Growth Plan · OSG Systems · Optimize · Scale · Grow
Four vendors are driving traffic to your practice. Nobody owns what happens after the click.
That's not a marketing problem — it's a plumbing problem. It's also the reason you can't prove to the joint venture that you outperform their team.
You don't need more leads than you're already buying. You need to stop losing them, and start proving they're yours.
Do that, and eight surgical cases a month stops being a stretch — which is the number that resets your JV contract. The math is right below.
In your words
“Maximizing qualified leads.”
Your one wish“Consistency. I'd feel a lot better if my numbers went up every month… versus the up and down.”
What keeps you up at night“We are really generating revenue. It's not because you guys are doing a good job. So give us the reins.”
The actual goalEverything below is built backwards from that third one. It's the highest-value sentence you said, and no vendor you're paying is working on it.
The number
Today: $22,000/month + $4,000 per case, averaging 2–3 cases. Original terms: ~$75,000/month + ~$2,000 per case, gated on eight.
| Scenario | Cases / mo | JV revenue / mo | vs. today |
|---|---|---|---|
| Today | 2.5 | $32,000 | — |
| Near-term goal, current terms | 5 | $42,000 | +$10,000 |
| Threshold hit, current terms | 8 | $54,000 | +$22,000 |
| Threshold hit, original terms restored | 8 | $91,000 | +$59,000 |
You told me your surgical capacity is 6–8 cases per week. Capacity isn't the constraint. Conversion and proof are.
I tested it
I texted your published line, (215) 821-7059, while we were still on Zoom.
86h 23m
Your stated goal is under five minutes. Your own landing page promises a callback within one business day. Your office was open all day Friday and the text still sat there — so this isn't only an after-hours gap. The text channel has no owner at all, and six landing pages advertise it.
Your team did nothing wrong. They called twenty minutes after the doors opened Monday — about the best a person can do. The system simply has no Thursday night, no Friday, and no weekend in it. That's architecture, not staffing, and it's the fastest thing on this list to fix.
Where the money leaks
“Send a message” returns a 404. Confirmed live on our call. The JV renamed the endpoint on their domain and didn't tell you. Everyone who chose to type instead of call hit a dead page.
Your after-hours greeting isn't your practice. “Thank you for calling the Joint Preservation Center.” A $7,700 regen prospect calling at 6pm hears another company's name.
Nobody can book, anywhere. No online scheduling, no portal, no e-intake. You named the blocker yourself: GHL doesn't talk to DrChrono. It's solved — see the third finding below.
Three systems, one of them a hand-typed spreadsheet. Meta leads land in GHL. JV leads arrive by email and get keyed into a Google Sheet. Appointments live in DrChrono. Your staff are the integration layer.
You can't prove your own performance. The JV logs “online search” as their win — including the Facebook ads you paid for. You meet their CEO in about a month. Right now you'd bring a story; they'd bring a spreadsheet.
Cash-pay series have no recall. Laser runs 6–12 sessions, shockwave 3–6, EMSCULPT 4–8. A patient who stops at session 5 of 10 is half a package that walked, and today nobody notices.
Your first regen cohort is coming due right now. 2.5–3 years of relief, and you opened 2.5 years ago. No list, no trigger, no owner. ~100 past patients returning at 25% is roughly $190,000.
Your 80%-converting channel has no system behind it. No partner CRM, no acknowledgment, no outcome report back to the referring doc. And Rater8 asks for reviews but never for a referral — your words: “that doesn't happen.”
Three things I don't think anyone has told you
Not restricts — prohibits. Your highest-margin service line is structurally locked out of Google paid search, permanently. Regen growth has to come from organic and AEO, Meta with careful copy, and referral partners. Your AEO signing was the right instinct.
Paid ads only. This does not touch the Map Pack, which is organic — so it isn't an argument for cutting Gridlock. Decide that one on Phase 0 data.
“Is your knee pain getting worse?” gets rejected. “Knee arthritis treatment options are available” doesn't. First consequence is ad rejection; repeat violations escalate to account restrictions, and health accounts are slow to recover.
Send me your Meta vendor's live ad copy — not the pages. I'll review it against the policy at no charge regardless of what you decide here.
DrChrono publishes a documented REST API, and HIPAA-compliant middleware already ships two-way DrChrono ↔ GoHighLevel appointment sync. Online booking without asking the JV for anything, and without double-booking your clinic.
Conditional on API credentials being enabled on your account — a 20-minute check, and the first thing I'd do. Fallback is staff-confirmed request-to-book.
The build
Nothing here touches the exam room. Every system sits in front of the encounter, so the 45-to-60-minute consult you built this practice around stays exactly as it is.
Weeks 1–3 from kickoff · before your CEO meeting
First because it's the only work here with a hard external deadline, it's the cheapest thing on the page, and it converts your ad spend from an expense into evidence.
Weeks 3–7 · turn 86 hours into 60 seconds
The routing is what you'll feel fastest. You described weeks where you see eight patients and bill nothing — that's triage, and it's solved before the appointment is made.
Weeks 5–13 · where 2.5 → 8 actually happens
Weeks 9–17 · make the JV optional
What it's worth
How much to trust each number. The JV figure is arithmetic from the terms you described — that's the one I'd bet on. The regen figure rests on an assumed ~7/mo baseline, because you gave me a best month and a worst month but not an average; if your real average is 10 the upside shrinks, if it's 4 it grows. Reactivation uses an illustrative cohort your patient list will correct in an afternoon.
I've deliberately not sized after-hours capture, series completion or referral asks, because you don't measure them yet and I'm not inventing a figure to make a page look better. Phase 0 makes all three measurable in two weeks. In the meantime, the threshold: one recovered regen patient at $7,700 pays for 2.2 months of the retainer.
Investment
Phase 0 — Scoreboard Sprint
$4,500
One-time · 3 weeks · no commitment
Attribution, call tracking, the dashboard, capture on your own domain, ad-compliance review, and the one-page JV brief — in your hands before the CEO meeting.
Credited in full against the build fee if you continue within 30 days. If it doesn't change how that meeting goes, stop there.
Growth System
$8,500 + $3,500/mo
Phases 1 & 2 · 6-month term · ~8-week build
Capture, response, routing, booking, conversion and retention — plus ongoing management, optimization and monthly reporting.
Voice layer priced assuming we integrate Preside. If you'd rather we build it: add $1,000 build / $500 per month.
90-day check-in. At day 90 we sit down with the numbers. If the system isn't earning its fee, you can walk for the back half — no penalty, no argument.
Practice OS
$12,500 + $5,500/mo
Phases 1–3 · 6-month term · ~17-week build
Adds the referral partner engine and BD enablement, reputation strategy, quarterly business reviews, and the JV reporting pack maintained monthly.
Optional: we assume paid channels — only if and when you want to consolidate vendors.
Same 90-day check-in. Day 90, numbers on the table, and you decide whether the back half is worth it.
One additional surgical case a month pays for the retainer.
You're paid $4,000 a case on your current JV terms. The Growth System retainer is $3,500. Not five and a half more cases — one, and it covers the whole thing with change left over. Put differently: one regen patient every three weeks, or about 6% of the $59,000 a month the contract reset is worth.
Where I fit alongside what you already have
| Vendor | Owns | What changes |
|---|---|---|
| Meta vendor | Paid demand | Keep. 15 leads in 36 hours. We hand him attribution so he optimizes on converted patients, not form fills. |
| AEO vendor | Answer-engine visibility | Keep — and it matters more than you knew, since paid search is closed to regen. |
| Social firm | Organic + boosted | Keep. We measure what it produces. |
| Rater8 | Review requests | Keep. We add the referral ask to the same flow. |
| Preside | AI voice | Integrate, not replace. |
| Gridlock | Map Pack | Decide on data. Phase 0 shows you exactly what they produce. |
| JV marketing | Google Ads, forms, phone, EMR | We route around every asset they control rather than fight for it — and build the evidence that changes the conversation. |
| OSG | Everything between the click and the bank | Nobody owns this today. It's where your money is going. |
Timeline
| When | What |
|---|---|
| Today | We walk this plan. You pick a starting point. |
| Kickoff | 30 minutes with your front-desk team. DrChrono API access validated. |
| Week 1 | 404 dead. Capture live on your domain. Tracked numbers deployed. |
| Week 2 | Dashboard live. Attribution running on every channel. |
| Week 3 | JV performance brief in your hands — and before your CEO meeting, whenever you set it. |
| Weeks 3–7 | Phase 1 — 24/7 capture, response, routing, booking. |
| Weeks 5–13 | Phase 2 — conversion track, PA lane, series recall, reactivation. |
| Weeks 9–17 | Phase 3, if selected — referral engine, partner CRM, reputation. |
Everything here is counted from kickoff, not from today. I'd rather commit to a sequence I can hold than a calendar I can't — you've been given enough dates that didn't happen.
What I need from you
Pick a starting point
There's a fourth: take this plan and run it yourself. It's yours either way, and I'd still send you the ad-copy review.
Build the scoreboard
$4,500 · one-time · start Monday
Attribution, tracked numbers, capture on your own domain, the dashboard, the ad-compliance review — and the one-page JV brief in your hands before you sit down with their CEO. Credited in full if you continue. If it doesn't change that meeting, we stop.
Scoreboard and the build together
$8,500 + $3,500/mo · 6-month term · Phase 0 credited
Same three-week sprint, but capture and response work start in parallel instead of waiting for it to finish. Roughly three weeks faster to a phone line that answers at 6pm on a Thursday.
Not yet
Free · no commitment
Send me your Meta vendor's live ad copy — I'll review it against the policy and send you the specific lines at no charge either way. Take this plan and run it with your own team. You've built something good here, and most of what's on this page is fixable by people you already pay. If you'd like a hand with any of it later, I'm around.
If you're not sure: take A. It's three weeks, it's credited back, and it's the only thing on this page with a deadline that belongs to you rather than to me.
Whichever one you pick — thirty minutes with whoever runs your front desk. They're in the office right now. Can we get it on the calendar before we hang up?