Practice: Harvey & Thomas Orthodontics. Starting point: $4.5M annual pace across 3 locations. Result: $9.5M in production by year-end. Time elapsed: 9 months.
The Starting Point
When Dr. Carter Thomas and his partner came to us in early 2023, the math told a familiar story. The group had grown by adding locations, but each new office added complexity and overhead. Production was running at a $4.5 million annual pace across three locations. The team felt stretched. The schedule was uneven. New patient flow was healthy, but conversion was inconsistent. The doctors were working harder than ever for a number that wasn't moving.
On paper, this is the moment most multi-location practices stall. They've already "bought" all the easy growth by opening offices. The next dollar of growth has to come from a different lever entirely.
What Was Actually Broken
Three things, none of them obvious from the outside.
First, the consult system was different at each location. Different TC scripts, different financial presentations, different handoff between doctor and coordinator. Patients at one office were getting a different experience than patients at another. Acceptance rate varied by location and nobody was tracking the variance.
Second, the team was understaffed for the production they were trying to hit. Same-day starts were rare because there wasn't open chair time and the financial agreements weren't structured for in-room signing. Cases that said yes on Tuesday started in three weeks, and roughly 20 percent of them silently disappeared in between.
Third, the operational rhythm was monthly, not weekly. The leadership team looked at production at the end of each month and reacted to what had already happened. There was no Monday-morning KPI session, no weekly accountability, no real-time view of leads, exams, conversions, and same-day starts.
What We Changed
The fix was a full PARF® installation. Brand, marketing, conversion, and team. Most of the heavy lifting happened in the conversion and team pillars.
Over a single weekend in March 2023, Dr. Thomas and his partner hired more than ten new team members.
That sounds dramatic because it was. The decision came out of a clear-eyed look at where the bottleneck actually lived. They could not staff their way to $9 million by hiring one new person every six weeks. They had to commit to the production target, then build the team to match.
From there, we installed PARF® to the letter. We rebuilt the consult flow across all three locations so a patient at any office had the same experience. We trained the TCs on the same scripts, the same objection responses, and the same financial presentation. We tightened the schedule template so same-day banding became standard, not the exception. And we put a weekly KPI cadence in place so the leadership team could see the practice's vital signs every Monday morning.
The Numbers
Inside the first 90 days, case acceptance moved measurably across all three locations. Same-day starts climbed. The new team members got fully ramped by mid-summer.
By the end of December 2023, the practice had invoiced over $9.5 million. That is more than $5 million of growth in the nine months between the March hiring weekend and the year-end close.
- Starting pace: $4.5M annual production
- Final result: $9.5M+ in production for calendar year 2023
- Growth: $5M added in 9 months
- Locations: 3 (no new locations opened during this period)
- Headcount added: 10+ in a single weekend
What This Took From the Doctors
It was not painless. Both doctors had to rethink things they'd believed about how their practice should run. They had to give up some of the control they were used to holding personally. They had to trust new team members in roles that hadn't existed two months earlier. They had to invest financially before they had revenue to justify it.
What separated them from most owners I talk to was the speed of the decision and the discipline of the follow-through. They committed in March and they did not flinch when the early weeks felt expensive. By summer, the system was running. By fall, the cash flow had caught up. By year-end, the number had doubled.
What This Means for Your Practice
The Harvey & Thomas story is dramatic, but the underlying work is repeatable. The principles applied to a $4.5 million three-location practice apply just as cleanly to a $2 million single-office practice or a $15 million seven-location group.
The growth almost never lives in the marketing budget once a practice is past a certain size. It lives in the consult, the team, the schedule, and the operating cadence. That is true at every scale.
If you're producing somewhere between $1.5M and $20M and you've been stuck at the same number for over a year, the levers Dr. Thomas pulled are very likely sitting inside your practice too.
See If Your Practice Qualifies
See If Your Practice Qualifies