Fractional CFO

After 19 years in corporate finance I started working directly with clinic owners as a fractional CFO. Here is what the role actually does, not the LinkedIn version. In a typical $5M outpatient clinic engagement, I own monthly close review, a rolling 13-week cash forecast, payer contract review, location-level P&L build-out, and the one-on-one conversations with the owner about whether the next hire or the next location actually pencils out. Your accountant handles bookkeeping and taxes. Your billing company processes claims. Nobody in that stack is sitting across the desk from you asking whether your strategy is working — that gap is what a fractional CFO fills.

The economics are straightforward. Per the U.S. Bureau of Labor Statistics data (chief executives, the category that includes CFOs) puts median annual pay at $197,090 in health care and social assistance and $213,990 across all industries, May 2025; add benefits at the rate BLS measures for management staff and the health care figure comes to about $242,000 a year (Sorso estimate). A fractional engagement delivers the same caliber of strategic finance work for a fraction of that cost because you are paying for outcomes and hours, not a full headcount.

What I look for in a clinic before I take the engagement: revenue between roughly $3M and $50M, at least one location that is already profitable, and an owner who wants a thought partner rather than a dashboard vendor. If that sounds like your practice, the place to start is the full scope breakdown, which covers exactly what the monthly cadence looks like.