Next Level Pros
#147: Losing $50,000 Every Month to $23,000 Profit in 60 Days / Increase Profits / Next Level Pros Podcast
Tue, 20 May 2025
Welcome to a new episode of Next Level Pros! In this engaging discussion, Chris Lee and Trent Lowenstein share the turnaround story of Amber's podiatry clinics in Portland, Oregon. Designed for medical practitioners struggling with profitability and business owners looking to scale efficiently, this episode provides actionable insights to transform your practice from running in the red to flourishing in the black. Learn how Amber went from a net operating income of negative $144,000 to a positive $23,000 in just a few months by joining the Next Level community, focusing on key metrics, and implementing strategic marketing initiatives. Discover the importance of staff accountability, the power of knowing and tracking key metrics, and how to effectively budget your marketing spend to fill up your practice’s calendar.Highlights:“Previously none of our employees knew what it meant to be successful.”“When you can measure something, you can control it. Before, there was no visibility—now we know our break-even, our gross margin, our average revenue per visit. That’s when it gets fun.”“It’s scary to spend money on marketing when you’ve been in desperation mode. But the opportunity cost of not spending is bigger.”“Nobody loves your business like you do. Everyone else gets paid, and the entrepreneur goes home wondering how they’re going to make payroll. That’s why alignment and incentive structures are so important—so your team starts pushing the wagon with you.”Timestamps:00:00 Introduction02:25 Turning Point: Joining the Community04:40 April's Success and Key Implementations08:50 Clinic Capacity and Staffing Issues14:24 Compensation Structures and Recruitment31:38 Marketing Strategies and Cost of Acquisition37:16 Addressing Marketing Concerns and Repeat Business40:16 Opportunity Cost and Scaling the Business49:44 Improving Front Desk Operations and Employee Incentives59:06 Exploring Marketing Channels and Strategies01:03:20 Conclusion
Chapter 1: What is the main topic of this episode?
That sounds scary, Chris.
One problem is you do not have visits. You have a cost of marketing, a cost of acquisition that scales, and you have $23,000 extra from this last month. The best advice I could give to you is spend $23,000.
Chapter 2: How did joining the Next Level community change Amber's clinics?
That sounds scary, Chris.
Can I give you a recommendation there?
Chapter 3: What key implementations led to Amber's financial turnaround?
Yes. Are you going to tell me not to do that?
Don't do it.
Oh, really?
Amber, thanks for joining us today on the show.
Chapter 4: How can accountability improve clinic performance?
Yeah, thanks for having me.
Excited to have you. So Amber, can you give us a little background? I know you own podiatry clinics, and can you give us a little bit more color behind that?
Yes, we own three locations of podiatry clinics in Portland, Oregon. My husband is a podiatrist, so he's one of our doctors. We have two other doctors in our other locations, clinic manager, billing manager, and then staff.
So you've got a lot of interesting things and I'll just like kind of point them out and then we're going to dive into them. So like one, up until you joined the Next Level community, you were losing money and we've seen some really cool things and we're going to talk a little bit about that, how you've been able to turn that around, make some money.
But yeah, so you've got some really, really cool things going on in the business. Can you give us like, give us a little bit more color? So you joined the Next Level community back in, was it February?
I think February, yeah.
Okay, cool. And up until February, what was taking place in the business?
So it's me and my husband running the business and trying to figure it out without any idea of what we're supposed to be doing. And so it literally was like fighting fires every day and trying to... I guess I listen to a lot of podcasts, and so I thought that I knew... kind of what I was talking about, but I really just had no idea.
So we weren't profitable, no accountability in place, just like kind of a disaster.
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Chapter 5: What marketing strategies helped increase patient visits?
That's exciting.
It's wonderful.
So you go from... essentially losing $50,000 a month to positive 23. That's a $73,000 swing. What were some of the main things that you implemented over that time? And then once you answer that, we'll dive into like more of like, okay, what can we do now? What is the next big moves that we got to take?
But yeah, what were some of those like key things that went from negative 50 grand to positive 23?
Yeah, so accountability of our staff members was probably the biggest driver. So previously, none of our employees knew what it meant to be successful. We didn't have those key metrics in place. That contributed a lot to the chaos of the day-to-day in the clinic. Um, we had some AR issues, um, also that we kind of figured out, um, and then marketing, we were doing no marketing.
And so we started implementing marketing strategies and.
Yeah.
Yeah.
Yeah.
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Chapter 6: What is the significance of understanding key metrics in a business?
Like, I don't know. And like today we're, we're sitting, we're sitting over some metrics that are obviously when, when you're talking about holding these people accountable, it's really what, I mean, holding them accountable to these type of productivity, right?
Yeah. Yeah. We jumped in hard to the metrics immediately with, with Trent. I think knowing, knowing the numbers was one of the first things that we clarified. So that was, that was huge.
Yeah, I mean, I'm looking at some things like, okay, what is your break-even, right? $100,000 a month is kind of what we call the nut that you have to cover to be able to start making money. Understanding, like, your gross margin of 95%, that your average revenue per visit is $250, what your total visits were last month versus this month, that type of thing.
Like, all these metrics are really where it becomes fun, right, to be able to, like... pull the levers and really just understand the game, understand the rules, understand the logic, understand like when I do this, it results in this versus just kind of like shooting from the gut or from the head.
Yeah, those numbers were non-existent before I started. I mean, we had no idea. I mean, I think even revenue per visit is a brand new number that we just came up with not very long ago. Yeah.
That's amazing.
We always said like, if you could measure it, then you could control it. So her issue was she couldn't measure it and she couldn't control it. There was no visibility. And now that you have your chart of accounts dialed in, you're in a lot better position.
Yeah.
So Trent, when you say chart of accounts, can you explain to the viewers more of what that means? Yeah, so on your profit and loss statement, you have descriptions usually on the left-hand side or almost always on the left-hand side that are the actual items that you are, the descriptions of the items that you're spending.
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Chapter 7: How do compensation structures affect staff motivation?
So like materials, direct labor, your insurance, your rent, your operational expenses, and having a clean chart of accounts where you can clearly identify sections where you should be spending a certain amount, like marketing as an example, what's the marketing spend here? help you gain clarity in your business so that you can protect that 25% net profit of your business.
Yeah. So like previously things were not necessarily in the right buckets. We had way more buckets and then there was no consistency as to like, this always goes in the marketing bucket. And we've even since dialed in deeper and have multiple different types of marketing buckets so that we can really see like, oh, I spend a dollar in this and this is my return. And that's all brand new.
So, um, one thing I'm not seeing on here and I'm interested to know if you, if you know about your business as far as like capacity, uh, do you, do you know your current like capacity metrics?
Uh, yes, we are under utilizing all three of our clinics drastically. Um, so yes, I think our, we can see, let's see a full day of, of 24 patients.
Um, so how many, how many days a week are you open right now?
Yeah, so that's another problem. So depending on the doctor and if they do surgery or not is how many days they're in clinic. So we have one associate who's non-surgical, but she's in clinic four days a week. She's spread out throughout the three clinics. Got it.
But she's only ever in for four days a week?
Right. And that means that one of our locations is, all three of our locations are fully staffed. But like one of them is only open two days a week seeing patients. One of them is open five days a week seeing patients.
And when you say fully staffed, are they fully staffed the other three days?
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Chapter 8: What are the best practices for marketing spend in a clinic?
Even though you're only seeing patients two days a week?
Yes. So sometimes the medical assistants travel with the doctors, but there are There are several days where we have a front office and a medical assistant sitting in an empty clinic.
Hey, guys, it's Chris. If you're finding value in what you're hearing, go ahead and like and subscribe. That way people just like you can find this content for free here on YouTube. Now let's dive back in the show. Right. Yeah, so it's interesting. So you have the capacity right now, like from a facility standpoint, to have 24 visits a day? Per clinic. Per clinic. Per clinic.
And if there were more doctors at those locations, could you see more than 24?
One of our clinics, for sure, we could see 48, maybe three times that. We have enough exam rooms. The other two clinics, we really only have capacity to see 24 patients a day.
Yeah, because I think it's important, like you're in the capacity game, right? Like what do you have capacity to fill and like what percentage of capacity are you hitting? And so when you're talking about that you have like a clinic that you have two different rooms and you could be doing 48 a day, the only limiting factor at that point is what?
Just volume of getting to the right patients.
Volume of patients, but then also a doctor, right? Because you don't have a doctor. Yes. So the first limiting factor would be a doctor and the second limiting factor is like getting to capacity.
We have the doctors are sitting and not seeing 24 patients. So really our problem right now is the patients.
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