01 —
Fractional Operations Leadership

You know what needs to get done.
You just don't have the bandwidth.

Leadership teams are often managing physician relationships, staffing gaps, compliance needs, financial pressure, and growth priorities at the same time. The operational reviews, workflow improvements, and stalled initiatives that belong on the priority list keep getting deferred. H. Douglas Advisory partners with existing leadership to create additional executive operating capacity. That may include structured assessments, workflow reviews, implementation oversight, project recovery, operating cadence, multi-site governance, or support translating priorities into action across the organization.

This engagement is designed for platforms and practices that need experienced operational leadership without adding a full-time executive role. The scope can flex around what is actually needed, from COO-adjacent support to project oversight, leadership cadence, integration support, or multi-site operating discipline.

02 —
Diligence, Integration & Stabilization

Pre-close clarity.
Post-close momentum.

PE-backed healthcare moves quickly. Whether you are evaluating a physician group, nearing close, or working through the first months after acquisition, operational credibility matters. Pre-close, H. Douglas Advisory provides practical assessment of physician group structure, workforce risk, revenue cycle visibility, leadership depth, operational complexity, and integration readiness. The signals that create post-close problems rarely show up clearly in a model. They surface in workflows, staffing patterns, provider alignment, systems, handoffs, and day-to-day execution.

Post-close, I work alongside local leadership as an operational partner. That may include leading cadence, reviewing performance, identifying early risks, and helping stabilize the organization while the longer-term plan comes into focus. This is not theoretical deal support. It is operator-led diligence and transition support from someone who has been on both the practice side and the platform side.

"Every engagement is a partnership. I work alongside your leadership, not around them. The goal is to get through the hard part together and leave the operation stronger for it."
Douglas Hemminger  ·  H. Douglas Advisory
03 —
Interim & Project Leadership

You need an operator who can start Monday,
not after six weeks of onboarding.

Leadership teams often face two different problems that look similar. A project has already been identified, but no one has the bandwidth to drive it. Or something feels off, but no one has had the time to diagnose it properly. For defined initiatives, I step in at the leadership level to help move the work forward: implementation, integration, workforce restructuring, operational buildouts, and stalled project recovery.

For less defined situations, I help clarify the issue through structured assessment, team interviews, KPI review, and leadership alignment. The result is a clearer view of what needs to happen, in what order, and who needs to own it. For healthcare organizations, technology companies, investment firms, and recruitment partners, the value is practical credibility. Not another framework. An operator who has sat across from CEOs, COOs, CFOs, physicians, and frontline leaders.

04 —
Team Performance & Adoption

The right process means nothing
if the team does not run it.

Many operational failures in healthcare are not design failures. The workflow may be right. The policy may be correct. The training may have happened once. But without buy-in, reinforcement, and hands-on support, change rarely sticks. I help close the gap between the way work is supposed to happen and the way it actually happens, assessing workflows, identifying where execution is breaking down, and working directly with supervisors and frontline teams to improve adoption, accountability, and day-to-day performance.

The retention connection is real. Undertrained staff leave. New team members arrive without context. Institutional knowledge walks out the door, and the cycle starts again. Investing in the people already in the room is often more effective than repeatedly replacing them.

05 —
Assessment Sprint

You have not had time for it.
That is exactly why this exists.

You may already know something needs attention. Your team may know it too. But between daily operations, physician alignment, staffing pressure, board updates, and performance expectations, the deeper operational review keeps getting deferred. This is a fixed-scope engagement built to create clarity quickly. I interview leadership and frontline teams separately, because the gap between those conversations is often where the real operating picture lives.

I review KPIs, listen for operational patterns, compare what the data shows against what people are experiencing, and deliver a prioritized plan that can be used with your board, investors, leadership team, or internal operators. No long-term commitment. No unnecessary disruption. A focused sprint with a clear deliverable and a practical path forward.

06 —
Flexible Advisory Support

Not every need arrives
in a recognizable shape.

Some of the most useful work does not begin with a formal scope. A board presentation needs operator credibility behind it. A leadership team needs a grounded sounding board. A decision needs to be pressure tested before it becomes a project. This engagement creates room for that kind of support. You bring the situation — whether it is a specific question, an upcoming decision, an early conversation, or a gap you cannot quite name, and I help define what useful looks like and shape the engagement around it.

Flexible advisory support is available to existing clients and to organizations exploring whether there is a fit. If the need is not fully formed yet, that may be the right reason to start the conversation.

Built for the teams responsible
for healthcare growth.

Primary
PE-Backed Healthcare Platforms
SVPs, COOs, and operations leaders navigating integration, leadership transition, performance improvement, or operational buildouts across specialty and multi-site platforms.
Primary
Private Equity Firms
Healthcare investors evaluating physician groups or platform assets who need practical operating insight into leadership depth, workforce risk, revenue cycle exposure, integration readiness, and scalability.
Selective
Healthcare Vendors, Recruiters & Investors
Technology companies, recruitment partners, and investment teams that need credible operator perspective from someone who has led inside the healthcare organizations they serve.

Start a Conversation

Not sure which engagement fits?
That's what the first call is for.

If you're not ready to commit to a longer engagement, the Assessment Sprint is built for exactly that. Thirty or sixty days, fully remote, with a clear deliverable at the end. Most clients know what they need after that conversation.

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