Straight answers,
before we talk.

What is a fractional COO?

A chief operating officer working part-time and embedded in your business, at a fraction of a full-time executive's cost. Same seat, same decisions, less time. Under a few million in revenue a full-time COO usually isn't justifiable — but the work still has to be done by someone, and right now that someone is you.

What does a fractional COO do for a clinician-owned practice?

Builds and runs the operational layer — the work a practice operations consultant does, but owned rather than advised. Systems, workflows, SOPs, decision rights, staffing structure, and the daily decisions that currently route back through the owner. Not clinical decisions. Not marketing campaigns. The structure underneath both.

How is this different from a consultant or a business coach?

A consultant hands you a slide deck and leaves. A coach works on your mindset. I'm embedded in the operation, building and running the systems alongside your team. It's structural, not motivational — and I'm in it, not advising from outside it.

Is this practice operations consulting or a fractional COO engagement?

Both, depending on where you are. The Thrive Operating Review and the work that follows it are practice operations consulting — diagnosing how the business actually runs and building what's missing. A fractional COO engagement is ongoing, and the difference is who owns execution: a consultant recommends and helps implement; a fractional COO is accountable for the operation performing. Most practices start with the Review and decide from there.

Who is behind Thrive?

Natalie Mason, Founder and CEO — an operator before she was an advisor. She co-owned and operated a multi-service clinician-owned practice spanning behavioral health, MedSpa, concierge mobile wound care, and recovery and longevity, building the wound care and MedSpa service lines from the ground up. Before founding Thrive, she spent years inside Fortune 500 operations, learning how world-class systems actually run. That combination is the point. Most consultants advising clinician-owned practices have never run one.

What kind of practices do you work with?

Clinician-owned concierge, MedSpa, and specialty practices that are already open and seeing patients — from a solo owner about to bring on a first clinician to a small group with up to three locations and roughly $250K–$2M in revenue. Cash-pay, membership, hybrid, or insurance. Also community wellness operators with institutional backing.

When does a practice actually need this?

When it has outgrown the way it's being run. The usual signs: revenue is fine but margin isn't, billing is chaotic, nothing is documented, good staff keep leaving, and nothing moves unless you touch it. Or earlier — when you're about to add your first clinician and everything still runs through you.

Do you work with practices outside Georgia?

Yes. Thrive is based in Georgia and works remotely by default, with engagements across multiple states. On-site work is available; travel is billed separately.

What do I need in place before hiring my first clinician?

At minimum: a written definition of what the role owns and what stays with you, clinical SOPs for the service line they'll run, an onboarding and credentialing checklist finished before their first patient, and a way to record their revenue separately at the point of sale. If they're paid on a split, add written split mechanics. Building that set is what The Thrive Operating Foundation does.

I'm adding a nurse practitioner to my solo practice. Where do I start?

Before their first patient, not after. Decide what they own and what stays with you, write the clinical SOPs for the service line they'll run, finish credentialing and onboarding, and settle how their pay is calculated — salary, or a split of what they bring in. If they're joining as a contractor, whether that classification holds is a question for your attorney. Building that structure is what The Thrive Operating Foundation does.

Do I need SOPs before I hire?

For the service line the new clinician will run, yes. Without them, the protocol is whatever you said out loud in week one. The minimum set: clinical protocol, patient intake for that line, supply and inventory handling, documentation and charting, and escalation and adverse events.

How do I structure a revenue split with a contracted provider?

Settle four things in writing before their first patient: what counts as revenue, how the percentage is calculated, when it's paid, and who reconciles it. Whether a percentage-based split is permitted for your practice type and state is a question for your attorney, not an operations one. Ask it before the number is set.

How do I track revenue by service line?

At the point of sale, not after. Each service is mapped to its line in your EHR or payment system, so every transaction is recorded under the right line when it's taken. Reconstructing it later from bank deposits is slower and less exact.

How does an engagement start?

With The Thrive Operating Review for most practices — a six-week operational and revenue diagnostic. I don't quote ongoing work before I understand the operation, so the Review is the front door. Everything after it gets scoped from what it finds.

A solo practice about to bring on its first clinician starts one step earlier, with The Thrive Operating Foundation — a three-week build of the operating structure a practice grows on. There's no operation to diagnose yet. There's one to build.

How fast will I see results?

The Review runs six weeks — two of discovery, two of analysis, two of delivery. You finish with a prioritized plan carrying owners and dates. I won't promise a specific outcome by a specific date, because every practice is different, but that's the rhythm.

What does it cost?

Engagements are fixed-fee and scoped to your practice — never billed hourly. What moves the number: how many locations, how many providers, how many distinct service lines, and how many outside parties (biller, bookkeeper, compliance) need coordinating. You'll get a real number scoped to your operation on the discovery call, rather than a range guessed before I understand it.

Can't I just hire someone in-house?

You could, and some owners should. It's a bigger, slower commitment — you'd be building the systems and hiring the person to run them at the same time. I already know how to build this, so it moves faster and costs less than a full-time hire while you work out whether the fit is right.

Do you access patient records?

No. Thrive does not access or handle protected health information. Operational review covers process and workflow only, and any reporting is aggregate and de-identified. PHI stays entirely inside your systems.

What if it isn't working?

Retainers are month-to-month with 30 days' notice and no minimum term. That's deliberate — I'd rather a client stay because it's working than because they're locked in.