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What can a CFO do for your practice?

Updated: Oct 21, 2022

A friend of mine recently went on a three-week European vacation with her family. She wanted to pack in as many experiences as possible while keeping a pace that wouldn’t exhaust the family. She also had a timeframe and a budget to stay within. With all of those variables, she called on a travel planner to take all of the pieces and translate it into a comprehensive plan for their family vacation. Through many conversations, the travel expert took my friend’s goals for the trip, discussed options that met the criteria, and then allowed the final itinerary decisions to rest with my friend. (They had an incredible trip.)

I mention my friend’s experience because it reminds me of the professional insight, planning, and peace of mind that a CFO can offer to your practice. Think that CFOs are only for Fortune 500-type companies? Think again. Fractional CFOs serve to put this kind of valuable information in your hands. Much like my friend who hired an expert in the travel industry to assist with a huge vacation decision, you may benefit from hiring a Chief Financial Officer to serve as a guide for your financial future.


A Chief Financial Officer, or CFO, is a financial strategist who looks for high level trends in business finances with a specific focus on the future. They provide a roadmap for your business to achieve the growth you desire in the most efficient, accelerated and sustainable way possible.

On a more personal level, a CFO is a trusted, unbiased advisor who knows your financial situation and can help gut-check decisions with you. You may already be feeling that owning a business can be lonely, and big decisions can seem overwhelming when you go it alone. A CFO comes alongside you and helps bring clarity to the decisions at hand.

A Fractional CFO is a person who performs all of these Chief Financial Officer functions, but not exclusively for your company. They split their time between multiple companies and are typically hired as a contractor or through an accounting firm. This arrangement makes it possible for you to have the invaluable input of a CFO without breaking the bank for a full time CFO employee on your payroll.


Sometimes practice owners simply have too much on their plates and would like to have another set of eyes on the financial systems of the practice. This is a situation where a fractional CFO would be a beneficial addition to your practice.

As a general measure, we typically don’t see a great need for a CFO until a practice is generating at least $500,000 in annual revenue. However, two specific scenarios where a practice can greatly benefit from hiring a CFO are in times of growth and periods of financial instability.


Time and again we see practice owners feeling completely overwhelmed by growth. Whether the growth comes in the form of hiring, adding benefits, or physical expansion, it can bring out the jitters in even the most business-savvy practice owners - understandably! Because fractional CFOs have a focus on the future as it relates to your numbers, they are experts at analyzing and advising you on your growth opportunities. A CFO will alleviate the stress of expansion-type decisions by helping you understand the financial implications of your options so that you can decide what direction is best for you and your practice.

Where do they get their crystal ball powers? In numbers and experience. CFOs provide financial forecasting by tracking your Key Performance Indicators (KPIs), analyzing compensation planning, and monitoring changes in your company that affect these forecasting measures. A CFO can answer questions such as: How many sessions would be needed to support another full time administrator? How fast can cash be accumulated for an expansion? How much do I need to save for my taxes? These metrics combined with their vast experience takes the mystery out of their recommendations.

Financial Mayday

Another scenario where we recommend hiring a CFO is when the private practice is in financial discord. The problems might manifest as eroding profit margins, or cash flow issues, or other financial conundrums. The red flags come in different forms, but the common factor is that the owner is unclear why they are in a financial dilemma. It may seem counterintuitive to add the expense of a CFO when you are facing cash flow issues, but if you're not sure WHY you are having problems, this is exactly the type of expertise you need to get back on track!

CFOs can provide budgeting that is specific to your industry and your practice needs, and will give you meaningful financial reports to peel back the curtain of your money confusion. They will identify the root cause of your financial woes and will provide you with a plan that is financially sustainable and consistent with your practice goals.


The benefits of having a CFO also extend to your overall financial health by helping you have enough money for personal goals like buying a house, retiring comfortably or selling your business. With your specific goals in mind, your CFO will reverse-engineer the Profit Margin and Cash needed to achieve your dreams. They will also identify tax saving strategies to help move you in the right direction.

We find that sometimes practice owners are afraid to really dream big because the Big Idea doesn’t feel doable. An experienced CFO will be able to draw on their knowledge to advise whether a particular goal is achievable, or if it is too aggressive.

CFOs are gurus in numbers, but they also can offer less tangible benefits through sharing your mental load. A great CFO will help you identify goals, will “gut-check” with you, and will provide you honest advice and feedback based on their deep understanding of the business.

For example, sometimes a practice owner will become so excited about an opportunity that they are unable to recognize the warning signs of the endeavor. A skilled CFO will gently bring the owner back down from their blind excitement and will explain how that opportunity could lead to negative financial consequences. Of course, the business owner is always in control and may decide to implement some recommended strategies, while choosing not to implement others that don't work for them. The CFO advises; the owner decides.


Due to the trust involved in working with a fractional CFO, it is important to make your selection wisely. A CFO doesn’t necessarily have to be a Certified Public Accountant (CPA) or an Enrolled Agent (EA), but they will definitely have a significant amount of time and experience in the accounting field. The invaluable piece of a highly skilled CFO are the intangibles they bring to the table: consulting, advising, gut-checking. Hiring a CFO with niche expertise in your field is going to be the best person for the job. All CFOs can evaluate and interpret financial statements, but the most qualified will know the industry so well that they can confidently provide advice from their base of first-hand experience.

If you're looking for this type of support in your private practice, GreenOak Accounting offers CFO services with our monthly accounting package. Because we work exclusively with mental and behavioral health businesses, we’re experts in your industry. We’ve helped hundreds of private practices achieve their dreams and we’d love to partner with you. Interested? Reach us here:


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