How To Build a 20% Profit Practice
Most clinic owners aren’t failing — they’re just trapped in outdated models. They’re working hard, seeing decent revenue on paper, but bleeding margin quietly in the background. If that sounds familiar, this guide is for you.
This page breaks down the frameworks, financial logic, and practical shifts you need to operate like a real business — one that serves patients and creates sustainable profit for its owner.
Why Most Clinics Struggle (Even When They’re Busy)
You look at your weekly revenue and think, “We’re doing okay.” You’ve got patients, a team, and a steady stream of referrals. But by the end of the month, there’s nothing left. No margin. No buffer. Just exhaustion.
- Third-party dependence — NDIS, WorkCover, TAC, health funds that cap your fees
- Time-based billing — charging per consult instead of per outcome
- Poor utilisation — therapists billing under 60%
- Broken wage ratios — wages + super over 50% of revenue
“It’s not a pricing issue — it’s a utilisation issue.”
The Boom-Bust Trap
Public holidays, school breaks, sick leave. When you're dependent on volume, the smallest dip wrecks your margin. The business starts to swing between feast and famine.
“You’re not building a business. You’re building a pressure cooker.”
The Three Models
Unsustainable
- <10% private payers
- 80%+ revenue from third parties
- Low margin, high admin, zero leverage
Sustainable
- 50%+ private revenue
- NDIS, EPC, CDM, etc used strategically
- More flexibility, better client mix
Scalable (The Dream)
- >80% private payers
- Predictable ops, quality clients
- 20%+ profit margin
“You don’t need to grow. You need to stabilise.”
What Changes at 20%
- Stop reacting to weekly numbers
- Pay yourself and your team properly
- Build a buffer — reinvest, hire, or exit on your terms
This isn’t about motivation. It’s about margin math.
How To Get There
- Fix your wage structure
Therapist wages + super must be under 50%. Admin = separate line.
- Raise your price floor
Make your clinic look and feel premium. Track NPS. Aim for 90+.
- Package what you already do
Use your existing pathways (post-op rehab, chronic pain) and sell programs, not sessions.
- Target ideal clients
Clients who value your work and can afford it. Not just "more patients."
- Track therapist utilisation
Under 60% = break-even or worse. 70%+ = actual profit. Track it weekly.
“If they’re not billing 23–27 hours a week, you’re bleeding margin.”
Build With Others Who Get It
The People Community is for clinic owners ready to move past theory and actually implement change.
- Monthly 2-hour coaching calls
- Templates, calculators, pricing models
- Access to Shane + private coaching threads
$697/year. Built for business owners ready to level up.
Join the People Community
Want the Full System?
The Profits Course is a complete business restructure for clinics under $1M who are ready to hit 20%+ profit.
- 10+ hours of training
- Live weekly calls
- Includes access to People Community
By application only — for People members.
Apply for Profits Course
About Shane
Founder of Culture of One. Ex-clinic owner. Now coaching 100+ allied health founders to build profitable, sustainable, no-BS businesses.
“You don’t need to grow. You need to fix the profit model first.”
📩 @shaneguna
🌐 cultureofone.com.au
