These five questions do not require a consultant. They do not require a framework walkthrough. They require honest answers: which, for most operators, is harder than it sounds. Read each question and give your actual answer, not the answer you wish were true.
One of these will make you stop. That one is your constraint.
Question 01
If you disappeared for 30 days, which part of your business would fail first?
If the answer is "everything" and your instinct says "quickly," you do not have a business. You have a job.[1]The entire operation runs on your presence, which means it cannot grow past your personal capacity. No amount of marketing spend, new patients, or better software will fix a business that is structurally dependent on one person's daily involvement. This is a leadership and organizational structure problem. It comes first because it prevents progress in every other area.
If your honest answer is "nothing would fail" and you have systems, a team, and documented processes. This is not your constraint. Move to the next question.
Question 02
Can you tell me right now what your best service line makes per patient, after the real cost of delivering it?
Not revenue. Margin. The real cost including clinician time, overhead allocation, administrative handling, and acquisition cost. If you have to say "I would need to look that up" or "it is probably around X," you are running the business on intuition instead of information. Every pricing decision, hiring decision, and growth investment you make is based on a number you do not actually have. That is a finance infrastructure problem.
If you have a unit economics model that is updated monthly and can answer this in 60 seconds. This is probably not your primary constraint.
Question 03
What is your 90-day patient or client retention rate, and how does that compare to what it was 12 months ago?
This question exposes the leak. Most practices that are stalling are not stalling because they cannot get patients in. They are stalling because patients leave too fast and the replacement treadmill never builds real revenue.[2] If you do not know your 90-day retention rate, you definitely have an acquisition problem: you are over-investing in acquisition to compensate for churn you are not measuring.
If your 90-day retention rate is above 65 percent and you track it monthly: move on. If it is below that or you do not know it, this is your constraint. More information is in Why Telehealth Clinics Are Still Leaving 40% of Revenue on the Table.
Question 04
Would your newest staff member describe your intake or onboarding process the same way your best staff member would?
Consistency is the operational standard.[3] If the answer is no, or if you genuinely do not know. The business is producing inconsistent patient or client experiences, which means quality is determined by who shows up that day, not by what the business has built. Inconsistency at the intake and onboarding stage predicts higher early churn, more complaints, and a patient experience that your best staff can never fully rescue.
If you have documented SOPs, a training system, and quality assurance that produces consistent experiences regardless of who delivers them. This is not your primary constraint.
Question 05
If a new patient asked you to tell them exactly what they would get and what it would cost over the next six months, could you give them a clear, confident answer?
If you stumbled reading that question, your offer is not structured.[3] An offer that cannot be explained in one clean answer is an offer that does not have a clear value proposition. Patients do not buy vague. They buy specific outcomes with a clear price and a clear path. If your practice is described primarily in terms of what sessions cost rather than what patients achieve, you are competing on price in a market where you do not want to compete on price.
If you can answer this in one confident sentence and your close rate reflects that. This is not your constraint.
If you answered honestly and one of these made you stop, that is your constraint. Not all five. One. That is where the work starts. Everything else is noise until that one is solved.
The Force Multiplier Diagnostic maps these five areas in your specific business and gives you the sequence. Not just the diagnosis.
SOURCES
[1] Gallup, “State of the American Workplace Report,” 2024, https://www.gallup.com/workplace/349484/state-of-the-global-workplace.aspx
[2] McKinsey & Company, “Organizing for the Future: Operational Resilience in Small Businesses,” 2024, https://www.mckinsey.com/capabilities/operations/our-insights
[3] Bain & Company, “Founder-Led Growth: Diagnosing the Constraint,” 2025, https://www.bain.com/insights/founder-led-growth
Brice M. Horrigan
Verified ExpertFounder, NOiC | Force Multiplier Practitioner
Brice M. Horrigan has diagnosed and scaled owner-operated businesses and healthcare practices across the United States. He built the Force Multiplier Framework from operator experience, not theory.