Business Advisory & Formation | SDR Consulting Inc.

Q: What does the growth advisory work actually involve?

Forward-looking work rather than historical reporting: cash-flow modeling, a budget you can actually run the practice against, owner pay planning, pricing and caseload scenarios, and modeling what a new hire or a second location does to your numbers before you commit to it. It suits practices at the point where decisions have started to be expensive.

Q: I want to add clinicians. What do I need in place first?

Current books so you can see what capacity actually costs, a clear decision on whether they are W-2 or contractor, a payroll system ready before the first payment, and a model of what the hire does to cash flow in the months before they are fully booked. Growth failures in practices are rarely about demand. They are about hiring into a cost structure nobody modeled.

A small team collaborating around a laptop while planning a new practice — **Advice while it's reversible**Not a diagnosis on next year's return

Why this exists

Most costly practice decisions are made without a CPA in the room

You formed an LLC because a blog post said to. You signed a three-year lease before you modeled what it does to cash flow in a slow August. You brought on an associate at a split that made sense until you worked out what it costs after payroll taxes.

None of that is negligence. It is what happens when the person who understands the tax and cash-flow consequences only sees the decision months later, as a line on a return.

Advisory work moves that conversation forward in time. Before you file the entity. Before you sign. Before you hire. It is the least glamorous service on this site and frequently the one that changes the most, because a structural decision compounds every year you keep it.

And where the question is genuinely legal rather than financial (a partnership agreement, a licensure issue, a dispute) you will be told to call an attorney rather than sold something adjacent.

What's included

Everything under advisory & formation

From the first filing to the point where the practice is big enough to need a finance function it cannot yet afford to hire.

Business formation & entity structuringLLC, PLLC, professional corporation or corporation, formed in the right state, in the right order, with the EIN and elections filed to match. Many states require licensed clinicians to use a professional entity.

Entity selection & tax structuringLegal structure and tax treatment are two different decisions. We model both against your profit, your state and your plans, including whether and when an S corporation election makes sense.

Business startup supportEIN, business bank account, bookkeeping from transaction one, payment processing, state registrations and the order to do them in so nothing has to be redone.

Healthcare consultingMedical practices, clinics and hospital groups, revenue cycle economics, provider compensation models, entity structure across multiple providers and the accounting behind them.

Growth & financial advisoryCash-flow modeling, an operating budget, owner pay planning, pricing and caseload scenarios, and the monthly discipline of comparing what happened to what you expected.

Growth & scaling advisoryAdding clinicians, rooms, locations, a second entity or a group model, modeled before you commit, including what it does to payroll, occupancy and your own take-home.

SDR Consulting provides accounting, tax and business advisory services. We are not a law firm and do not provide legal advice, for operating agreements, partnership terms, employment contracts and licensure matters you will be pointed to an attorney.

Who this is for

Anyone standing in front of a decision they cannot easily undo

Advisory work is most valuable at transitions, the moment before something changes shape. If you are in one of these, this is the service.

Clinicians leaving agency work Opening a first private practice Solo practices becoming group practices Partners forming a practice together Medical practices & clinics Owners considering a second location Practices adding courses or programs Early-stage startups outside healthcare

How it works

Three steps to a structure that holds up

01

Understand the practice you're building

Not just what you do, but where you want it in three years. Solo and staying solo is a different structure from a group practice with six clinicians and a second location, and it is cheaper to build for the second one now.

02

Model the options

Entity type, tax election, owner compensation and the cost of compliance in your state, compared side by side on your numbers rather than on a general rule you read somewhere.

03

Implement and revisit

Filings made, accounts opened, bookkeeping started, elections filed on time. Then revisited as the practice grows, because the right structure at $80,000 of profit is not always the right structure at $200,000.

Start smaller if you'd rather

Business & Tax Consultations

Not every structural question needs an engagement. If you are weighing one decision (which entity, whether to hire, whether to open the second location, how to structure a partner buy-in) book a single paid session and get a straight answer from a CPA who has seen the version of this that went badly.

Starting at $75 for one clear question
Longer sessions when the decision has moving parts

See consultation options

How a session runs

Submit intake formStep 1

Receive payment linkStep 2

Scheduling link1–2 days

Session heldTue–Thu

Consultations are available Tuesday through Thursday, 11:00 AM – 2:00 PM ET.

Questions, answered

Advisory & formation, specifically

LLC, PLLC, S corporation or sole proprietor, which do I need?

Two separate questions get confused here. The first is legal structure (sole proprietor, LLC, PLLC or corporation) and many states require licensed clinicians to use a PLLC or professional corporation rather than a standard LLC. The second is tax treatment, which is elected separately: an LLC can be taxed as a sole proprietorship, a partnership or an S corporation. We pick the legal structure your state allows for your license, then model the tax election against your actual profit. The S Corp Strategy Report exists precisely for that second question.

Should I form the entity before I see my first client?

Ideally yes, because the order matters. Entity first, then EIN, then a dedicated business bank account, then bookkeeping, then payment processing and your EHR. Doing it in that order avoids months of personal and business money mixed in a single account, which is the most common thing we have to untangle in a first clean-up, and it is not a cheap way to save money on formation.

Do you actually file the formation paperwork?

We handle the formation and structuring work and coordinate the filings, EIN application and tax elections so the pieces line up and nothing is filed in the wrong order. Where a matter is genuinely legal rather than tax (operating agreements between partners, buy-sell terms, employment contracts, licensure questions) you will be told plainly that you need an attorney. That is a feature, not a limitation.

What does the growth advisory work actually involve?

Forward-looking work rather than historical reporting. Cash-flow modeling, a budget you can genuinely run the practice against, owner pay planning, pricing and caseload scenarios, and modeling what a new hire or a second location does to your numbers before you commit. It suits practices at the stage where decisions have started to be expensive but a full-time finance hire is still years away.

I want to add clinicians. What do I need in place first?

Current books, so you can see what capacity actually costs. A clear decision on whether they are W-2 or contractor, see Payroll & Retirement for why that matters more than it looks. A payroll system ready before the first payment rather than after. And a model of what the hire does to cash flow during the months before they are fully booked. Growth problems in practices are rarely about demand; they are about hiring into a cost structure nobody modeled.

Get the structure right before it gets expensive