Your accountant sends a P&L. We send you this.
Every month you receive a board-grade financial package built for clinic owners — the numbers that matter, by location, with a clear read on what to do next. Below is the full deliverable on a sample clinic group. Expand any section to see the real depth.
Revenue, gross profit & operating profit
16-month trajectory — the trend that a single month's P&L can't show you.
Revenue by location
Which sites carry the network — colored by profit tier.
Where each revenue dollar goes
16.3¢ of every dollar reaches operating profit.
The findings that make owners say “why didn't I see this?”
A clean P&L tells you what happened. The job is finding what it hides. A sample of the kind of insight we surface — anonymized.
One location subsidized another for 14 months
$31K a year quietly leaked because no one ran location-level P&L. The group number looked fine the whole time.
The busiest clinic wasn't the most profitable
By patient volume it ranked #1 — by operating profit, #4. A smaller, cash-pay-heavy site out-earned it. Volume was being mistaken for value.
A provider was overpaid ~$28K a year
Compensation ran on total RVUs instead of work RVUs — paying for practice overhead the provider didn't control, on identical clinical effort.
$90K was hiding inside a 95% collection rate
Collections looked healthy, but $90K sat in 90+ day AR the billing team had been reporting as “in process.” Cash that was one workflow fix away.
The highest-margin service line was under-marketed
Cosmetic work ran a 78% margin vs. 71% for medical — but the marketing budget was weighted to the lower-margin line. The growth lever was hiding in plain sight.
A $250K device was expensed, not capitalized
It understated EBITDA by six figures — right as the owner was starting exit conversations, where every turn of EBITDA is worth multiples.
What's in your monthly package
Every engagement includes the same core deliverable, tuned to your practice. Expand any section to see the full sample.
1Executive summaryThe five or six numbers that actually matter this month, in plain English — not a 40-tab spreadsheet.
What's working
April set a new revenue record on broad-based strength, not one outlier — Riverside ($238K), Oakmont ($192K), and a surging Fairview (+29.8% YoY) all contributed. Gross margin held above 73% for the full trailing year, a sign of disciplined COGS as revenue scales.
Operating strength — April
A clean operating month: 7 of 8 locations were operating-profitable, with only Cedar Heights (a new ramp site) at a marginal loss. The group generated $248K of clinic operating profit for the month — a 24.3% operating margin.
2Revenue & profit trendA rolling 16-month view of revenue, gross profit, and operating profit — the trajectory, not just the snapshot.
Quarterly revenue
| Quarter | Revenue | vs prior year |
|---|---|---|
| Q2 2025 (Apr–Jun) | $2.36M | +9.4% |
| Q3 2025 (Jul–Sep) | $2.47M | +11.2% |
| Q4 2025 (Oct–Dec) | $2.55M | +13.6% |
| Q1 2026 (Jan–Mar) | $2.80M | +18.1% |
3Consolidated monthly P<he whole group on one page — revenue, gross margin, OpEx, operating profit, and overhead, every month.
| Month | Revenue | Gross profit | GP % | Clinic OpEx | Op. profit | Op. margin | Mgmt OH | After mgmt |
|---|---|---|---|---|---|---|---|---|
| May '25 | $798K | $587K | 73.6% | $392K | $195K | 24.4% | $60K | $135K |
| Jun '25 | $760K | $558K | 73.4% | $376K | $182K | 23.9% | $58K | $124K |
| Jul '25 | $815K | $600K | 73.6% | $401K | $199K | 24.4% | $61K | $138K |
| Aug '25 | $802K | $589K | 73.4% | $397K | $192K | 23.9% | $60K | $132K |
| Sep '25 | $848K | $624K | 73.6% | $417K | $207K | 24.4% | $63K | $144K |
| Oct '25 | $835K | $613K | 73.4% | $413K | $200K | 24.0% | $62K | $138K |
| Nov '25 | $812K | $596K | 73.4% | $415K | $181K | 22.3% | $61K | $120K |
| Dec '25 | $905K | $668K | 73.8% | $452K | $216K | 23.9% | $67K | $149K |
| Jan '26 | $868K | $638K | 73.5% | $441K | $197K | 22.7% | $64K | $133K |
| Feb '26 | $922K | $679K | 73.6% | $461K | $218K | 23.6% | $68K | $150K |
| Mar '26 | $1.01M | $742K | 73.5% | $498K | $244K | 24.2% | $75K | $169K |
| Apr '26 | $1.02M | $751K | 73.5% | $503K | $248K | 24.3% | $76K | $172K |
| L12M total | $10.40M | $7.65M | 73.5% | $5.17M | $2.48M | 23.8% | $0.78M | $1.70M |
Clinic OpEx excludes corporate overhead (shown separately as Management OH). Op. profit after mgmt is before debt service, D&A, and taxes.
4Revenue & profit by locationEvery location ranked by revenue and profit contribution — including the one quietly running a loss.
| Location | Nov '25 | Dec '25 | Jan '26 | Feb '26 | Mar '26 | Apr '26 | L12M rev | GP % | Op. profit | YoY |
|---|---|---|---|---|---|---|---|---|---|---|
| Riverside | $228K | $252K | $241K | $244K | $268K | $238K | $2.55M | 74.2% | $679K | +11.8% |
| Oakmont | $148K | $162K | $171K | $159K | $178K | $192K | $1.92M | 72.8% | $508K | +17.2% |
| Lakeside | $126K | $138K | $131K | $134K | $142K | $151K | $1.55M | 73.5% | $437K | +9.4% |
| Summit Ridge | $96K | $104K | $99K | $108K | $119K | $128K | $1.24M | 71.9% | $289K | +21.3% |
| Westpark | $88K | $95K | $91K | $97K | $102K | $106K | $1.08M | 75.1% | $309K | +14.6% |
| Brookfield | $71K | $78K | $73K | $75K | $80K | $84K | $0.90M | 70.4% | $177K | +6.2% |
| Fairview | $52K | $58K | $61K | $64K | $71K | $79K | $0.67M | 76.2% | $113K | +29.8% |
| Cedar Heights | $29K | $34K | $38K | $36K | $39K | $41K | $0.46M | 69.1% | -$39K | new |
The point of the package: Cedar Heights looks fine on the group P&L — it's losing $39K a year. A consolidated QuickBooks file hides that. A per-location read surfaces it in month one, while it's still a $39K problem and not a $300K one.
5Revenue by service lineWhere revenue and margin actually come from — so you grow the lines that pay, not just the ones that are busy.
L12M revenue by service line
| Service line | L12M revenue | % of total | Gross margin |
|---|---|---|---|
| Medical dermatology | $4.6M | 44% | 71% |
| Cosmetic & aesthetics | $2.8M | 27% | 78% |
| Mohs & dermatologic surgery | $1.6M | 15% | 74% |
| Pathology & lab | $0.9M | 9% | 68% |
| Skincare & retail | $0.5M | 5% | 42% |
The insight: cosmetic & aesthetics runs a 78% gross margin versus 71% for medical dermatology — but it's only 27% of revenue, and the marketing budget is weighted toward the lower-margin line. Re-weighting toward cosmetics is the single highest-ROI growth lever in this network.
6Profit-tier analysisLocations grouped into leaders, growth, and watch — with the ones quietly losing money flagged before they cost you a year.
Revenue vs. operating profit by location (L12M)
Tier 1 — Established leaders (3 locations)
The profit engine: $6.02M combined L12M revenue, 73.5% blended gross margin, $1.62M operating profit. Mature sites that still show upside — Riverside grew +11.8% YoY off the largest base.
Growth — Solid revenue, room to scale (3 locations)
$3.22M combined revenue and healthy margins, but operating leverage isn't fully captured yet. Each additional dollar of revenue above the fixed-cost floor flows largely to operating profit — the priority is appointment volume.
Watch — New & ramping (2 locations)
Fairview is small but the fastest grower (+29.8% YoY). Cedar Heights is a new location still below breakeven at −$39K L12M — flagged so it gets a volume target before the loss compounds.
7Operating profit by horizonEach location's profit across the month, the quarter, and the trailing year — so one soft month isn't mistaken for a trend.
| Location | Apr (last month) | Last 3M | Last 6M | L12M |
|---|---|---|---|---|
| Riverside | $62K | $198K | $374K | $679K |
| Oakmont | $58K | $156K | $281K | $508K |
| Lakeside | $44K | $128K | $241K | $437K |
| Westpark | $33K | $96K | $171K | $309K |
| Summit Ridge | $38K | $92K | $159K | $289K |
| Brookfield | $19K | $54K | $98K | $177K |
| Fairview | $14K | $38K | $62K | $113K |
| Cedar Heights | -$4K | -$9K | -$28K | -$39K |
| Network | $264K | $753K | $1.36M | $2.48M |
Operating profit before corporate overhead, debt service, D&A, and taxes.
8Cash flow & working capitalProfit isn't cash. Where the money actually is, how long it lasts, and what's trapped in receivables.
| Operating cash flow (L12M) | $1.48M |
| Less: capital expenditure | −$0.42M |
| Free cash flow | $1.06M |
| Days sales outstanding (AR) | 47 days |
| Days payable outstanding (AP) | 31 days |
| Cash conversion (op. profit → cash) | 60% |
The gap that surprises owners: operating profit was $2.48M, but operating cash flow was $1.48M — roughly $1M is tied up in receivables that grew with the business. Collecting five days faster frees about $140K of cash without earning a dollar more.
9Balance sheet snapshotWhat the practice owns, owes, and is worth — the view your P&L never shows, and the one a lender or buyer asks for first.
At a glance: current ratio 1.8x and debt-to-equity 1.0x — a healthy, financeable balance sheet. This is the page a bank or acquirer opens first; most clinic owners only see it once a year at tax time, if at all.
10A written read — what to do nextWhat's working, what needs attention, and the actions to take — the to-do list your accountant never sends.
Working
Record revenue on broad-based strength, gross margin disciplined above 73% all year, and the three growth locations scaling without margin erosion. The network is healthy and compounding.
Needs attention
- Cedar Heights is below breakeven (−$39K L12M) — acceptable for a ramp, but it needs a volume target.
- Brookfield's 70.4% gross margin lags the group by ~3 points — roughly $27K/yr of recoverable margin.
- Revenue concentration: the top three locations are 58% of the network. Diversification reduces fragility.
Do this quarter
- Set Cedar Heights a Q3 appointment-volume target to cross breakeven; review monthly.
- Audit Brookfield's COGS line — supplier pricing and injectable waste are the usual culprits.
- Accelerate marketing spend at Westpark and Summit Ridge, where each new visit drops largely to operating profit.
Common questions
What does a fractional CFO actually deliver each month?
A board-grade financial package: an executive summary, a consolidated and per-location monthly P&L, revenue and profit trends, a per-location profit ranking, profit-tier analysis, operating profit across multiple horizons, and a written read on what to do next. The expandable sample on this page shows every section in full.
Is the sample report real client data?
No. The company, locations, and every figure on this page are fictional and for illustration only. We never publish real client financials — confidentiality is the foundation of the work.
How is this different from what my accountant sends me?
Most accountants send a backward-looking P&L and a balance sheet. This package separates the network into locations, surfaces which sites make money and which lose it, tracks the trend across horizons, and ends with decisions to make — not just numbers to file.
Do I need multiple locations to get value from this?
No. Single-location practices get the same package focused on service-line and provider profitability instead of per-location. The multi-location sample is shown here because it makes the per-site analysis easy to see.
Want a package like this for your practice?
Take the free 4-minute assessment to see where your clinic stands — then we'll show you exactly what your monthly report would surface.