"Am I Actually Making Money?" Understanding the Numbers That Matter Most in Private Practice Featuring Sean Healy and Keith Campagna, EP 234
Running a profitable medical practice requires more than clinical excellence—it demands financial clarity that most healthcare providers were never trained to achieve. Many practice owners find themselves caught in a frustrating paradox: their accountant tells them they're profitable, yet their bank account tells a different story. Cash flow problems persist, credit card debt grows, and the question "am I actually making money?" remains unanswered.
In this episode, Tracy sits down with Sean Healy and Keith Campagna from Accounted For LLC to explore the critical difference between cash flow and profitability, and why understanding both is essential for building a thriving practice without burnout. Sean and Keith have spent seven years developing a comprehensive approach that goes far beyond traditional bookkeeping to include insight extraction and strategic coaching specifically designed for private practice owners.
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Whether you're struggling with time management for healthcare practice owners, trying to build a profitable medical practice, or simply want to run a successful medical practice without the constant financial stress, this conversation offers practical frameworks and strategic guidance you can implement immediately.
Key Takeaways
The cash flow vs. profitability gap is real: Most accountants focus on profitability for tax purposes, but practice owners operate in cash flow reality—understanding the difference is crucial for making sound business decisions.
Hope is not a strategy: While gut instincts are often correct, running "napkin math" before major decisions helps validate or challenge assumptions and prevents costly mistakes.
Three-part approach to financial clarity: Effective financial management requires data management, insight extraction from that data, and coaching to take action on those insights.
You're not alone in this struggle: The challenges you face as a practice owner are systemic across the industry—asking for help is a strategic advantage, not a weakness.
Goals must be quantified: Knowing you need 20% profit isn't enough—you need to know exactly what profit level gets you to your specific retirement and lifestyle goals, then work backward from there.
Q&A
Why do practice owners struggle to understand if they're actually making money? Most accountants present profitability (which drives tax liability), while business owners operate in cash flow reality. This creates a significant disconnect where someone can be "profitable" on paper while struggling to make payroll or watching credit card debt increase. The two metrics tell different but equally important stories about practice health.
What makes Accounted For LLC different from traditional bookkeeping services? While traditional accounting firms manage data to file tax returns, Accounted For LLC manages data to extract insights, then provides coaching to help practice owners take action on those insights. Their approach combines financial analysis with accountability and strategic guidance specifically tailored to private practice ownership challenges.
How much profit does a practice actually need to be successful? The answer isn't a generic percentage—it's however much profit you need to achieve your specific goals. Most practice owners say 20%, but the real question is: have you quantified your retirement goals, lifestyle needs, and legacy objectives? Once you know those numbers, you can determine if your current business model will get you there or if significant changes are needed.
What's the first step practice owners should take to gain financial clarity? Start with a complimentary financial analysis to understand what story your numbers are telling. Getting a second set of eyes on your financials—and slowing down to truly understand cash flow versus profitability—can reveal opportunities you're missing and help you make more informed strategic decisions.
Episode Highlights
The origin story of Accounted For LLC and the simple question that started everything: "Am I making money?"
Understanding why healthcare training creates a psychological barrier to asking for help with business challenges
The bow and arrow analogy: how financial clarity acts like a laser sight for hitting your business targets
Why "slowing down to speed up" is essential before making major business decisions
The three components of effective financial management: data, insights, and coaching
How capacity and goal-setting can transform practice performance without additional hiring costs
The importance of weekly strategic partnerships and peer networks for business owners
Why most practice owners' gut instincts are correct—they just need validation through the numbers
Memorable Quotes
"Hope's not a strategy." - Sean Healy
"You're not alone. The same trend is there. They feel like they're alone, but they're not... Ask for help and you'll feel better sooner." - Keith Campagna
"All change starts with self awareness." - Sean Healy
"Does this mean I'm going to sleep better? That was all she needed to ask." - Keith Campagna (sharing a client's response after their financial assessment)
"Prescription before diagnosis is malpractice. That applies to business too." - Sean Healy
The journey from wondering "am I making money?" to confidently leading a profitable practice starts with asking for help and gaining clarity on what your numbers are actually telling you. Sean and Keith remind us that the struggles practice owners face aren't unique—they're systemic across the industry—but the solutions become clearer when you have the right partners and tools in place. Whether you need a comprehensive financial partnership or simply want a second set of eyes on your current situation, taking that first step toward financial clarity can transform not just your business outcomes, but your sleep quality and overall wellbeing.
Guest Bios:
Sean Healy and Keith Campagna are the driving forces behind Accounted For LLC, a financial services company built specifically for private practice owners who need more than traditional bookkeeping. Founded seven years ago from a single client question—"Am I actually making money?"—Accounted For bridges the gap between profitability and cash flow with CFO-level insights at a fraction of the typical cost.
Their approach combines three essential elements: data management, insight extraction, and strategic coaching. Whether you're struggling with cash flow, planning to scale and grow your practice, or simply want to make informed decisions with your money, Accounted For uses your accounting data as a platform to provide actionable perspective. Their proactive, outcomes-driven methodology helps practice owners focus on what matters most while gaining the financial clarity needed to sleep better at night.
Accounted For offers a complimentary financial analysis to any practice owner who wants to understand what story their numbers are telling. This no-obligation assessment often reveals money being left on the table and provides insights you can keep regardless of whether you choose to work together.
Find Sean & Keith:
Inquire: email Keith kcampagna@accounted4llc.com
See Where Your Practice Stands: Take our Practice Growth Readiness Assessment
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