A Charlotte multi-specialty clinic generating $4.8M needed to know the optimal sequence for adding two new physicians. Our model confirmed cardiology-first, it hit break-even by month 11.
01The Situation
The lead physician had grown the practice from solo to 5-physician multi-specialty over 12 years. Two specialists wanted to join and two adjacent office spaces were available. The expansion felt right. But he had never modeled the financial impact of adding two specialties simultaneously.
He needed to know: could the clinic support both additions? Which should launch first? What was the cash requirement during the ramp period?
02What We Did
We modeled each specialty independently. Ramp curves calibrated against benchmark data for similar specialty additions in Charlotte. The model showed cardiology reaching break-even by month 14, neurology by month 22. Running both simultaneously required $480K in additional working capital. Staggered opening, cardiology first, reduced peak cash requirement to $290K and improved the overall risk profile.
The lead physician chose staggered. Cardiology hit break-even in month 11, 3 months ahead of projection.
03Client Impact
The lead physician would have made the same expansion decision either way, he had good instincts about both specialists. What the model gave him was the confidence to do it in the right order with the right cash plan.
Breakdown
| Specialty | Physicians | Current Rev. | Year 3 Projected | Margin | Break-even |
|---|---|---|---|---|---|
| Internal Medicine | 2 | $1,920,000 | $2,160,000 | 34% | Established |
| Orthopedics | 1 | $1,080,000 | $1,260,000 | 38% | Established |
| Dermatology | 1 | $960,000 | $1,080,000 | 41% | Established |
| Pediatrics | 1 | $840,000 | $960,000 | 32% | Established |
| Cardiology (new) | 1 | — | $1,140,000 | 42% | Month 14 model / 11 actual |
| Neurology (new) | 1 | — | $600,000 | 36% | Month 22 est. |
What changed
Expansion Model Built, Both Specialties Modeled
Physician-level revenue, ramp curves, overhead allocation, and break-even for both additions.
Cardiology-First Sequence Recommended and Adopted
Staggered launch reduces peak cash requirement by $190K. Cardiology launched Q2 2025.
Month 11 Break-even, 3 Months Early
Cardiology tracking ahead of model. Physician fully productive earlier than projected.
Neurology Launch Scheduled Q4 2025
Second addition on track based on cardiology performance.
The lead physician would have made the same expansion decision either way, he had good instincts about both specialists. What the model gave him was the confidence to do it in the right order with the right cash plan.
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