The One Role Every Practice Owner Can't Delegate w/ April Stroink

Why every practice owner needs to be their own chief financial wellness officer

Most chiropractors and health practitioners didn't get into the profession to run a business. They got into it to help people. But the moment you open a practice — or take over one — you're a business owner whether you like it or not. And the financial side of that role is one most practitioners are wildly underprepared for.

April Stroink, a fractional CFO who's spent years working with multidisciplinary clinics, calls this role the chief financial wellness officer. The idea is simple: the same way you'd never tell a patient to outsource their health and stop paying attention to it, you can't outsource the financial health of your practice and check out. You're at the top of the org chart whether you act like it or not.

Here's the trap a lot of practice owners fall into. They hire a bookkeeper, hire an accountant, and assume the financial side of the business is handled. Then cash flow gets tight, taxes come due, and suddenly there's no money in the account. That's usually the first time anyone takes a real look at the numbers — and it's almost always too late to be anything but a panic.

Build the right team, and stay involved

Your first hire is a bookkeeper. Bookkeeping isn't a regulated profession in Canada, which means anyone can take a QuickBooks course and hang up a shingle. Vet them. Ask whether they'll help build out your chart of accounts, how often they'll reconcile, and what kind of interaction you'll have month to month. You get what you pay for — skimping here will cost you more on the accounting side later.

Your second hire is a CPA, ideally one who works with healthcare practices and operates in an advisory role rather than a transactional one. Most practice owners only see their accountant at tax time, and the goal of that conversation is usually to write off as much as possible. That feels good in April, but it backfires when you walk into a bank looking to fund a practice purchase or expansion and your books say you're not making any money.

Round out the team with a lawyer, a banker who understands healthcare, and a financial planner who can sit in the middle of all of it. The point isn't to become an expert in any of these areas — it's to know enough to ask the right questions and recognize when something doesn't add up.

Stop chasing top-line revenue

One of the most common assumptions in practice ownership is that more revenue solves everything. More patients, more associates, more locations. But adding revenue without understanding your margins usually makes the cash flow problem worse, not better. Expenses go up, complexity goes up, and the owner ends up burnt out and no further ahead.

The better question is what you're actually making on each service or product. If you have an in-house dispensary, multiple practitioners, or a mix of revenue streams, each one needs its own line in the books with the corresponding cost of goods. Otherwise you can't tell which parts of the practice are pulling their weight and which are quietly losing money.

Sometimes the fix is small. Charging for no-shows. Adjusting an associate split that's eating your margin. Repricing a service that's been underpriced for years. But you can't fix what you can't see.

Build a margin of safety

The last piece is the buffer. A line of credit isn't an emergency fund. A good practice keeps a cash reserve — three to six months of expenses is the goal — and supports it with the right insurance coverage. Disability insurance, critical illness, and proper business coverage aren't liabilities. They're what turns a problem into something manageable instead of a panic.

If you're not sure where to start, here's the simplest possible exercise: open a separate savings account, label it "margin of safety," and start moving 1% of your revenue into it every month. Do it for three months. If you can't leave the money alone, you've just diagnosed a cash flow problem.

That's the work of a chief financial wellness officer. Not running the books yourself — knowing your numbers well enough to lead the people who do.