podcast, Tracy Cherpeski names one of the most overlooked bottlenecks in independent practice ownership: not a staffing gap, not a capacity problem, but a standards problem — one that founders build carefully, one "I'll just do it myself" at a time.

This episode isn't about delegation as a time-management tactic. It's about recognizing the moment when the habits that made your practice work in year one start quietly capping its growth in year three. If you've ever felt the exhaustion of being the bottleneck, the guilt of resenting a team you haven't actually handed work to, or the quiet dread of watching something go out that doesn't sound quite like you — Tracy's talking directly to you.

For independent practice owners navigating burnout prevention, sustainable growth, and what it actually looks like to lead a team instead of just absorbing all the work personally, this episode is a must-listen.

Key Takeaways

It's a standards problem, not a capacity problem. Most practice owners aren't behind because they don't have enough help — they're behind because their standards are so specific to them that nothing can leave their hands. That's a bottleneck you built.

"For now" has a shelf life. There's a legitimate season where you really are the only one who can do it. The problem is when that season quietly becomes permanent — and no alarm goes off to tell you it did.

The guilt loop is real — and it's not a character flaw. Resentment toward a team you haven't actually handed things to, followed by guilt about the resentment — that loop exhausts founders faster than the task itself. Recognizing it is the first step.

Letting go doesn't mean lowering your standards. It means trusting that your standards can be taught, absorbed, and carried by other hands — even if the first few attempts don't quite land.

You make room for things you can't build. One client's team started coordinating across locations on their own — not because she engineered it, but because she finally stepped aside long enough for it to happen.

Q&A

Why do high-achieving practice owners become the bottleneck in their own businesses?

It's rarely about lacking help — it's about standards so specific to the founder that nothing can leave their hands until it sounds, looks, and feels exactly right. Without ever deciding to be the bottleneck, they build one, one "I'll just do it myself, it's faster" at a time.

How do I know if it's still the right season for me to be doing this work myself?

Ask yourself: is "I'm the only one who can do this right" still a temporary truth about your team's skill level — or has it become a permanent story about who you are in this business? If there's no plan attached to "for now," it may have already become permanent.

What does delegation actually cost when you delay it?

Tracy's client was losing on three fronts simultaneously: potential leads (inconsistency loses browsers before they book), returning patients (sporadic communication makes even loyal patients forget you), and team growth (if you're still holding everything, you're blocking the exact doors you built for your team to walk through).

What does the transition actually look like — does it go smoothly?

Usually not at first, and that's the point. The adjustment period — where things don't sound quite like you yet — is exactly when most founders grab the task back. The ones who don't grab it back are the ones whose teams eventually start solving problems the founder didn't even know existed.

Episode Highlights

The cold open question that reframes what your job actually is

Why this is a standards problem, not a staffing problem

A real client story: two locations, one human bottleneck, three hidden costs

Sitting with the discomfort — what it actually feels like at the tipping point

The guilt loop: resentment, then shame for the resentment

The root-bound plant metaphor: what happens when your business runs out of room to grow

"For now" — since when, and until when?

A three-question gut-check to see where you actually stand

Why the bottleneck is yours to dismantle — and why that's actually good news

The TPC founding member invitation

Memorable Quotes

"You're not behind because your standards are too low. You're behind because your standards are so specific to you that nothing can leave your hands until it sounds like you, looks like you, feels like you." — Tracy Cherpeski

"The season never ended. She was still doing all of it long after 'I'm the only one who can do this well' had quietly turned into 'I am the only one who does this, period.'" — Tracy Cherpeski

"That loop — resentment, then guilt, then shame for the resentment — will exhaust you faster than the actual task ever could." — Tracy Cherpeski

"She didn't build that. She made room for it." — Tracy Cherpeski

"The bottleneck you're frustrated by? You built it carefully, with good intentions, one 'I'll just do it myself' at a time. Which means you're also the only one who can take it apart." — Tracy Cherpeski

The task you're still holding — the one you keep telling yourself is temporary — may be the single thing standing between where your practice is now and where it could go. Tracy's not asking you to lower the bar. She's asking you to trust that the bar can be handed to someone else. If this episode hit close to home, share it with a colleague who's carrying the same weight. And if you're ready to do this work alongside a community of practice owners who get it, visit ThrivingPracticeCommunity.com to learn about TPC founding membership.

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Tracy Cherpeski 6/26/26 Tracy Cherpeski 6/26/26

“I Don’t Want to Burden Them”: The Real Reason Practice Owners Go It Alone – A Special SNACK Episode, EP 265

Private practice ownership comes with a particular kind of loneliness that no one warns you about. In this SNACK episode, Miranda Dorta turns the mic around and interviews Tracy Cherpeski about what isolation actually costs practice owners, and why so many high-achieving providers resist the very support that could help.

Private practice ownership comes with a particular kind of loneliness that rarely gets named out loud. You’re surrounded by patients, staff, maybe a partner or two, and still making most of the big decisions on your own. In this SNACK episode, Miranda Dorta turns the mic around on Tracy Cherpeski to talk about what that isolation actually costs practice owners, and why so many high-achieving providers resist the very thing that could help.

Tracy gets candid about a pattern she sees constantly in her work with practice owners: people who don’t even recognize their own isolation until someone else names it first. It’s not that they lack support at home, she explains. It’s that they don’t want to burden the people who do support them. That single distinction reframes a lot of what looks like self-sufficiency as something closer to quiet overload.

The conversation also digs into why generic networking and professional communities often fall flat, what actually shifts in a practice owner’s body language and decision-making once they let their guard down with true peers, and why “I don’t have time” is often less about the calendar and more about what busyness lets people avoid.

Key Takeaways

Isolation often hides behind competence. Many practice owners don’t identify their own situation as lonely until someone else reflects it back to them; it just feels like “I’m the only one who makes these decisions.”

It’s not a lack of support, it’s reluctance to burden others. Spouses and partners often do understand, but practice owners hold back because those people already carry their own full plates.

Peer-specific community works differently than general networking. Being understood by someone in a nearly identical professional situation creates a kind of recognition that coaching or consulting alone can’t replicate.

Letting your guard down changes more than you’d expect. Tracy describes visible shifts in body language, like relaxed shoulders and a sense of relief, the moment practice owners feel safe enough to be honest with peers.

Busyness can be a convenient shield. Being “too busy” sometimes functions as a socially acceptable way to avoid harder internal work, including the work of delegation and letting go of control.

Q&A

Why don’t practice owners talk about how isolating ownership can feel?

Many don’t recognize it as isolation in the first place. It often surfaces only after trust has been established, sometimes when one person in a group setting names the feeling first and others realize they share it.

Isn’t this just about not having support at home?

Not usually. Tracy points out that the issue is rarely a lack of understanding from spouses or partners. It’s that practice owners don’t want to add to a partner’s already full plate by bringing them into every decision.

What makes peer community different from typical networking?

According to Tracy, the difference is being instantly understood by someone in a very similar role. A coach or consultant can offer expertise, but a fellow practice owner offers recognition: someone who has lived the same kind of decision fatigue and knows exactly what it costs.

Is “I’m too busy” a real barrier or an excuse?

Both, in different ways. Tracy says time constraints are real, but busyness can also become a badge of honor that conveniently excuses people from doing harder internal work, like learning to delegate or examining why they’re holding onto control.

Episode Highlights

How isolation shows up for practice owners who appear successful from the outside

The difference between “not supported” and “not wanting to burden someone”

Why peer-specific community beats general professional networking

The visible, physical shift Tracy has witnessed when practice owners let their guard down

Busyness as a badge of honor, and what it often conceals

The risk of losing control as practices grow and owners start delegating

What the smallest first step toward real professional community actually looks like

Memorable Quotes

“It’s usually not that they’re not supported at home, it’s that they don’t want to burden people.” — Tracy Cherpeski

“The richness of instantly being heard, seen, and understood, and then seeing yourself reflected in another person who’s in a very similar situation to yours. That is gold.” — Tracy Cherpeski

“How conditioned are we all to be like, busyness is my badge of honor. And also it keeps me from having to commit to crap I don’t want to do.” — Tracy Cherpeski

“Some safety revealed itself and they felt like they could let their guard down, and literally everything changes.” — Tracy Cherpeski

“It’s a really, really powerful decision to decide not to do something as well. You can always leave.” — Tracy Cherpeski

If you’ve ever felt like the only one carrying the weight of every decision in your practice, this episode is a reminder that the feeling is common, and that it doesn’t have to stay that way. Sometimes the smallest first step is simply being open to checking out what a real professional community could look like for you. Visit thrivingpracticecommunity.com to learn more, or head to practicesuccess.co to schedule a consultation with Tracy.

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Tracy Cherpeski 6/24/26 Tracy Cherpeski 6/24/26

Whoever Answers the Phone Wins: The Hidden Cost of Missed Calls Featuring Erika Sanchez, EP 264

Five missed phone calls could be costing your practice $5,000 to $10,000 a month — and most practice owners have no idea it's happening. In this episode, Tracy Cherpeski talks with Erika Sanchez, CEO of Healthcare Call Center, about the hidden gap between marketing spend and practice growth.

Five missed phone calls. That's all it takes to quietly drain $5,000 to $10,000 a month from a healthcare practice — and most practice owners have no idea it's happening. In this episode of The Thriving Practice Podcast, Tracy Cherpeski talks with Erika Sanchez, CEO of Healthcare Call Center, about the hidden gap between marketing spend and practice growth: the front desk.

Erika's team is built almost entirely of stay-at-home moms working from home across the country, and they've helped healthcare practices triple their lead-to-new-patient conversion. For independent practice owners trying to run a profitable medical practice without burning out their front office staff, this conversation gets at a problem that rarely gets named directly: clinicians are excellent at healing, but most were never trained to run a business, let alone manage the speed-to-lead demands of modern healthcare marketing.

Whether you're a practice owner wondering why your ad spend isn't converting, a clinician feeling stretched between patient care and operations, or someone exploring time management for healthcare practice owners, this episode offers a clear, practical look at where the money is actually being lost — and how to fix it.

Key Takeaways

Missed calls are missed relationships, not just missed dollars. Erika reframes the cost of a missed call from a sterile number into what it actually represents: a prospective patient who needed care and didn't get a response.

Nearly half of new patient interest happens after hours. Roughly 46 percent of inquiries come in outside business hours, which means a practice that only answers 9-to-5 is missing a huge share of potential patients.

Speed to lead is everything. Prospective patients who don't get a response within about five minutes are roughly four times more likely to go to a competitor instead.

Front desk and lead follow-up are two different jobs. Asking one person to handle in-office patients and respond to new leads in real time sets both the role and the practice up to fail.

A simple three-question framework builds trust fast. Asking what's going on, how long it's been an issue, and whether the patient has seen another provider can build real trust in under two minutes.

Q&A

Why are independent practices losing money even when their marketing is working?

Most practice owners are clinicians first, not business operators, and the disconnect usually shows up at the front desk. Leads come in from marketing campaigns, but if no one follows up quickly — especially after hours or on weekends — those leads go to a competitor who answers first.

How much revenue can a missed call actually cost a practice?

Erika shares that with an average patient value of a few thousand dollars, missing just a handful of calls over a single weekend can leave $5,000 to $10,000 on the table — money the practice already spent to generate through advertising.

Why don't patients want to talk to an AI bot when scheduling healthcare appointments?

Even as practices lean on automation for administrative tasks, patients consistently want a human on the other end of a healthcare conversation, particularly for sensitive topics. Erika notes that trust, more than efficiency, is what determines whether a caller becomes a patient.

What makes stay-at-home moms particularly effective at this kind of work?

Erika has built her team almost entirely of stay-at-home moms because, in her experience, empathy and the ability to multitask are qualities she can't easily teach — but the technical and process side of the job, she can. The flexible schedule also lets her offer meaningful part-time work to women who want it.

Episode Highlights

Erika's path from healthcare marketing into building a call center built for medical practices

Why front desk staff and lead follow-up are fundamentally different jobs

The real dollar cost of a missed call, explained in plain terms for non-business-minded clinicians

Why nearly half of new patient inquiries come in after standard office hours

The "speed to lead" principle and why five minutes matters so much

Why patients still want a human, not a bot, when it comes to healthcare

The simple three-question framework that builds trust in under two minutes

How Erika trains her team using an AI role-play bot so new hires practice on simulated patients, not real ones

Erika's advice for overwhelmed practice owners: find people you trust and build real partnerships

Memorable Quotes

"Whoever answers the phone wins." — Erika Sanchez

"It's a speed-to-lead game. If you don't answer a text or call within five minutes, they are 400% more likely to go elsewhere." — Erika Sanchez

"I will not treat patients and you will not do marketing. Everyone just stay in their lane and do what they're really good at." — Erika Sanchez

"It's really important when you're spending money on marketing, you're missing so many opportunities that you're already paying for." — Erika Sanchez

"Find the people that you trust, find the people that you want to partner with, and we can grow together." — Erika Sanchez

Erika Sanchez makes the case that the biggest leak in a healthcare practice's growth often isn't the marketing — it's what happens, or doesn't happen, after the phone rings. For practice owners who've felt the frustration of paying for leads that go nowhere, this episode offers a clear, actionable place to start looking. If this conversation helped you see your front desk differently, share it with a colleague who's wondered why their ad spend isn't converting into new patients.

Guest Bio:

Erika Sanchez spent over a decade in restaurant marketing before a move into healthcare marketing introduced her to a problem she couldn't shake: practices were generating leads they weren't equipped to convert. That insight eventually led her to Healthcare Call Center, where she's now CEO and has built a team of stay-at-home moms who consistently out-schedule what most practices manage in-house. Outside of work, Erika homeschools her three daughters and recently celebrated 16 years of marriage.

Find Erika:

Website: HealthcareCallCenter.com

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Tracy Cherpeski 6/17/26 Tracy Cherpeski 6/17/26

Is Your Practice a Sellable Asset? Luisa Alberto on Cash Flow, Sustainability, and Building to Exit, EP 263

What does it really take to run a profitable, sustainable healthcare practice — and why does the financial side feel so impossibly hard? In this episode of The Thriving Practice Podcast, Tracy Cherpeski sits down with Luisa Alberto, CEO of People First Finance, People First Foundations, and Kindredly, for a conversation that is equal parts practical and genuinely energizing.

Luisa didn't grow up as a "money person." She was an art kid who studied philosophy, built and closed a brick-and-mortar business, and raised her daughter as a single mom in San Francisco. Through necessity and determination, she mastered personal and business finance — and built three companies around helping self-employed professionals do the same. Her perspective is especially valuable for healthcare practice owners who are excellent clinicians, often capable leaders, and genuinely overwhelmed by the business side of what they have built.

If you've ever wondered where all the money went, why your practice feels profitable on paper but tight in practice, or how to even know what you don't know when it comes to finances — this episode is for you.

Key Takeaways

Financial clarity is a leadership tool. Understanding your numbers isn't just an accounting task — it's what lets you make confident, strategic decisions for your practice.

There's an emotional cost to doing it alone. The mental load of unresolved financial questions can wake you up at 3am and quietly erode your focus and wellbeing.

Know the difference between a bookkeeper, a CPA, and a CFO. Each plays a distinct role. Understanding who does what helps you build the right team and ask better questions.

Your practice is a sellable asset. Building with sustainability and profitability in mind sets you up to exit on your terms — and potentially change your family's financial trajectory.

You can outsource the task — not the thinking. Staying engaged with your finances, even at a baseline level, protects your business and your relationship with the professionals serving you.

Q&A

What does financial clarity actually mean for a practice owner?

Luisa defines it as understanding how money flows through your business — revenue in, expenses out, net profit — and knowing what portion needs to be set aside for tax, how to pay yourself correctly based on your entity structure, and what your cash position looks like several months out. The goal isn't to become a finance expert. It's to be informed enough to ask the right questions.

What's the real cost of managing your own finances without support?

Beyond compliance risk and potential tax errors, Luisa highlights the emotional cost: carrying a heavy mental load of open financial questions leads to the kind of sleepless nights and low-grade dread that compound over time. She calls this "burnout brain" — a state where you're making survival decisions rather than strategic ones.

What's the difference between a bookkeeper, a CPA, and a CFO?

Bookkeeping accurately records all money flowing through your accounts. A CPA handles compliance and tax filing. A CFO manages cash flow strategically — forecasting revenue, planning for seasonal dips, identifying your runway, and helping you build toward long-term profitability. Many practice owners conflate these roles and end up either under-served or paying for expertise they aren't fully using.

How should practice owners think about building something they can eventually sell?

Luisa encourages owners to think about their practice as a sellable asset from day one. A practice that runs profitably, has sound systems in place, and doesn't collapse when the owner steps back for a few weeks is a practice with real market value. That kind of exit can represent generational wealth — a motivator that makes the work of building sustainable systems feel genuinely worth it.

Episode Highlights

Luisa's origin story: from philosophy student and art kid to business finance expert — by way of a bankruptcy and single motherhood in San Francisco

Why business owners feel isolated — and why niche professional communities are helping to change that

The physician's version of "now what?": the moment after the doors open and the overwhelm sets in

"I'm not a money person": why that belief can cost you your practice

The cash flow forecasting skill that keeps Luisa running profitably every year — and how to build it yourself

Why financial clarity is a leadership skill, not a personality trait

Burnout brain vs. growth mindset: two very different places to make decisions from

What a CFO should actually be doing for your practice

Building a practice that can run without you for three weeks — and why that matters for your long-term exit

Parting advice: keep going

Memorable Quotes

"If you're just like, 'I'm not a money person' — having your own business is going to be very, very difficult for you." — Luisa Alberto

"What a CFO should be doing is helping you make strategic decisions that protect your cash and increase your profitability over time." — Luisa Alberto

"You're making decisions from burnout brain. The opposite is making decisions from a place of growth mindset — knowing you're on the right path." — Luisa Alberto

"Can you take real time off? Can you step away for a few weeks and nothing breaks? That's another marker." — Luisa Alberto

"A large portion of owning a business is making sure that you have enough money. If you don't have those things on lock — you don't have a business. You have a very expensive hobby." — Luisa Alberto

Luisa is proof that financial clarity isn't a personality trait — it's a learnable skill that changes everything. For practice owners who want to enjoy the autonomy they signed up for, build something sustainable, and eventually exit on their own terms, this episode is a roadmap. Connect with Luisa at luisakalberto.com or find her on LinkedIn, and explore the Self Employment Built to Last email series while you're there. And if you're ready to bring more strategic support into your practice, visit practicesuccess.co to learn how the Thriving Practice Community can help you build a practice that truly thrives.

Guest Bio:

Luisa Alberto didn't set out to become a finance expert — she became one out of necessity. After running her own brick-and-mortar business, becoming a single mother, and facing a landlord threatening to evict her from her apartment in one of the most expensive cities in the country, Luisa realized that loving her business wasn't enough; she needed to master her own financial literacy to protect her family's future. That experience became the foundation for People First Finance, People First Foundations, and Kindredly — three ventures she now leads to help self-employed business owners (with a particular soft spot for women) achieve the financial clarity and independence that real freedom requires.

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Websites: PeopleFirstFinance.com LuisaKAlberto.com

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Tracy Cherpeski 6/12/26 Tracy Cherpeski 6/12/26

The One-Lever Method: Tracy Cherpeski on Course Correcting Your Practice Without Chaos – A Special SNACK Episode, EP 262

Does your practice still reflect why you started it? In this SNACK episode of The Thriving Practice Podcast, host Tracy Cherpeski joins co-host Miranda Dorta to unpack what Tracy calls "practice identity drift" — the subtle, gradual process by which a once-intentional practice loses its center. If you're a healthcare practice owner who's checked all the boxes but still feels like something is off, this episode is for you.

Practice identity drift rarely announces itself. The practice may be profitable and running smoothly on paper, but the owner feels disconnected, bored, or quietly resentful without knowing why. Tracy draws a direct parallel to burnout progression: the drift often starts with outside forces — the relentless pace of change in a heavily regulated industry — before compounding through overcommitment, reactive decision-making, and a gradual erosion of the things that made the work meaningful.

Whether you've been in reactive mode for years or just sense that your practice has drifted from what you originally envisioned, this conversation offers a practical framework for finding your way back — without overcorrecting.

Key Takeaways

Drift is subtle — until it isn't. A practice can look successful from the outside while the owner feels disconnected, bored, or resentful. Recognizing the drift is the first step.

Overcommitment compounds the problem. Physicians rarely have bandwidth to spare — and when yes becomes the default answer, drift accelerates.

Slowing down is the starting point. Tracy's first coaching sessions focus on deep intentional reflection before any action is taken — typically a 90-minute session that helps owners get outside their regular thinking.

Pull one lever at a time. Course correction works best when changes are made incrementally, observed over roughly eight weeks, and adjusted before the next change — not all at once.

Clinical thinking has business applications. The methodical diagnostic approach physicians use with patients is directly transferable to identifying what's not working in a practice.

Q&A

What is practice identity drift, and how does it happen?

Practice identity drift is the gradual process by which a practice owner's original vision becomes obscured by external demands, overcommitment, and reactive patterns. Tracy describes it as similar to burnout progression — subtle at first, often invisible from the inside — driven largely by the speed of change in healthcare and the compounding pressure to stay on top of compliance, patient needs, and clinical obligations.

How can a practice owner course correct without making things worse?

The biggest risk in course correction is overcorrecting — making too many changes at once and losing the ability to assess what's actually working. Tracy recommends pulling one lever at a time, observing for approximately eight weeks, and then making the next adjustment. The exception is a practice that needs a complete overhaul, in which case a more intensive engagement makes sense.

How does Tracy help practice owners figure out what they actually want?

Tracy's onboarding process starts with a 90-minute deep-dive coaching call structured around pointed questions designed to move clients through a progression of clarity. She warns clients in advance: the first four to six weeks will feel slow and uncomfortable. But that discomfort is where the insights live — and clients regularly surprise themselves with what they articulate out loud for the first time.

How do I know if my practice has drifted?

Tracy offers a simple three-part diagnostic: ask yourself whether the challenge you're facing is a people problem, a process problem, or something external. That distinction alone helps practice owners prioritize what to address first and where to focus their energy.

Episode Highlights

What practice identity drift looks like — and why it's so hard to see from the inside

The role of healthcare's pace of change in pulling practice owners away from their original vision

Why overcommitment isn't just about saying yes too much — it's a cascade of displaced priorities

The "patient as customer" tension and when adapting to patient needs starts working against the practice owner

Tracy's onboarding process: slowing down as a strategic move, not a delay

What a client's first F-bomb in a coaching session revealed about the power of the process

Why course correction beats pivot — and the Friends reference that explains the difference

The one-lever-at-a-time method: how practice owners can test changes without chaos

When clinical diagnostic thinking is exactly the right tool for business problem-solving

The three-question self-assessment: people, process, or external?

Memorable Quotes

"The drift is usually pretty subtle until it's not. It might still be humming along — on paper, on the surface, externally successful — but something feels off." — Tracy Cherpeski

"That first call is 90 minutes. We take a long deep dive. And it's amazing what happens. You get outside of your regular thinking, especially when someone is taking you through a progression to get to where you want to be." — Tracy Cherpeski

"Not overcorrecting. That's the hardest part of course correction." — Tracy Cherpeski

"Just because you can doesn't mean you should." — Tracy Cherpeski

"Is it people? Is it process? Or is it something external? Chunk it down — that helps you figure out what's next." — Tracy Cherpeski

Practice identity drift doesn't happen overnight — and course correction doesn't have to either. Tracy's message in this episode is both practical and reassuring: you don't need to blow things up to find your way back. You need to slow down, get honest about what's not working, and make deliberate, measured changes one step at a time. If this episode resonated with you, visit practicesuccess.co to schedule a consultation with Tracy, or explore the community at thrivingpracticecommunity.com.

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Tracy Cherpeski 6/10/26 Tracy Cherpeski 6/10/26

Market Yourself, Not Your Practice: Ginger Allen on Personal Branding for Physician Growth, EP 261

What if the most powerful marketing tool a physician has isn't a website or an ad campaign — it's themselves? In this episode, Tracy Cherpeski sits down with Ginger Allen, founder of Your Medical Liaison and president of the Florida Medical Association Alliance, to talk about what actually works when growing a functional medicine practice or any independent healthcare practice.

If you've ever wondered why a beautifully designed website and a $50,000 piece of equipment still aren't bringing new patients through the door, Ginger Allen has some thoughts on that. In this episode of The Thriving Practice Podcast, Tracy Cherpeski sits down with Ginger — founder of Your Medical Liaison (YML) and a 12-year veteran of medical marketing — to talk about what actually works when it comes to growing a functional medicine practice or any independent healthcare practice.

Ginger's take is direct: the old model of marketing a practice is over. The physicians who are building sustainable, burnout-resistant practices right now are the ones marketing themselves as people — not their clinics, not their credentials, not their equipment. For independent practice owners trying to cut through the noise and attract patients who are the right fit, this conversation is both validating and actionable.

Whether you're a physician making the move from a hospital system to private practice, a functional or integrative medicine provider trying to grow your patient base, or simply a practice owner who's tired of throwing money at marketing that isn't working, Ginger offers a perspective shaped by years of working alongside physicians on the front lines of building something they actually love.

Key Takeaways

People connect with people, not logos — and the physicians gaining traction are the ones leaning into authentic, visible personal brands. Personal branding has replaced practice branding.

Ginger has seen too many providers invest in high-cost machines before they have a patient base to support them. The marketing has to come first. Patients must come before equipment.

Most doctors didn't go into medicine to create content or manage ad campaigns. Removing that burden is one of the most direct ways to protect their longevity. Getting marketing off a physician's plate is burnout prevention.

Functional and integrative medicine practices can't rely on insurance referral pipelines. They need intentional patient acquisition strategies built around visibility and trust. The self-pay model requires a different marketing strategy.

Across her interviews and client relationships, Ginger has noticed a consistent theme: providers who make the shift to root-cause, relationship-centered care report far higher levels of professional satisfaction. Functional medicine physicians are genuinely happier.

Q&A

Why do functional medicine practices need a different marketing approach than traditional medical practices?

Because the business model is fundamentally different. Most functional and integrative medicine practices are cash-pay or membership-based, which means they can't rely on insurance networks or hospital system referrals to keep the schedule full. They have to actively build visibility, earn trust, and attract the right patients — which looks far more like running a small business than hanging a shingle and waiting.

What's the biggest marketing mistake physicians make when starting or growing a functional medicine practice?

Investing in expensive equipment before building a patient base. Machine reps will tell you the equipment sells itself — Ginger says that's simply not true. You have to have the patients first. People will buy whatever their doctor recommends, but the machine won't bring the patients in on its own.

What does personal branding actually look like for a physician who's not naturally comfortable on camera?

Ginger's approach: batch it. Once a month, she guides clients through a one-hour recording session on Streamyard, prompting them with questions so they're in the flow of talking about what they love — their work, their patients, their approach. They're not creating content, they're having a conversation. That content then gets repurposed across channels, and the physician barely has to think about it.

How does strong marketing support help prevent physician burnout?

When physicians are carrying the full weight of running a business — clinical work, operations, and marketing — something eventually breaks. Ginger's philosophy is to take marketing entirely off their plate so they can stay in their zone of genius: caring for patients. That reduction in cognitive and administrative overload is a real factor in helping physicians stay sustainable over the long term.

Episode Highlights

How Your Medical Liaison grew from field marketing to a full-service boutique agency over 12 years

The two-division model: field marketing for specialists, digital marketing for functional and integrative medicine providers

Why Ginger niched into functional and integrative medicine — and what she's observed about physician happiness in that world

The machine rep problem: how predatory sales practices push new practice owners into serious overhead before they're ready

What Ginger's intern's marketing professors told her about the future of brand strategy — and why it matters for healthcare

Why millennials and younger patients respond to genuine content, not polished productions

The autonomy factor: why physicians consistently cite independence as the primary reason they go into private practice

Ginger's own wellness practices — nature, sunlight, grounding — and how they align with what her functional medicine clients prescribe

Memorable Quotes

"People like to work with people, not companies. We are no longer marketing the business. We are marketing you." — Ginger Allen

"You have to have the patients first. Machines will not bring business in." — Ginger Allen

"I don't want my physicians burning out. I want you to get that monkey off your back, because it is not what you went to school for." — Ginger Allen

"The freedom to be autonomous far outweighs the stress of running a business." — Ginger Allen

"Market you. That's what I'd like to leave them with." — Ginger Allen

Ginger Allen brings something rare to the medical marketing world: she genuinely cares whether her physicians thrive. And the through-line in everything she shared — from personal branding to equipment purchasing to patient-first strategy — is that building a healthy practice starts with building a sustainable one. If you're a practice owner who's ready to stop doing it all yourself and start showing up as the face of your own brand, this episode gives you both the rationale and the roadmap. Visit ymlteam.com to learn more about Ginger's work, and explore thrivingpracticecommunity.com for resources to help you build a practice that truly thrives.

Guest Bio:

Ginger Allen is a seasoned marketing professional with 25+ years of experience in sales, customer service, and consulting. As the Chief Joy Officer and owner of Your Medical Liaison, she leads a full-service medical marketing agency specializing in both digital and field marketing, helping functional and integrative medicine practices maximize ROI while reclaiming their time.

She is passionate about creating meaningful connections through strategic marketing and supports small medical practices with personalized consulting for startups and reorganizations.

Ginger currently serves as President of the Florida Medical Association Alliance and is an active member of several national organizations supporting physicians and women business owners. She is also the host of The Functional and Integrative Medicine Podcast for Providers and a co-author of the best-selling book Everyday Women’s Guide to Doing What You Love.

Find Ginger:

Website: YMLteam.com

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