Case Study

Paragon Podiatry

Dr. Ernest Isaacson

The Challenge

Dr. Ernest Isaacson sought a new accounting team after expanding his podiatry practice to multiple locations with associate doctors serving patients in each location. He bought the new practice just before COVID started and the revenue dropped by 60% as a result of the pandemic.

He needed to continue operations in order not to lose his investments and ensure that each practice was profitable so it could continue to serve the benefit of his staff, his patients, and the overall business.


Goals & Needs

  • To not to be involved in the daily finances, so he could focus on patient care. instead
  • Better visability into each of the practices and control of the finances
  • Reduce interest costs due to inefficient debt structure
  • Operate a new practice profitably during the pandemic
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"This is a team that does not get phased. The word 'No' doesn't exist. Nothing is impossible. Anything can be done."

~ Dr. Ernest Isaacson


After looking at tax returns from previous years we were able to get a basic business picture and make some recommendations that would make significant positive change to the practice's bottom line.

We were able to provide direction and structure to Dr. Isaacson as he opened a new location, as well as help him reduce his taxes, and obtain federal COVID relief grants and loans on his behalf without any effort on his part.

Actions we took

  • 1

    External Setup

    We helped him hire an outside bookkeeper to ensure all the vendor bills were paid, bills were tracked to the proper location, to ensure purchases and services were as cost-effective as possible, and monitor the usage of supplies.

  • 2

    Internal Setup

    We provided each practice manager with a uniquely designed worksheet to estimate daily revenue for each associate doctor and for each facility. This allowed them to monitor whether a doctor was profitable for the practice or a net cost.

    We could compare doctors in different locations and if one seemed to be underperforming we could determine whether it was because of the location deficiency or a bad fit personal issue.

    We were also able to work with the marketing team to target more profitable patients.

  • 3

    Reduced Interest Costs

    We took a deep look at all debt and the interest rates associated (including tax debt). After looking at all financial options available, we advised on how to restructure all of the debt. The result was a significant interest costs reduction.

  • 4

    COVID Relief

    To ensure that we get through this pandemic with the least damage possible, we kept Dr. Isaacson informed about all COVID relief options available throughout the pandemic and applied for any applicable federal, state, or local government help that was available. 

dr ernest isaacson

"You can't have an accountant that's reactive. You need somebody that's proactive. And you need someone that's going to look at your big picture and say 'This is what you need to do, and this is how you need to structure things."

Dr. Ernest Isaacson
Paragon Podiatry – New York, NY


We were able to take things off of Dr. Ernest Isaacson's plate so he could focus on helping his patients and enjoy family time, while still having a clear picture of what's going on in his practices. The new practice not only reached the prior owner's revenue levels, but increase it by an additional 80%.

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