End The Year Strong, Start The Year Smarter - Financial Clarity For Private Practice Owners: A PPOClub Expert Webinar Series With Eric Miller And Sean Healy

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End The Year Strong, Start The Year Smarter - Financial Clarity For Private Practice Owners: A PPOClub Expert Webinar Series With Eric Miller And Sean Healy

End the Year Strong, Start The Year Smarter (Private Practice Owners Club)

We’re talking about financial strategies for 2025 and 2026 as we’re looking forward. We’ve got Eric Miller of Econologics and Sean Healy of Accounted4. If you’ve seen the show before, you know Eric has been a long-time guest on there over twenty times. I am excited to have him back. Sean Healy and Keith Campagna have been present at other workshops that we’ve done in the past. We’re excited to have them both on here.

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Welcome to the Private Practice Owners Club final webinar of the year 2025. We’re going to talk about all things money with our friends, Eric Miller of Econologics and Sean Healy of Accounted4 Bookkeeping. We’re here to focus on how we wrap up 2025. What do we need to do to prepare for 2026 properly? We’ve got some great experts to talk about that with us. Before I get started, you can always offer up your questions in the chat at any time over the next hour and a half as we speak.

For the calendar item, if you haven’t seen it on social media or gotten any texts or emails, January 9th and 10th, Adam Robin and I are going to be in New Orleans, Louisiana, doing an in-person workshop on strategic planning and goal setting for 2026. It’s going to be a small, intimate 20 to 30-person meeting in New Orleans at the Riverfront Hotel. We’re going to be helping you and guiding you through how to set your priorities for 2026 and how to set your goals appropriately for 2026, so you are totally clear on what your top priorities are and what you need to get done in that year, so you can get unstuck.

A lot of times, I wake up on Monday morning, and it’s not totally clear what I need to do. The idea behind this is to make sure you know exactly what you need to do and what your top priorities are as you attack the week. I will put the registration or landing page in the chat for you to go and register for that. I found out that we have continuing education credits that you can get for joining as well, approved through the Louisiana Physical Therapy Board. I will put those in the chat now.

As I’m posting it, I would also say for those people who are on the call right now, I’m also going to post the discount code so you can get 20% off the registration fee for the first ten people who sign up during this call. After this call, we’re going to put that discount code PPOCLUB20 out to everybody who registered for the call. This is only available for the first ten people who take advantage of it. I highly recommend you take advantage of it now during the webinar. Eric, why don’t you first start and give a short bio of who you are, where you’re from, and what people need to know about you?

I’m in sunny Clearwater, Florida. Everywhere else in the world is probably cold. Not here. It’s 75 degrees. I’m actually sweating a little bit, but I’m going to rub it a little bit more. We’ve been helping healthcare owners with their personal finances since 2008. It’s been a labor of love for us because I come from a healthcare background. My family was in healthcare. We saw the results of bad financial advice for people who were trying to help patients get well.

I didn’t see the monetary benefits that I thought they deserved to have. Our focus is on making sure that your household is financially strong and stable, that you’re utilizing your practice as an investment and treating it like an investment, and that you’re able to harness the power of your practice to build personal wealth and then eventually go out at the top of your game.

Sean, share a little bit about yourself, please.

My name is Sean Healy. I’m in not really sunny Philadelphia right now. Once again, thanks for rubbing that in, Eric.

It’s always sunny in Philadelphia.

I’m the founder of Accounted4. We provide everything from bookkeeping to virtual CFO support, small, mid-sized companies. We’ve had a focus on everything in private practice. We work with clinics in 30-plus states, something along those lines. It has given us a unique view into a lot of the problems that end of the day, we see a lot of issues that land on your P&L. We see a lot of the issues that impact profitability, but also, we see all the issues that impact cashflow.

One of the big things that we try to preach and we try to touch on is that there’s always a big difference between making a profit, making money. There’s always a little bit of a translation gap in there. We try to help companies be able to take a look, build plans, and then, most importantly, execute on plans that are going to allow you to take home extra money, ideally, so that you can then give to Eric to invest in and build more of a personal financial future for yourself. 

Sean, just to be clear, you are not a CPA, right?

No. We don’t do tax or compliance work, but we do partner with a lot of CPAs. We do see a lot of different strategies that other companies are using. A lot of times, we try to make sure that all the data is being managed in a way that everything is beyond prepped and ready to go for a tax preparer to come in and file that for you.

Same thing with you, Eric. You’re not a CPA. You are a financial advisor, however, right?

We are not CPAs. We’re what’s called a registered investment advisor. More simply, you’ve probably heard the term fiduciary advisor. We’re definitely classified as that. As I said, our target is making sure that your household is financially strong. Honestly, if your business isn’t profitable and it isn’t running well, then it’s going to be difficult for you guys to recognize the fruits of your labor. It’s important that you integrate the two. Too many people try to separate them. You have to integrate the two. That’s a successful action that a lot of people have done.

That’s why I love having both of you on. I personally don’t feel like we need a certified CPA out there talking to us right now. If we had one, it would be great. I don’t think it’s totally necessary because what we get from you, Sean, is boots on the ground. This is how the numbers work. This is what you need to do to make the numbers work and be profitable. Eric is coming from now that you’re profitable and you made some money, this is what you should do with it. I’m excited to have both of your perspectives on there, but I wanted to throw that out there.

Your 2025 Financial Checklist: Tax Strategies & Intentional Spending

If at any time you guys have questions, as I said, go ahead and throw them in the chat. I’ve already put the registration for our January 9th and 10th workshop in there, along with the discount code for the first twenty people who use it. Let’s get started. We’re in December of 2025. What are some things that practice owners could or should be doing towards the end of the year to wrap up their 2025 well financially? What are some general ideas that they should be doing? Are there 1, 2, 3, 4, 5 things that they need to do? What do you recommend? I’ll start with Sean and then go over to Eric.

The first thing is that you should be communicating with your CPA if you haven't already. You should 100% be meeting with your CPA if you have not already by the end of the year. What we have found with a lot of CPA firms, because they get so many different clients sending them information, sometimes partial information, is that if you reach out to them proactively and say, “This is where I'm at as of a certain date. This is how I’m projecting to do for the rest of the year”, you can at least put an end of the year plan together. Number one, talk to your CPA. Make sure you have some form of a strategy in place. 

The second thing you want to do in that conversation is ask them what your tax strategy is. Ask them what tax strategies could be implemented for your company. One of the biggest things that most people tend not to do is they don’t shoot for a particular profit number. If you’re any type of pass-through entity, so if you’re an LLC filing as a sole member, if you are an S corporation, if you are a partnership, anything that you are getting in profit, there’s a way to get a 20% tax deduction if you are under a certain threshold.

It’s something that came out with some of the laws that have been passed over the last several years. I actually did look up the deduction amount. If you are a single filer, if you are making over $197,000 in taxable income, that 20% deduction starts to go away. If you are married, filing jointly, it’s up to $394,600. If your family has a total income of that dollar amount or over, you might be missing out on some of the deductions. If your profits are close, a good strategy would be to make sure we’re intentionally spending some money before the year ends to be able to get us underneath that threshold if possible.

This is not a tax strategy that everybody should be implementing. It’s always something to bring up to the CPA and see how they respond. One thing we also notice is that if you are looking to sell in the next 2 to 3 years, it might not be advantageous to save a bunch of money on taxes and show no profit. One thing I always recommend when meeting with your CPA, let them know where you are as of now, where you’re projecting to be, whether we should try to aim for this threshold, and what we can do to get to that threshold, but also let them know what your long-term goals are.

Once again, if you’re looking to sell, it might not be the best idea to show no profit. There are a couple of conversations we always recommend having. In a perfect world, you want to do it at least 2 to 3 months ahead of time. We still have a little bit of time, though. What we want to try to avoid is that conversation where your CPA reaches out to you in the last week and tells you to go buy a new car. We want to try to avoid that. If you’re going to spend money, we want to make sure that you’re spending money on things that are intentional and things that can be deducted in the year. We will lean on your CPA to identify that.

How often do you recommend people meet with their CPA?

At an absolute minimum, twice a year. In a perfect world, quarterly. One of the big problems we find is that most companies, their bookkeeping is usually in arrears by 30, 60, or 90 days. There are usually no good double checks to be able to tell them where they’re at. The other big problem that we tend to see is that most companies, when we first start working with them, don’t have any projections. If you can’t see into the future, it’s hard to plan for the future. 

The analogy we always use is that if you’re only looking at your bookkeeping data, it’s like driving a car, staring in the rear-view mirror. You’re only looking backwards. You’re bound to crash. We always recommend that if you can get projections put together, if you can tie that to where you are, if you have real-time data, most CPAs don’t have access to that. Being able to present that to a CPA, give them as much information as you can for them to build the best possible strategy for your current situation. Once again, make sure they know your goals.

I love you sharing that. I had to force my CPA to meet with me on a monthly basis initially to get an idea of where I was and understand what all these reports were that I should know as an owner. It was helpful to at least talk about it quarterly, “This is how much you made. This is how much you need to set aside for taxes.” It is because I got bitten a few times by coming up to April 15th of a given year, and the CPA calls me and says, “Nathan, you had a great year. Do you need to send $75,000 to the IRS today?”

No problem. Do they take cash?

Boost Your Personal Wealth: Retirement Plans, HSA, And Beneficiary Review

Unfortunately, I had to experience that once or twice before I learned my lesson, and then I forced my CPA to meet with me and talk to me about what I should prepare for ahead of time. I highly recommend the same thing. Meet with your CPA at least quarterly or semi-annually. Talk about the financials. Go over all that stuff. What do I need to prepare for? What are you looking at? What do you see, Mr. CPA, Mrs. CPA? How do I need to prepare better? What can I do better? Where should I be looking at things? How does this compare to what we have in terms of pro forma projections and all those things? We will talk a little bit more about looking forward here a little bit further on in the hour, but I love all the recommendations you made, Sean. Eric, your turn. What are some things from the financial advisor perspective that people can do or should be taking advantage of as they wrap up 2025?

I do want to say the last thing on that because I can’t emphasize that point enough in terms of developing a meeting cadence with not just your CPA, but with your whole financial team. It’s imperative to do that. I’m trying to remember the other point that Sean made. It’s a great idea to make sure that you do that. On the household side, there’s certainly not a shortage of things to do. There’s always a good time to put financial order into your household. It’s always a good time to do it.

There are a couple of things that you should be looking at. Obviously, looking at your contributions to your retirement plans. There were a couple of things that changed with the Secure Act 2.0 that I know. If you’re between the ages of 60 and 63, they actually provide what’s called a super catch-up. Not only do they have a catch-up, but now they have a super catch-up. If you’re 60 to 63, in your 401(k), you can put an additional $11,500 in there. If you have a simple plan, I believe it is right around $8,000. You have to be between those two ages. Most people have a retirement plan. We would all agree that it is a great way to reduce some of your taxable income. Making sure that you’re making those contributions to those would always be beneficial as well.

They can make those up until April, can they not? Do they have to make them in this calendar year?

You’re right, up until April.

It might be the tax return. If you have an extension on your tax return, at least on the corporate side, you might be able to do that as well.

Another thing, too, if you have a high deductible health insurance plan and you have the ability to contribute to a health savings account, that would be, for a family, pretty close to $8,000 that you can defer there. That’s going to be pre-tax. You won’t have to pay any tax on that. If you use it for medical services, you won’t have to pay any tax on it at all. Those two things are pretty basic, but a lot of people don’t do them, especially the HSA. I would certainly recommend people to do that as well.

Another one, too, in case you haven’t done this in a long time, check the beneficiaries of some of your accounts, especially your retirement accounts, your IRAs, and your 401(k)s. People go through divorces. They go through all kinds of life issues and everything like that. Unfortunately, we’ve had some cases where people forgot to change the beneficiary designations on their accounts. Sorry, I’m laughing. All of a sudden, money goes to people you don’t necessarily want it to go to. It’s always a good exercise to check your beneficiary designations.

That would upset people if the beneficiary was an ex of some kind or something like that. For some people, the common thing is you’ve got to buy your car by the end of the year for tax purposes, that kind of stuff. What do you say to big purchases, equipment purchases, and stuff like that?

That’s what Sean said. I agree with him on that. I don’t want to spend money on something just because there’s going to be a “tax benefit” to it. The whole purpose of money is so that you can multiply it and expand it. You don’t want to be buying things that are going to depreciate to that degree. If you can invest in something, whether it’s investing in your staff, training, or something that’s going to allow you to appreciate, and you get a tax benefit for it, or it’s going to improve the overall organization or the practice, then great. You should certainly do that. If it’s to buy something just to get a tax break, I’m not sure that’s the wisest use of money. I agree with Sean on that point. 

Unlocking Hidden Tax Advantages (Augusta Rule, Payroll) And When To Fire Your CPA

Is there anything they can do tax-wise that maybe you see on a regular basis that practice owners aren’t taking advantage of that maybe they should consider? This could bleed into 2026 as well. I’ll bring up the Augusta rule or something like that. Are there things like that that you could explain or share for people to consider in terms of tax advantage?

A far as that is concerned, yes. A lot of these things you have to be proactive about. You can’t sit around and think that your tax liability is going to go down all by itself because it’s not. Minimizing your taxes takes effort, energy, willingness, and documentation to be able to minimize your tax liability. All these things are great. Having an office meeting at your house and being able to offset that expense to the business, absolutely. Putting your kids on payroll who are actually going to perform a function that you’re going to be able to document, absolutely. Those are all things that are beneficial to do.

Those are a couple we’ve mentioned. Buying real estate and being able to use depreciation is always beneficial as well. This is the point I wanted to make. Hopefully, this doesn’t rub people the wrong way. Don’t be afraid to fire your CPAs if you’re not getting what you need. I say that not because I want you to go out and fire your whole financial team. I want you guys to understand that not all CPAs are built for you. If they’re not calling you back, if they’re giving you lazy tax planning, or if they’re not doing planning for you, it may be time for an upgrade. 

I’m sorry. That’s going to happen. It probably happened to many of you. You can’t be afraid to replace them. It’s not hard to find a good CPA. They don’t have to be down the street from you to work with them. None of us does. We can do everything remotely right now. Make sure that your financial team is in alignment, as Sean said, with your goals and what your purposes are, and that they’re there to help you. They’re not telling you what to do.

As people ask about CPAs and what they should look for, you and I have done an episode about this, Eric, in the past. The one thing I tell people all the time is communication. I would always recommend a CPA who is willing to communicate with me on a regular basis. As you said, timely responses to emails, a willingness to sit down in person and review things in person or virtually, whatever it is, but sit down and review reports, and calling me back after I leave a message are vitally important. Surprisingly, not all of them are very willing to do that on a regular basis, especially. Finding people who will be willing to do that is vitally important.

It is tough to find them sometimes, though.

Did you want to add to that, Sean?

When our clients are not happy with their CPA, the first thing I always recommend before jumping ship and finding a new one, which sometimes is the move, like with any vendor, is to make sure that you level set and set some good expectations. What I find is that a lot of times, CPAs fall into the trap of getting the info from you, filling out a tax return, and just filling out a document. They have the ability to provide a lot of insight.

A lot of times, what we hear from our CPA partners is, “I didn’t have enough information to be able to give that insight.” Sometimes, it takes, unfortunately, yourself or somebody to almost project manage it and say, “I want to have a sit-down. This is what I want to talk about. What are the strategies we’re implementing? What are the strategies we can implement? What are the things we’re not doing?” Mind you, if they turn around and say, “We’ll do the Augusta rule. Put your kids on payroll,” and that’s the end of the strategy, then you are probably at a point where you need a CPA that can be more of a tax strategist.

Those are things that I 1,000% agree with Eric. Those are things that you can and should be doing if you’re not. If you are just learning what the Augusta rule is, or just finding out you can put your kids on payroll, that might be a red flag there with your current firm. At the same time, there are a lot of different options and different strategies that we see people implementing, things as simple as, “Is my entity the right entity type?” There are different tax advantages to changing your entity type. I’m changing my entity type in 2025.

There are a lot of different things that you can do. What we found, though, is that you have to go and ask the appropriate questions to get the appropriate insight. If they’re not giving you good answers, then go find somebody proactive. Go find somebody who’ll give you a good cadence. Go find somebody who responds. If your CPA reaches out to you in the last week of the year and tells you to buy a car, no. Maybe go find another firm.

Upgrade Your Financial Team: Finding A Proactive Tax Strategist (Not Just A CPA)

Eric, I don’t know if it was you guys at Econologics who told me you were totally fond of leaning on the CPAs for all of the tax strategy advice. Is that totally appropriate? Where should someone look for tax strategy advice?

The state of Utah always has the best tax strategies that come out of that state for some reason.

He’s making a joke.

Define who they are. There are CPAs who are tax planners. Those are definitely people that you would want to vet and make sure that, “You’re a CPA, good. You’re going to do all the filing, good.” We also do tax planning. We meet, and we try to minimize your tax liability. You’re trying to measure everything. What is my overall tax liability? That would be the total amount of tax that you’re paying compared to how much income you made. All you’re trying to do is minimize that down every single year. If you’re trying to find someone to do that, that’s advantageous. There are tax strategists out there as well. You can google tax strategists who find something in the tax code that they specialize in.

You have to be careful about this because none of you wants to get in trouble with the IRS, and I don’t want any of you to get in trouble with the IRS. There are firms out there that specialize in certain types of tax strategies. They know how to implement them. They know all the rules. They have attorneys and everything like that. Until you get to a point where you have probably $800,000 to $1 million of EBITDA, I would start looking at something like that. That’s something we would call a tax strategist. They specialize in a particular section of the tax code. They find what I don’t want to call loopholes. They take advantage of the tax code.

Alison posted a good question. She’s not sure what types of questions to ask her CPA or where she can find these types of questions. “What kind of questions would you ask if you were ‘interviewing CPAs’ to find out if you should work with them or not?”

The two that I always use are, “What’s an appropriate cadence that we should be meeting?” and I always follow up with, “Are you going to be reaching out to schedule those meetings, or do I need to reach out to schedule those?” You can figure out from that question alone one very important thing. Is this firm going to be proactive or reactive? If they don’t reach out, how are they going to remedy that? Whose responsibility is it to create that cadence? The other thing is, what’s the typical strategy that you provide? I like to keep questions open-ended because they might turn around to you.

If they start giving you an answer, they are probably not the greatest firm to work with. If they start asking you a lot of questions, they are probably a good firm to work with. They turn around and say, We’ll put your kids on payroll.” I don’t have children. “We’ll do something called cost segregation for your building,” but I don’t have a building. We’ve always found that good advisors tend to come with answers. Good coaches and good consultants come with good questions. There are questions that you want to ask because you want good answers from them, and you want that insight, but how they answer it also goes a long way.

Eric, I don’t know if you have any insights around that.

I can’t top that. That was perfect. That was great. That’s exactly right.

That goes to the heart of it. What kind of communication are you willing to share or be on with me? Are you going to learn a little bit more about me before you start giving your advice? I love it.

It goes back to finding people who are interested in you, not trying to be interesting.

I’ll quote you one of these days, Eric. I like that.

That’s pretty good, isn't it?

You might want to.

Philosopher Eric Miller. There you go.

Future-Proof Your Practice: Setting 2026 Profit Goals (Begin With The End In Mind)

As people look forward to 2026, let’s talk about preparing for the next year. What are some things that you would recommend as people look forward into 2026 to best set themselves up financially? We’ll start with you again, Sean.

It all starts with beginning with the end in mind. You need to have a goal. One of the hard parts that we find, especially when people are looking at the next year, is this. I’m going to use some random numbers. I made $1 million in revenue this year. I’m going to add 20% to that and make that my goal. A lot of times, that’s an arbitrary number. We’re shooting blind. I always tell people, whenever you’re planning for the next year, start with a forecast based on the resources you have today, the people you have today, how you’ve been performing, and the spend that you’ve been spending.

If nothing else were to change and you kept that going through 2026, where would you land? What would that profit number be? Ask yourself. Out of that profit, am I making enough profit to get myself to my goals? Can I compensate myself enough through distributions and draws in a way that gets me to my retirement goal? Do I have enough money to pay down my debt? Do I have enough money to save for my taxes? Do I have enough money to put savings away for a rainy day? Usually, you want to come up with cash flow buckets of, “I want to put one payroll away in savings by the end of the year,” because what’s our biggest fear as business owners?

I want to put one payroll away. I want to pay down that one line of credit. I want to pay myself $100,000. I know that out of that profit, I should probably save 30% of it. Am I making enough profit to get me to these goals? If the answer is yes, at least you’re on the right path. The goal is not to backtrack, or maybe you’re not shooting high enough. If you’re not making enough profit to get you to some of these goals, then you’ve got to sit back and figure out, “What do I need to do with my business algorithm?” I think J.B. Schreier has called it a business algorithm before. I like that term. What do I need to do to adjust either my current income or current expenses to get me to that profit number?

Sometimes, we’re spending too much money. We have too much overhead. We’re paying our people too much for the results that we’re getting. Other times, we need to open up our capacity. We need to increase our incomes. We need to go and hire three people. We have this beautiful location, but it’s only half-filled. We need to go and find more people. I always recommend starting with the end in mind. How much money do you need to be making? How much profit do you need to be making to be successful, which means to get you to that goal? Work your way back and figure out what changes you need to make in 2026 to be able to bridge that gap, if there is one.

Translating Profit Goals: Working With Your Financial Team For A 2026 Proforma

Is this a conversation that you can work through with your CPA, or recommend working through your CPA or bookkeeper? That is, “Listen, I have this goal of this take-home profit number by the end of 2026. Can you help me figure out the calculations of how many visits that entails? What is my expense ratio looking like?” Is that an appropriate question or exercise to with someone else?

You certainly can. Mind you, there are a lot of good CPAs, a lot of good bookkeepers, and a lot of good CFO consultants who can help get back into it. Part of the reason why we started this company is that we realized there was a big lack of tools and resources to have a conversation around cashflow. Most accounting professionals talk about profit, profit, profit. We find that cashflow is not something that they’re very good at communicating or translating. 

I would say it doesn’t hurt to try to have that conversation. Not every CPA is going to be equipped to be able to communicate it, at least in your language. We always say that the language of business owners is cashflow. A lot of times, we find that CPAs tend to struggle to communicate and translate from that profit number to that cashflow number. It doesn’t hurt to have that conversation, though.

I talk about building out your pro forma for the upcoming year. Budget could be another word you use for pro forma. Is that something you can expect from a bookkeeper or your CPA to say, “I at least want to make this much more in revenue. I want a 20% growth, 10% growth, or whatever it is, by the end of 2026. Can you build out the month-by-month pro forma of what that would look like?” Is that an appropriate ask as well?

It depends on your team. As a shameless plug, those are the conversations that we tend to have with our clients.

I was going to say it was a great time to promote yourself. My experience is that most of them don’t do any of that at all. What he said was perfect. You need to set your life up. How do you want your life to look in the next twelve months? The struggle that most owners seem to have is that they’re only making enough just to get by. That’s what most of them do. They don’t set up the financial system from the practice, as Sean said, to be able to set aside money into retirement, to be able to set aside money for your taxes, or for business reserves, and all those things. That is the vital part of going into 2026. That’s not something that you can just hope.

You have to do it. You've got to do it now. You have to attack that because that will allow you to change. The inertia does set in for a lot of practice owners, and how they handle money. It’s an inertia. “I’ve been doing this for so long.” You have to change the inertia of how you handle the money, especially going into 2026, where it’s seemingly getting harder. I’m sure you guys have heard all of the reimbursements, finding people, and all these things. It’s getting harder. Your ability to handle money is going to be paramount to your having financial success in 2026.

When we say financial success, it’s not just, “I have a couple of bucks left over in my bank account.” It is that, “My retirement for my next ten years is being handled. My business has enough money to handle emergencies. We can expand. I can take care of other things.” It’s a necessity to do what we're telling. If your financial team is not doing that for you right now, then you've got to get with people who are going to push you to do that. I hope that didn’t come across too hard.

I was thinking the same thing. As Sean was talking, I was thinking that what some of us lack as business owners is simply intentionality about the business. We get caught up in the doingness of the therapy or whatever service we're providing. We’re not thinking about, “I need to get to a certain dollar.” Let’s be honest. We’re in this to get a nut, to make this certain amount of money so that we can retire at a certain age and not be worried about our financials at that time when we can no longer provide that therapy or that service.

We may forget that part of it, but what you’re talking about, Eric and Sean, is being intentional about not just 2026. Let’s look at ten years from now, or whatever that retirement age is. What’s that number I’m trying to get to? What do I need to do this year, revenue-wise and profit-wise, to know that I’m on the path to getting to that end goal? Sometimes, we lose track of that end goal and get too busy with what I might call distractions, in this case, around us, about running the business.

It is getting intentional, as you said, Sean, with your CPA and your bookkeeper, and saying, “These are my goals. This is what I want to achieve. Help me understand how I get there. What do I need to do to get there?” I feel bad that you’re saying that there are a lot of financial teams that don’t do that because I know that I can email my bookkeeper right now and say, “I need a pro forma for the next 8 to 12 months. These are our goals. These are some of the expense ratios that I’m expecting. Show me what that’s going to look like and what we have to do.” That’s unfortunate that not a lot of people can do that.

They should be able to. Most are not able to. It’s one of those things where it’s common sense, but it’s not common practice.

I see that for sure.

It doesn’t hurt to ask them. Start by asking to see if they can.

Planning For Retirement: How Practice Goals Impact Your Long-Term Financial Future

To push that out a little bit further, Eric, talk to us a little bit about setting up 2026 so that it helps out with your end goal of retirement or where you are financially.

It’s good to start with having targets and a plan. We often talk about what your ideal financial scene looks like for your household, whatever that is. Most people have that missing, or they’re not very precise on exactly what that looks like. Everyone should have that. They should know, “Exactly in 7, 10, 12, 15 years, I want to have X amount of dollars. I want to have X amount of income coming in. I want to have no debt. I want to at least have control over my financial situation. I’m not 100% dependent upon the practice now to be able to run my household.”

Start with that. From there, start gradiently putting in, “What are the actions that I can start setting up that are trackable now, so that I can measure along the way that I’m getting to that point?” That’s where a personal financial plan comes into play, making sure that you have a roadmap of something that you can measure that allows you to see that you’re making progress. Most people just want to see that they’re making progress towards something. If you can see it, great. The best stories I always see from people that we’re working with or my advisers are that someone saved an extra $150,000 this year.

They’re like, “I’ve never saved that much money in my entire life.” I’m like, “I know.” You set up the system so that the money could be captured, and it didn’t get spent anywhere else. You multiply that by seven years at a 6% interest rate. You’re talking over $1 million all of a sudden in doing that. It’s setting those things up and having someone be able to push you, run you, and hold you accountable for those things. That to me is important. Going back to what we talked about, your money doesn’t take time off. 

I always use this analogy. Anybody who has had kids who never went out to a store, you take your attention off them for a second, and they’re 7 miles away, it seems like. That’s what happens with your money, too. You take your attention off your money, and you don’t know where it’s going to go. I can promise you it’s going to go somewhere. I’m not saying that you have to look at your bank accounts every hour on the hour.

Don’t do that.

It is probably not a good idea. Make sure that you have the ability to look at your finances, or hire someone who can help you decipher this and do that. It’s all for the end goal, the purpose that it serves your household at the end of the day.



The Simplest Step: Setting Up Your 10% Profit Savings Account

The simplest action that we can recommend to people is to have that separate savings account set aside for that top 10% of revenue that comes in the door. Establish a break-even point. Establish a line item in your expenses that says this top 10% goes over here to the savings account that I don’t touch. It happens on a regular basis. That’s one of the easiest ways to start.

Does anybody ever have a grandparent who used to put money in envelopes? Do that. Put X amount in this envelope. That works. It did because one of the natural laws of money is that if you have to physically remove money from a place, if you ever expect to have reserves or emergency funds, meaning that you have to physically remove it. Now, we don’t physically remove the money. You have a bank to do an electronic transfer to a specific account. That to me is so important.

If you have an account that has a purpose to it, say a business savings account, what is the purpose of that account? Business savings, emergencies, or an old crap fund. Does it take a little extra work to set up the account and have it? Yes, but you run into a situation where all of a sudden, you have a drop in patient visits. How are you going to make payroll? I got $150,000 sitting right there for that purpose. When we talk about setting aside money for you personally, you have to physically remove the money to get it into an account that you can use for future investments. That to me is the important action. It is to be able to do that. 

Your thoughts on that, Sean?

I agree with all points.

A good book on that is Profit First by Mike Michalowicz. He talks all about it. If you’re uncomfortable with starting at 10% of your revenue, going over to a savings account, start with 1% or 2%, and then build up once a month. Add another percentage as you go, or every quarter. Click that up a percentage or two until you do get to 10%. The people who have routinely done it, and you guys tell me if you have different stories, are usually like, “I’ve got $40,000 there. I had no clue that I could get there. It wasn’t that hard,” especially if you do it on a frequent basis, like every week or once a month.

We have a lot of clients who will move to a weekly cadence for savings. I do enjoy that book, by the way. That’s a good book reference. If you haven’t read it, a lot of good nuggets in that book. One of the hard parts, though, is that you have to make sure you’re making enough profit to put away towards savings. There are a few things in that book that are like the rules of thumb. We take some different approaches personally, but one of the biggest ones is a concept called mental accounting, where we put different values on money based on what it is.

Like your retirement plan, it’s out of sight, out of mind. You want to be able to do that with savings. You need to be very intentional about what you are saving, because if you’re not making any profit and you’re like, “I’m going to go save money now,” you’re just going to end up taking that money out. You have to be intentional. It has to be based on profit. It can’t be based on what’s in your bank account on that particular day. There needs to be some intentionality. The number of people I’ve seen that save a bunch of money because they have money in their account, and then they have three payrolls the next month, take a wild guess where that money’s coming from. It is that savings account that you put into play.

We always recommend that if you have a good forecast and know where those ebbs and flows are coming from, you can plan around them proactively. There are goals that you’re not taken by surprise. You’re shooting for a goal, but also, they say SMART goals. One of them is that it has to be attainable. If you don’t make enough profit to put that savings in the savings account, it’s not going to stay there very long. It’s having that plan and then making sure you’re executing on it.

The ROI Of Expertise: Can You Afford A Bookkeeper For Financial Insight?

Alison did ask, “What if you can’t afford a fancy or expensive bookkeeper to do some of the things that we’re talking about?” Tell us about that. What can people expect to pay to have bookkeepers to help them out? Does it cost a lot to have a bookkeeper on your team to build out a pro forma? Give us some reality on that, Sean.

Never heard the words fancy and bookkeeper in the same sentence before, so I thank you for that. It comes down to ROI. There are a lot of companies that I’ve heard say that. Sometimes you can’t afford not to have somebody giving you that financial insight. If you're not getting that financial insight from somebody and you don’t have a forecast or a plan moving forward, you need to do something. Doing nothing is not going to be an option. If your business is not thriving and you’re not hitting your goals, it’s because something probably needs to change.

There’s probably an issue somewhere in that business algorithm that you’re not aware of. There might be a significant ROI with one conversation with somebody who can take a look at your numbers and be like, “You’re not making enough off of this particular employee,” or “You have two employees that are actually losing you money.” It’s not that things are tight. It’s not that the business is not going well. You have a couple of problems in your business that you’re probably not aware of. I always say it never hurts to have a conversation with anybody. It never hurts. You never know what you’re going to learn.

Thriving businesses have a little more cash flow to be able to take risks for some of these different services. No matter what, you need something or somebody who is giving you guidance because it’s hard to cross a specific threshold if you don’t have those people in your corner. I’m sure you’ve heard that you are the five people you surround yourself with. Businesses are the same. Six months into me starting my company, I realized I had never had any mentors professionally in my life who had a positive influence. I went out to a group of people who knew things that I didn’t and asked them to be advisors. 

That was probably one of the smartest decisions I made because I started getting other insights. It wasn’t just what I thought was a best practice or the best thing to do. I had people to challenge me to think differently, look at stuff, and give guidance. You need those people, regardless of cost, because at the end of the day, the price of what somebody is going to cost is just the meeting point between the value and cost. If you’re not getting value from it, then you can’t afford it. If you can get more value than what the price is, then it’s a no-brainer.

The hard part with many owners is that they are high-achieving individuals. A lot of things they feel they can get done by working a little bit harder and putting their nose to the grindstone. We do have to recognize that we are not experts in these other fields. Learning QuickBooks alone isn’t enough for us to be very savvy regarding our finances. We need to talk to other people who are experts, get on the webinars, read the books, and watch the YouTube videos. Ultimately, you need someone who is personally involved in your financials to help you understand your financials a little bit better and where you are making mistakes.

It might feel like a stretch, but it’s vital to have a CPA. You might as well spend a little bit more to either meet with them or spend a little bit less to meet with a bookkeeper to go over some of those financials and give you some ideas on what could be going wrong. If they find something, it might not only pay off in that month in which you’re looking, but if you continue that practice, it’s going to pay off year over year over year as long as you own the business.

They tell you, “You’re in a great financial scenario. You can’t get much better. You just need to hire one or two more people.” Maybe you're in a great scenario as is, and you don't need somebody.

Q1 Survival Guide: Proactively Navigating Rough January Cash Flow

We talked about how to wrap things up and then look to the end of 2026 and where we want to be. Is there anything in the first quarter that you recommend, especially as you’re considering that April 15th is looming? That’s tax deadlines and that kind of stuff. What initial steps at the beginning of the year do you recommend that owners follow?

Prepare for a rough January?

What do you mean by that?

No matter what I project every January, almost across the board, every state, every size, everybody always lands around 85% of what’s projected in January because of illness, because of weather, or because of beginning-of-the-year authorizations. However you think you’re going to do in January, assume that January is always tight for eight out of ten private practice owners. Also, this January, half the people who do bi-weekly are going to have three payrolls. Cashflow is going to be a little tight by the end of January for a lot of people. 

I was going to say everybody’s coming off the sugar high of the holidays. There is something to speed. Money loves speed. We say this around our practice all the time. Try to take time out of the equation. You know how people are sometimes. You get a given task. They allow too much time for the task, and it takes longer. You’re always looking for ways in which you can take time out of the equation because time is the enemy of money. Money loves speed. You could do things quickly, but competently at the same time.

As an owner and as the executives of your practices, try to get your people to move a little bit faster than they are. That’s going to start from the top, that you’re showing them that. You need to move a little bit faster. Whatever the action is, I can promise you that the timeframe can be cut down somehow to get that action accomplished. As Sean said, going into the first quarter when everyone is like, “Money is slow,” and whatever the excuses are, you guys are going to have to increase the speed at which you operate. Hopefully, that has some impact on your cashflow.

By the way, if you know that you’re going to have a rough month coming up, try to get a line of credit now. If you don’t have a line of credit, go get a line of credit. It is so much easier to get access to money when you do not need it first than when you do. I can tell you my big goal going into January. I’m increasing my line of credit. It’s one of the first things I’m doing when I wake up on January 2nd.

It’s definitely easier to get access to money when you don’t need it as opposed to when you do need it. The banks will say no. People get lines of credit against their houses or lines of credit against any assets that they have. If you have a brokerage account, you can get a securities-backed line of credit to be able to access the money. Are the interest rates awesome? Not really. We’re still 6.5%, around that percentage rate. If it’s between that and not being able to make payroll or not being able to sustain the business, I’ll pay the interest rate all day long, but you have to have access to the money first and foremost.

Most clinics, at least therapy clinics, know that January can be a tough month altogether. As you said, Sean, because of authorizations and deductibles restarting, people are hesitant to continue on with their care or start care. Those are conversations that a lot of owners need to have in December with their patients, I believe. It’s like, “January is coming. You’re not done with therapy. You need to continue. The deductible I know is going to reset. How are we going to manage this? This is the recommended plan of care. This is what you need to do.”



Beyond January: Q1 Financial Planning And Getting Rid Of Excuses

Let’s start talking about and having those conversations in December. When January rolls around, owners and therapists aren’t thinking, “Where is everybody?” The deductible got reset, and they decided not to keep coming. Let’s have that conversation now instead of in January, trying to catch them on the phone. Is there anything else in quarter one that you might consider outside of January, preparing for the best 2026? We talked a little bit about performance budgets and preparing ahead by having a line of credit. Anything else that you think we’re missing to set yourselves up financially?

It is going to go back to having good targets, trying to follow through on those targets, and not being reasonable about it as well. It is not, “It’s this, or it’s that,” or taking the reasonability out of it. When I say reasonability, it’s things that we use to explain away a bad condition. That’s what I mean by that. We all do it all the time. It was this. It was that. It was the weather. It was that person, or whatever it is.

It was deductibles. It was always like this in January.

If it’s always like that, then what could you do in November or December to make sure it’s not like that again? It is getting rid of some of those things. Maybe a mental checklist that would allow us to have more money is to clear the road of all the objections or whatever viewpoints that we have, so that we can have money. It’s okay to have money. It’s okay to have a lot of money. It’s okay to have gobs of money. It’s okay. I’m giving everyone permission to have tons of money in their accounts. 

What do you want to add to that, Sean?

There are two things. Number one, whatever goals you end up setting, I always recommend doing them before the year comes to a close, especially the week between Christmas and New Year’s. It’s a great time to take a little time for yourself and put on paper what you want to accomplish for the company.

Join us in New Orleans. Another plug there.

Communicate those goals with your team. Communicate expectations for your employees with your team. It is probably the most simplistic way to change your business overnight. A good seven out of ten companies that I speak with, that maybe we’re not working with, if I ask them, “Do your employees know what a good day looks like? It ties into your goal,” most will go, “Yes, I think so.” I ask, “Will it match up with what you think a good day looks like for them?” I got to tell you, 7, 8, 9 out of ten times, the answer is no.

Once you have these goals, figure out how do I break that down into good bite-sized expectations for my employees? Am I communicating it over? Do my employees actually know what success looks like in their role? It goes a very long way. The second thing is you’re going to have all these different goals. January is going to hit. Let’s talk through a scenario. My CPA calls me a week before the end of the year and tells me to buy a car. I go and do it. I already have three, but what’s a fourth? All of a sudden, I don’t realize that in January, I have three payrolls.

On top of that, all the metrics that we thought we were going to hit, we didn’t hit from an income perspective. I spent all this money at the end of the year. All of a sudden, I have this huge loss that I didn’t see coming, even though it was pretty much right there in front of us. I can’t sleep at night. I’m struggling to make payroll, and credit cards are rising. I’m freaking out. I had all these goals that I set the last week of the year that I wanted to hit.

What you’ll notice in business is that there are always goals and tasks that are extremely urgent, like making payroll, and then there are goals and tasks that are very important. If you’ve ever read The 7 Habits of Highly Effective People or ever heard of the Eisenhower Matrix or the Important-Urgent Matrix, in Q1, if you have big goals, make sure that you are blocking specific time out in Q1 in that first month where you are stepping away from the business to work on your business, like your conference, Nathan.

Take that time and be very intentional. They say that things that are important but not urgent tend to go by the wayside because of things that are not important but urgent. You have to plan them out. You have to do it well ahead of time. If it’s not in your calendar, it’s probably not going to happen. Block that time out proactively. Know when a good time of the month is because you’re going to get stressed. Things are not going to go according to plan. They never do. Put that time aside now to work on the most important piece that’s going to get you to that goal.

I love what you said about sharing your goals with the team. January is a great time to say, “Guys, beginning of the new year, this is what we’re looking at. These are our top priorities. This is where we’re going. Here’s the flag I'm putting in the ground. This is where we’re headed. This is what that vision looks like. This is how we’re going to get there. Who’s on board with me?” As you said, let everybody know this is what we’re all about. This is where we’re headed. Join us on the team, and let’s go there together.

The biggest fault of most families is that they don’t talk about money. It’s deadly not to talk about money with your kids and with your family. Your money should be an open book. The same thing in your business. It’s okay to show people. You don’t have to show them everything, but they do need to know, “This is the financial reality of this organization.” That’s good, because it does create the demand. It creates necessity.

Most of the people who are on board with your organization want it to do well. If they see that this is what we need to do for us to do well and get paid well, they get raises, and they get bonuses, and for the owner to do fun things for everybody, then everyone must do it. I never understood why owners never talk about money with their staff. Why are you not? Why are you doing that? Let them know.

You’ll weed out the ones and find out pretty quickly, which ones are all about the money, and which ones are actually about the purpose. You can slowly or more quickly start to remove those people who are not going to be part of the problem. I’ve said this before. If you want to see your income rise by 20% or 25%, get rid of the one person that you know is trying to counterintend the organization, because there’s generally just one. Most of you guys already intuitively know who it is. It will skyrocket your stats.

I’ve seen that personally before. The thing I always talk about when talking money with the team is to always tie it back to the purpose of the organization. If you talk about money for the sake of “You guys need to do this for us to make more money,” that doesn’t always land well. It is tying it back to, “This is how we further live out our purpose as an organization. This is how we live out our values. This is how it benefits the patients. This is how it benefits you.”

When we know what this break-even point is and where our goal is, which is well above that, and if we do that, to your point, guys, there are greater opportunities for you as a team to grow and develop to get bonuses and raises. We can do more as a company for the community. These are all the things that we can do for our patients now that we are well above our break-even point, things are flowing well, and everyone is productive and on board. If you can tie it to all of those things and the benefits that come to the patients and to the team members, then they buy into some of those numbers and metrics. That’s what I’ve seen.

Ask them what you should be doing differently. What should we be investing in? You would be amazed. They always say the boots on the ground are the ones who see all the issues in your company. As an owner, it’s our job to ask for that feedback and to listen.



Final Thoughts & Resources: Acquire, Control, And Invest Your Money

It’s a great opportunity to take advantage of this at the beginning of the year, especially. We’ve shared a lot of information about how to wrap up 2025 and what to look forward to in 2026. Before we go into any final comments, Sean, quickly, how do people get in touch with you if they want to reach out to Accounted4 and talk about bookkeeping services?

I’ll put an email address in. My sales director is probably the best person to speak with. We always do a complimentary analysis. If anybody is interested in “What’s the story my numbers are telling me? Are there any good insights or any changes that my current bookkeeper can go and make?”, we always offer a free analysis to give as much insight as we can. It’s like a little QuickBooks checkup, if you will.

I will put in a plug. I’ve been doing high-level audits on organizations where I ask for some high-level data on your financials, your operations, billing, and your collections teams, to see where you’re leaking money. Frankly, of the audits that I’ve done, I’m usually finding opportunities to capture well over six figures in most of these organizations. If not six figures, stuff that you can implement in the next week or two could net you $25,000 over the course of the next year.

There are opportunities to shore up your current systems and operations to make more top-line revenue, with all things being equal, which goes into your pocket. It’s called the Get Paid What You’re Worth audit. I’m happy to share that information with anyone who is on the call. Reach out to me, Nathan@PPOClub.com. I’ll share with you the details on that. I’ll frankly tell you there’s a money-back guarantee. If I can’t find $10,000 in your organization, you’ll get your money back from the cost of the audit. Reach out to me individually on that. Eric, what do you want to share?

The biggest problem most people have is the financial “I don’t knows.” I don’t know when my debt is going to be paid off. I don’t know if I’m going to have enough for retirement. I don’t know how I’m going to send my kids to school. I don’t know how much I should be making. You guys need to eliminate as many financial “I don’t knows” as you possibly can from your life. They are killers. They take your attention. They create anxiety and all those things.

I would encourage everyone to go to WealthForPTs.com. That’ll take you to a landing page, and we can get started. We have a financial scorecard. After about 20 to 25 minutes of answering some questions, you can get a financial scorecard. We’ll show you exactly where you stand in some critical areas. What are you going to do about it after that? That’s where I would start.

Is there anything else you want to share to wrap this up, Sean, in terms of people looking at their financial situations and how to best wrap this year up and look for next year?

I would say probably the number one thing as a business owner that you can be doing, and I know we’ve brought it up a number of times, is to make sure that you’re blocking time out to set some good goals. I can’t say that enough. The number of times we talk with people who don’t have any concrete goals, if you’re not sure of a good way to set a goal, there are a couple of things I always recommend looking into. Look into SMART goals. I know that’s always an easy one. You can just google that.

There’s also a great book called The 4 Disciplines of Execution. The 7 Habits of Highly Effective People and The 4 Disciplines of Execution, I read both of every single year between Christmas and New Year’s. One of the big things that they talk about in The 4 Disciplines is when you are setting a goal, I want to go from X to Y by Z, meaning I want to go from $1 million to a $1.2 million company by 12-31-2024.

By starting with that mentality, it forces you to, number one, figure out where you are today. It helps you come up with what the difference is in the goal, from to. The most important thing is that it makes it more timely by putting it into that simple format, just having those goals and then communicating them to your team. If you do those two things differently this year, I can guarantee you’ll see a big difference in your company. They cost nothing, by the way.

Eric, how do you want to wrap this up?

There are three very important skills that everyone needs to have to be successful with money. You need to know how to acquire it. You need to know how to control it. You need to know how to invest it. Nathan, with what you guys have done in the PPO Club, you guys show practice owners how to better acquire money, market, promote, sell, and deliver. Sean, you guys show people how to control money so that when money is made, it is controlled and it is going in the right places. I would say we show people how to then invest that money. If you can do those three things and you can do those things for blood, then you will have success. It just so happens that both of you guys fit those other two skill sets. That’s why it all aligned perfectly. 

Great information you both shared. I appreciate you being on here again. It’s a great mic drop moment. The only thing I’ll add to it is that what came up for me that hit was being intentional about our finances. Instead of using a bookkeeper, a CPA, or a financial advisor to tell you what’s happening, and you’re rather passive and at the effect of everything else that’s going on around you, you’re not going to get to where you want to be if you’re in that situation.

Instead, be intentional and say, “Wait. I want this much revenue so that I can generate this much profit, or I need this much profit in order to subsidize my family and my retirement. Therefore, I need to get this much revenue.” Now, you can start asking questions. How do I get there? What do I need to do? How do I manage my expenses? What pieces of equipment can I get ROI on? Who do I need to invest in to know how to do XYZ?

Being intentional about the end in mind, like you brought up, Sean, and is in The 7 Habits of Highly Effective People, gives us the power to look forward to, “How do I get there? What do I need to do?” Get experts on your team to give you some guidance so you’re not trying to go it alone. I consider what you invest in a financial advisor, a bookkeeper, and a CPA is like tuition. If you could do it yourself, you would have gone through university to learn all these things. You didn’t, so that the experts could do what they do, and you do what you do.

You’re paying tuition to have that additional information on your team and have those experts on your team. They pay off. Otherwise, they wouldn’t be there for you. Being intentional and taking control of your finances was a big takeaway for me as well. Thank you all so much. I have posted in the chat the registration link for our workshop for strategic planning, January 9th and 10th, in New Orleans. PPOCLUB20 is a discount for the first ten people who use it. Look forward to that. Sean and Eric, thank you again for joining us on the call. I appreciate it. I’m looking forward to talking to you again.

Thank you for having us.

Thanks, Nate.

Have a great day. Have a great holiday. Take care.

Important Links

• Econologics
• Accounted4
• Eric Miller on LinkedIn
• Sean Healy on LinkedIn
• Profit First
• The 7 Habits of Highly Effective People
• Physical Therapists - Econologics Financial Advisors
• The 4 Disciplines of Execution
• Private Practice Owners Club
• Discovery Call with Nathan Shields
• PPO Club on Linktree

About Eric Miller