For practice owners

Every practice needs someone whose job is to notice.

In most independent practices, that person is you — and you're the one with the least attention left to give it. Retained strategic support, one half-day a month, so the medium term stops being something you think about at 11pm.

Take the practice health check

A surgery that didn't happen

Five years ago a specialist recommended surgery for me. It was booked. Then I heard nothing — until he rang himself, the day before, to confirm. At less than twenty-four hours' notice I couldn't attend, and it was cancelled.

I asked what had happened. The reminder email had gone out a week earlier, as always. It had: into my junk folder. The detail that stayed with me is that he already knew his reminders tended to land in junk. It wasn't news. It was a known, unfixed issue in his own practice — and I found myself wondering how many other patients, other surgeries, had quietly fallen through the same gap and never been traced back to a cause.

Nothing about that specialist was incompetent. He was skilled, and decent enough to call me himself. But his practice, like most independent practices, had no one whose job it was to step back from the clinical work and ask why appointments were being missed — or whether something as small as an email deliverability setting was quietly costing him patients.

Scale that gap up and you have the risk this service exists to close. A missed email is a small failure of attention. A practice with no strategic layer is running that same risk at every level, all the time.

The offer

What large health services buy, sized for you.

Hospitals and health services have Chief Information Officers — senior people whose job is the medium and long term. In Australian healthcare a CIO costs between three and five hundred thousand dollars a year. Your practice can't afford one and doesn't need a full-time one. It does need what they provide.

That's what a Virtual CIO is: a senior adviser on retainer, part-time, giving your practice strategic capability it otherwise has no way to access. The model has existed in accounting and law for decades. It's newer in independent healthcare, and it works.

What you get

One half-day a month, in person or by video, with you and any senior staff you want in the room.
Access between sessions for time-sensitive questions — capped at a sensible volume so it stays a relationship rather than a helpdesk.
A twelve to eighteen month strategic plan, produced in the first quarter and delivered against thereafter.
Specific deliverables with specific dates. Not an open-ended retainer that bills while nothing moves.

How it runs

Months 1–3

Assessment

I learn the practice. Review the systems, talk to the staff, form a view about what's working, what isn't, and what the medium-term priorities should be. You get a strategic plan we both agree to.

Months 4–12

Delivery

I don't implement the changes — your staff do, supported by specialists where needed. My job is to guide, to escalate, and to make sure the strategic priorities don't get eaten by the day-to-day pressure of running a practice. They otherwise always do.

Month 18 onward

Positioning

Are you preparing the practice for sale? Passing it to a junior partner? Anticipating a regulatory change that will reshape your discipline? These are the questions that most need strategic capability and are most poorly answered alone.

The four criteria

How to choose an adviser — including whether it should be me

In Chapter 13 of the book I set out four things that separate a strategic adviser worth retaining from one worth avoiding. I wrote them before I sold against them, so let me hold myself to them here.

Prior operational experience in Australian healthcare, not technology generally.

Twenty years. The MBS, the Privacy Act, AHPRA, My Health Record conformance — I've worked inside the programs that built this environment, not adjacent to them. I started my career at AGPAL, the body that accredits Australian general practices against the RACGP Standards, building the e-learning used by 7,000 GP surgeries. Accreditation is not a market I have entered. It is where I began.

Vendor independence.

I resell nothing. I hold no commercial relationship with any practice management, telehealth, scribe or security platform, and I never will. You pay me; nobody else does.

Engagements structured around specific deliverables.

Fixed rhythm, named outputs, agreed timelines. No open-ended hourly billing.

Willing to tell you uncomfortable things.

An adviser who tells you what you want to hear is one of the worst investments an independent practice can make. That's not a bug in the engagement; it's the point of it.

Value

What a strategic layer is actually worth

A health service employs a Chief Information Officer to do this thinking. In Australian healthcare that role costs between three and five hundred thousand dollars a year. You need the thinking. You do not need the salary — and this is what the thinking costs on its own.

Three things change, and they change in this order.

The decisions get made.

The platform question. The security question. The one about what happens to this practice in ten years. They have been sitting at the back of your mind for two years, not because they are hard but because there has never been a week with room in it. They get decided, in sequence, with someone other than you accountable for keeping them moving.

The leakage stops.

Under-claimed items. Administrative hours that produce nothing. Appointment reminders landing quietly in junk folders. Most practices are losing more each year to friction they cannot see than this work costs to fix.

You stop carrying it alone.

Clients mention this last and value it most. There is a difference between a practice that runs because you notice everything and a practice that runs because it is built to. The second is a better business. It is also, and this is the part nobody puts in a proposal, a considerably better way to spend your forties and fifties.

If you ever sell

Buyers price the risk that the earnings leave with you

Most practice owners think about this only once they start thinking about leaving, which is usually a decade too late to do much about it. It is worth understanding earlier, because the same work that changes the answer also changes your working week.

When a practice sells, the buyer is not really buying last year's earnings. They are buying the likelihood that those earnings continue once you have gone.

So valuers discount for reliance on a key person. Goodwill attached to an individual does not transfer with the sale — the patients came for you, the staff worked for you, and the process lived in your head. Courts have upheld that discount. They have also declined to apply it where succession had been planned and management depth already existed.

The premium is not something you add. It is a discount you stop attracting.

None of which is an argument about your retirement. It is the same work either way: a practice that does not depend on you noticing everything is worth more to a buyer in fifteen years, and it is a better place to work on a Tuesday.

Price

What it costs

I publish my prices. Most in this market do not.

Practice Digital Health Assessment

$3,500 one-off, fixed

Two to three weeks. I review your systems, your compliance position and your workflows, and you get a written assessment and a prioritised twelve-month roadmap that you own outright.

Quarterly Advisory

$1,200 a month

Half a day together each quarter, and access between sessions when something will not wait.

Foundational Retainer

from $4,500 a month

A day or two a month, for multi-site groups, corporates and larger specialist clinics carrying real regulatory exposure.

Both retainers run for a minimum of twelve months. Strategic work on a shorter horizon than that is not strategic, and I would rather say so now than take the engagement and disappoint you.

Prices exclude GST. I resell nothing, take no commissions and hold no vendor relationships. You pay me, and nobody else does.

If you are a single practice, start with the assessment.

Do you need this?

Four questions. Answer honestly.

Do I have a documented twelve to eighteen month strategy for my practice?
If I took six months off, would the practice still be functioning when I got back?
Could I describe the value of my practice to a prospective buyer in concrete terms?
Do I have ready access to strategic advice when I need it?

Two or more “no” answers and this is probably worth a conversation. Four “yes” answers and you don't need me — which I'd rather tell you now than three months in.

Start with the health check.

It takes about five minutes and you'll get something useful back either way.

Take the full health check