Your numbers feel scary and your marketing feels random for the same reason.
A practice owner tells their bookkeeper one thing every month: just get it done.
Not a request to see where things stand. Not a question about what to change.
That request is a sign there’s no target to measure against.
The pattern behind the avoidance
This shows up in call after call. One owner ran a profitable, growing business.
And still avoided opening the P&L for weeks at a time.
They’d never actually decided what the number needed to be. Profitable felt vague, so any number on the page could be read as a verdict instead of a checkpoint.
Without a target, every number is either good news or bad news. There’s no way to just use it.
If you run a physical therapy, occupational therapy, speech, or mental health practice, you’ve felt this. A P&L without a target attached is just a mirror. No wonder it’s uncomfortable to look at.
The same gap shows up in your marketing
Owners who avoid their numbers usually chase marketing tactics the same way.
A new platform, a new ad type, a new post format, whatever’s trending this quarter.
Without a defined target for what marketing actually needs to produce, every tactic looks equally promising and equally exhausting.
Depending on one channel, even a reliable one like referrals, carries real risk when that channel shifts, as a recent Harvard Business Review analysis of customer acquisition found. Owners without a target don’t notice the dependency until the channel already slowed down.
Chasing tactics and avoiding numbers are the same habit wearing different clothes. Both happen when there’s nothing specific to aim at.
Why a missing target feels like fear
People are wired to avoid a loss far harder than they’ll work for an equivalent gain, a finding confirmed at global scale in a 2019 replication of the original prospect theory research.
Without a target, every number defaults to a potential loss. There’s nothing to measure it against except a vague hope that it’s fine.
A target changes what the number means. Hit it or miss it, either way you know exactly where you stand, and that’s a different feeling entirely from opening a report with no idea what you’re looking for.
Setting the targets that change the behavior
Neither target has to be perfect on day one. It just has to exist somewhere other than your head, where you can actually check your decisions against it.
Pick the actual number, not a vague sense of one
Decide what profitable means in real dollars. What you need to pay yourself, what savings need to hit, what debt needs to shrink by.
A specific number turns the P&L into a checklist instead of a verdict.
Give your marketing one job to do
Pick a single result marketing has to produce this quarter, a number of new patients or a percentage of revenue from a second channel.
Everything that doesn’t serve that number gets ignored, no matter how trendy it looks.
Check both numbers on the same schedule
Review the financial target and the marketing target together, monthly, not once a year when it’s already too late to adjust.
Seeing them side by side keeps both honest.
Start with the target, not the number
Before you open the report or launch the next campaign, write down what you’re actually aiming for.
The number stops being scary once it has something to be measured against.
Freedom By Design, Season Two
This is exactly what came up in three recent conversations on Freedom By Design, our podcast, with Sean Healy, Joshua Brummel, and Chad Madden.
Season two is out now on Apple Podcasts, Spotify, and YouTube. These three conversations go deeper into what happens once you actually define the target you’ve been avoiding.
Partner Highlight: Prompt V10 Roadmap
Setting a clear target only works if the systems underneath it aren’t eating your time.
Prompt just released a look at where their V10 roadmap is headed, covering front office workflows, clinical documentation, revenue cycle management, and practice performance.
The theme lines up with everything above: less manual work, more of the revenue you’ve already earned actually collected, and more of your week back for the parts of the practice only you can do.
Watch the roadmap video here. Versions are available for PT and rehab therapy, pediatrics, and chiropractic.
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