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Keystone Practice
For group practices

Which of your clinicians actually make money?

Your P&L tells you the practice made money. It can’t tell you which clinicians did. Keystone scores each one after pay, and the answer catches many owners off guard: your top biller often isn’t your top contributor. About five minutes, rough numbers are fine.

Get your Sunday-night spreadsheet time back.

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Free. No signup. The free read runs in your browser.

No patient data, everNothing clinical leaves your deviceNo integration to set up
What you see

The per-clinician numbers your EHR won’t show you

Who actually contributes
Every clinician scored after pay, fully loaded.
Model the hard calls
Comp, the next hire, owner pay: change a number and watch both sides of the ledger move before you commit.
Check the work
Built for practices your size by people who ran one. Every figure shows where it came from.

How we measure it, written out: the Keystone Standard →

Where this fits

A layer on top, nothing to rip out.

Your EHR
Scheduling, utilization, billing.
Keystone: tells you whether each clinician is profitable after pay.
Your bookkeeper
What happened to the whole practice.
Keystone: breaks it down by clinician and points at what to do next.
A fractional CFO
Does this well, on a recurring monthly retainer.
Keystone: gives you the per-clinician read for a one-time $79.
How it’s priced

Free to see the shape. $79 to make it exact.

Free Snapshot
Rough hand-entry, no signup. You see the per-clinician reversal and your own effective rate.
Full Snapshot: $79 once
Your real books, exact and saved: break-even, what the practice nets, who needs a closer look. One-time, no subscription.

The full Snapshot is built and working. Payments just aren’t open yet.

Want this on your own numbers?

We’re not open yet. Leave an email and we’ll send one message when we are. Joining now is first claim on one of the 25 charter seats: the ongoing monthly review of your practice’s numbers, $290 a year, locked in for as long as your subscription runs without a break. No newsletter, no drip sequence.

Less than a single hour of a fractional CFO, and yours to keep. Where it’s going next →

From the blog

More for your group practice

June 11, 2026
Why your P&L can't tell you if a clinician is making money
Your P&L shows whether the practice made money, not whether each clinician does. Here's the per-clinician number it hides, and how to find it.
June 25, 2026
What a clinician actually costs you
Pay is only half of it. Payroll taxes, benefits, supervision, and admin time decide whether a clinician makes money. How to run the real number.
July 9, 2026
Three ways to pay a clinician (and how to pick)
Three ways to pay a clinician, and how to pick. The right model depends on their rate, how full their schedule is, and the behavior the plan rewards. A plain-English guide for owners.
July 10, 2026
The one number every practice owner should know, and how to find it
Most practice owners track revenue and some sense of expenses. Few can name the single number that tells them whether the practice is actually working for them. This is how to find it.
July 10, 2026
Why your books don't show you whether each clinician is profitable
Standard bookkeeping adds everyone together. The per-clinician number, the one that tells you whether each seat is actually earning its place, is never in your P&L, your EHR, or your accounting software. Here is what it misses and how to find it.
July 10, 2026
Owner pay is not profit, and treating them as one number costs you
When the money you take home and the money the practice earns are the same line, you can't tell a healthy practice from one that's quietly underpaying you. Lesson 2 separates the two.
July 10, 2026
Your real rate is lower than the number on your fee schedule
The fee you charge and the rate you actually earn per scheduled hour are two different numbers. The gap is no-shows, cancellations, and late reschedules. Lesson 3 shows you the real one.
July 10, 2026
Fully-loaded net per clinician: the number that decides who you build around
In a group practice, the number that drives almost every staffing decision is what each clinician nets after their full cost. Lesson 4 shows you how to find it.
July 10, 2026
Cash runway: how long your practice can keep its promises
Profit is whether the practice earns. Runway is how long it can keep paying people if the money stopped tomorrow. They're different numbers, and the second one is the one that keeps owners up at night. Lesson 5.

See it on your own practice.

About five minutes. Rough numbers are fine. Free.

See your numbers free →View a sample first

Running solo? Start with the solo version →