Know the commitment.
Before you make it.

No. The purpose is to test the decision before committing. Staying employed, renegotiating, delaying, or pursuing independence can each be a reasonable outcome.

Employed procedural specialists considering independent practice, initially in Greater St. Louis: orthopaedics, ophthalmology, ENT, urology, dermatology/Mohs, gastroenterology and interventional pain. We also consider GYN-focused practices selectively. Full OB/GYN requires a separate coverage, hospital-access, malpractice and economics screen; it is not automatically included in the priority launch audience. Fit depends on your circumstances, not specialty alone.

No. We provide business and operational advisory. Independent counsel addresses restrictive covenants and legal rights; your CPA and other licensed professionals address matters within their scope.

If the initial case warrants deeper work, we can discuss a separate independence model and, later, launch or operating support. There is no obligation to purchase a later engagement.

One additional, bounded four-week workstream: a baseline charter, redesigned workflow or SOP, an implementation session, a test or measurement record, and an owner handoff. Scope and fee require separate written approval before work starts. A sprint is not required to correct or complete already-agreed core work.

For one physician-owner, one site and one launch: integrated master plan, critical path, RACI and risk log; one focused recovery workstream; four 45-minute owner meetings and two 30-minute targeted vendor huddles/month; weekly filing/credentialing evidence tracking; monthly capital reconciliation and one selected decision comparison/month.

Over the engagement: one cross-vendor test cycle plus one retest, up to three role/workflow packages, two operational training sessions, one remote dry run plus documented retest, and three scheduled opening-week check-ins replacing regular meetings that week. First-30-day dashboard, reconciliation and handoff are included if within the agreed term. Month-three operating review belongs to Tier 3 if purchased.

Remote coordination, not delegated COO authority. Counsel and qualified vendors execute regulated work, filings, integrations and coding validation. Requires an accepted Tier 1 plan or equivalent, committed financing, retained counsel/CPA and implementation vendors, and a client decision-maker. Routine acknowledgment within two business days is not a resolution guarantee. Monthly acceptance uses dated plans, risk/status records, budget variance and milestone evidence. Additional work and extensions require written agreement; third-party costs, travel and on-site services are excluded.

The same client entity and practice must complete the agreed Tier 2 scope, pay at least three Tier 2 months and all due undisputed Tier 2 invoices, and accept the documented handoff. Both parties must sign Tier 3 within 30 calendar days after accepted handoff and start it within 60 calendar days after that handoff. Justified deadline extensions require written agreement. The three-month eligibility threshold is not a mandatory Tier 2 term.

Apply $1,000 to each of the first two Tier 3 core invoices only. Once per qualifying launch; no cash value, transfer or automatic renewal benefit. Excludes sprints, A1, A2, third-party costs and already-discounted duplicate onboarding. A separately eligible Tier 0 credit and A2 waiver may coexist. If no second core invoice occurs, the unused second credit expires; there is no new clawback of a used credit. Ordinary signed payment and termination terms remain.

Tier 3 starts after the agreed Tier 2 stabilization handoff; no period and deliverable may be billed twice. Tier 3 purchase is optional and is not required before the final Tier 2 invoice. The credit rewards continuity and reuse, not referrals or financial results.

Tier 1 has a $25,000 list fee. When Tier 1 is signed within 30 days of the Tier 0 readout, the paid $4,000 Tier 0 fee is credited once, leaving $21,000 payable for Tier 1. Together, Tier 0 and Tier 1 total $25,000, excluding optional add-ons. After the window, Tier 1 is $25,000 additional and the two stages total $29,000.

For up to four physician owners, two sites, one specialty group, one state and one named decision-maker: group formation plus one primary ASC or MSO pathway; one 36-month financial model (monthly year 1, annual years 2–3), base/downside/upside scenarios and partner allocation sensitivities; up to five 45-minute stakeholder interviews, three 90-minute partner meetings, three 60-minute counsel-coordination meetings, two consolidated revision cycles and one clarification session within 15 business days after readout.

Deliverables cover group economics, governance choices, selected facility/MSO options, a diligence/readiness index, an indicative financial sensitivity range, partner decisions and a counsel handoff. A secondary ASC/MSO interface is screening only, not a second full structural engagement. Remote delivery is indicatively 12–16 weeks after complete-data readiness; external delays are documented, not guaranteed away.

Four payments total $50,000: $15,000 mobilization advance; $12,500 on accepted reconciled economics; $12,500 on accepted structural decision pack; $10,000 on accepted final model, readout and handoff. After M1, invoices are due net 15 following written milestone acceptance. The client has five business days to accept or identify specific deficiencies; silence is not acceptance. In-scope corrections are included. Advance reconciliation and termination are governed by the signed agreement; the advance is not automatically earned or non-refundable.

No legal drafting, formal valuation/FMV opinion, securities or real-estate brokerage, capital raising, financing procurement, clinical advice, construction or transaction execution is included. Third-party costs, travel, extra owners/sites/jurisdictions and material scope changes require separate arrangements. No automatic Tier 4 credit or earlier-tier prerequisite; reused work must not be billed twice. The signed engagement controls and existing signed contracts are not changed by this website.

No client return has been established. ROI depends on attributable contribution profit and verified savings, less advisory fees and all other incremental costs, over the same period. Higher fees do not create a higher client return. We test a client-specific case rather than promise a multiple.

Illustration only: at an assumed 50% incremental contribution margin, $100,000 in additional attributable collections would recover the $50,000 Tier 4 advisory fee alone. Startup capital, implementation costs, time and risk are still additional. A sound no-go decision may be valuable without a measurable cash return.

The target is seven calendar days after confirmed kickoff. Kickoff requires the signed letter, payment, your current employment agreement with amendments, and at least twelve months of net collections statements by month. If supplemental data is missing, we identify assumptions and deliver by day 21 under the draft terms. The readout is scheduled within five business days of document delivery.

No. Faith informs our own commitments to preparation and honest measurement. Clients are welcome regardless of religious belief, and recommendations depend on evidence and your objectives.