Learn how to use a structured 24-month financial look-back to uncover what’s really driving your practice’s performance and where to focus next.
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Episode 8
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To build a strong future, you must honestly assess where you've been. In this episode, Brandon Seigel guides practice owners through a structured 24-month financial look-back, one of the most powerful tools for identifying what's working, what's not, and where to focus next.
Most private practice owners look forward without adequately examining what their historical data is telling them. A full 24-month look-back, examining revenue, expenses, cash flow, patient volume, and key operational metrics, gives you the context you need to plan with confidence rather than optimism.
The look-back process starts with identifying profitability patterns. Which months, quarters, or service lines drove the most profit? Which created drag? Brandon notes that seasonal trends are often more pronounced than owners realize, hiring cycles, patient intake surges, and revenue slowdowns frequently repeat in recognizable patterns once you step back far enough to see them.
Budget adherence is a critical lens in any look-back. Did the practice hit its revenue targets? Were expenses in line with projections? If not, why? The goal isn't to assign blame, it's to improve forecasting. A budget that's consistently missed in specific line items tells you something important about how your practice actually operates versus how you assumed it would.
Cash flow analysis is separate from profit analysis, and Brandon treats it that way. A profitable practice can still face cash flow crises if collections are slow or revenue timing is uneven. Looking at the gap between when services were rendered, when they were billed, and when payment was collected reveals the real rhythm of your financial engine.
Once the look-back is complete, the data should feed directly into next year's planning. What investments are justified based on past performance? What service lines should be scaled, restructured, or retired? The look-back isn't just an accounting exercise, it's your strategic foundation.
Key Takeaways
