Product
The five numbers to check every month in your practice
What to measure to know whether your practice is healthy beyond revenue: retention, no-shows, client sources, value per client, and real workload.
Most practices measure one thing: how much was billed this month. It is the most visible number and the worst at explaining what is happening, because it arrives late and does not distinguish a good month from one where packages sold three months ago were collected. These five indicators give a fairly complete picture and take under half an hour to calculate.
1. Active clients
How many people you have seen in the last ninety days. Not how many are in your database: how many are alive as a care relationship. It is the number that best predicts your revenue over the coming months, and almost nobody has it to hand.
2. Retention at the second and fourth visit
Of the clients who had a first visit three months ago, how many came back a second time, and how many reached a fourth. Two percentages telling different stories:
- The drop between first and second visit is about expectation: what the client thought they would get versus what they got.
- The drop between second and fourth is about method: whether the plan is sustainable and whether follow-up adds anything.
The distinction matters because the fixes are opposite. If you lose people after the first visit, the problem is how you sell and what you promise; if you lose them by the fourth, it is how you work.
3. No-show rate
Appointments missed without notice, over total appointments booked. It is the indicator with the most direct link between action and result: automatic reminders and upfront payment move it measurably within weeks.
Look at it separating first visits from follow-ups. They usually behave very differently, and mixing them hides the real problem.
4. Where new clients came from
Where each person who had a first visit this month came from: referral, social media, search, your own site, collaboration with another professional. It is the easiest data to collect — one question at the first visit — and the one that saves the most marketing decisions.
| What you see | What it usually means |
|---|---|
| Mostly referrals | A good quality signal, but slow growth that is hard to accelerate |
| Mostly one channel | Concentrated risk: if that channel drops, everything drops |
| Many enquiries, few first visits | The problem is conversion, not acquisition |
| You do not know where they come from | Any marketing spend will be blind |
5. Average value per client
How much a client brings in on average across their whole relationship with you, not what one session costs. Divide revenue over a period by the distinct clients seen in that period. It serves one concrete decision: how much you can afford to invest in acquiring a new one.
The sixth number, which is not a business one
Hours worked versus hours billed. This is the indicator that catches the problem no revenue metric reveals: a practice can grow in billing while deteriorating, if that growth rests on unpaid hours of messaging, reports, and plan adjustments outside sessions.
You do not need to time everything. One week of logging every three months gives a good enough estimate to know whether the ratio is heading the right way.
Setting it up without it becoming a job
- Pick a fixed day each month, always the same, and block half an hour.
- Start with two indicators, not six: active clients and second-visit retention.
- Record them in the same place every month, even a six-column spreadsheet.
- Do not decide anything on one month: wait for three points to see a trend.
- Add a new indicator only once the previous one is actually driving a decision.
Frequently asked questions
How many clients does this need to make sense?
Below twenty active clients, percentages become noise. In that case look at absolute numbers and quarterly trends rather than monthly rates.
What retention rate is good?
It depends so much on the type of practice and the market that comparing yourself to someone else’s number helps little. What is useful is comparing yourself to yourself three months ago.
How do I ask about source without sounding commercial?
Built into the first-visit form alongside contact details, it works well and nobody reads it as a marketing question.
Is adherence worth tracking as a business indicator?
It is a clinical indicator that ends up explaining retention, so yes — but look at it per client rather than as a practice average: the average hides exactly the cases you are losing.
About the author
Equipo Almendra
Editorial · Almendra
The Almendra editorial team brings together nutritionists, engineers, and product managers writing about how to run a modern nutrition practice.
Next step
Take clinical nutrition to the next level with Almendra
Design plans, manage clients, and automate follow-ups in a single platform.