Fractional COO & CEO
An operator in the seat — not advice from the sidelines.
Fractional COO and CEO engagements for cash-based medical and wellness businesses. We take real operating responsibility — building the systems, running the team, and owning the numbers — so the business runs like a national company before it is one.
Sound Familiar?
The signs you need an operator, not another advisor.
You can't step away for a week without revenue dipping — the business runs on you, not on systems.
Turnover resets training to zero every few months, because the training lives in people's heads instead of a documented system.
You can't pull your booking rate, show rate, or close rate at the click of a button — the software stack can't show you the business.
You've had consultants before. You got a deck. Nothing changed, because nobody owned the execution.
Every location runs a little differently — and opening the next one means rebuilding everything again.
Ownership is stuck in daily operations when it should be working on growth, the next location, or the exit.
These aren't effort problems. They're structure problems — and structure is what an operator installs.
Every engagement moves five numbers
How We Work Together
Every engagement starts with the audit. Then you choose the depth.
Nothing gets rebuilt until we understand what's actually happening. The audit is a full 360° review — the funnel end to end, operations, financials, vendors, marketing, technology, staff interviews, and the client experience, including unannounced mystery shops of your locations and your competitors. It ends in a written findings document: every finding paired with a recommendation, prioritized into an action plan we attack through the course of the engagement.
Advisory & Consulting
We guide — your team executesWe audit the business, hand you the findings and the plan, and work alongside you while your team executes it. Best for owners with a strong team who need the playbook and a coach. This is the engagement covered on our consulting page.
Fractional COO — The Operations Build
Agreed cadence of onsite + remoteOperations only: we build and install the complete operating system.
- Full training system with train-the-trainer handoff
- Documented call, lead & patient flow charts
- Sales scripts, consultation frameworks, SOPs & operating controls
- CRM conversion, call tracking & a live KPI dashboard
- Rollout with the reporting rhythm that keeps it all in place
Revenue strategy, financial management, and growth planning stay with you.
Fractional CEO / COO — The Full Operating Engagement
Day-to-day operating authorityThe whole business, end to end — everything in the operations build, plus we assume day-to-day operations with defined authority:
- P&L discipline, vendor negotiation & recurring-revenue rebuild
- Medical operations workflows with your medical director
- HR structure & org design built to scale
- Marketing measurement — CAC down, LTV up — & new profit centers
- New-location launch & the structure for national growth
Built so ownership can step out of daily operations entirely and focus on growth.
How engagements run
- Audit first, then attack the plan — the full 360° audit produces the action list, and we work through it item by item for the course of the engagement
- We go onsite — the audit and the build happen in your building, not over a video call. After that: a standing weekly call, a written weekly update, and onsite as the work demands
- Short minimum engagements — no long lock-in, with longer contracts available if you prefer the stability
- Defined authority in writing — direct reports, decision rights, and scope agreed before we start
- Training, two ways — a custom training system built on your model, or our proven system — refined over 20 years and a national exit — installed under license, scoped separately
- Built to be handed over — train-the-trainer certifies someone internal to run the system after we're gone
- Recruiting for key roles — providers, front desk, and management — scoped separately
- Specialist network — CTO, video and creative team, marketing agencies, and senior operators — direct introductions, scoped separately
- Your people, our processes — we never force our vendors or our people on you. Your existing team running our systems is a perfectly good outcome
What Gets Built
The work that gets installed.
Not a strategy deck — the actual assets your business runs on, documented, built to a national standard, and turned over to your team. The point: opening location twelve requires no rebuild.
Operations & Structure
- Org chart built for national scale
- Documented call, lead & patient flow charts
- SOPs, new-hire checklists & operating controls
- Clinical & safety protocol documentation
- HR structure: onboarding, comp, review cadence
- New-location launch sequence
Sales, Training & Team
- Sales scripts & consultation frameworks
- Phone & booking scripts with lead-handling discipline
- Complete custom training system
- Train-the-trainer certification for your staff
- Consultation scorecards & recurring audits
- Staff assessment against what each role requires at scale
Revenue, Tech & Growth
- CRM evaluation, conversion & implementation
- Call tracking & a live KPI dashboard
- Membership, pricing & recurring-revenue rebuild
- New profit centers & online store build
- Vendor agreement negotiation
- Marketing measurement: CAC down, LTV up
The Barton Method
A system for every number that matters.
Two decades designing operations, sales, and marketing systems — distilled into one method. We take every KPI, build the workflows, scripts, trainings, and follow-up around it, then inspect what we expect. When a number dips, the system shows the exact step that slipped — so you fix the step, not the symptom.
Measure
Audit every number that matters — per provider, per program, per visit. You can't fix what you don't track.
Systemize
Install the operating playbook: scripts, workflows, org structure, job descriptions, membership and pricing architecture.
Train
Your team learns the system — front desk to providers — with train-the-trainer handoff so it sticks after we leave.
Audit
Inspect what you expect. Ongoing accountability against the numbers, so slips get caught and fixed at the step.
What The Systems Produce
Numbers, not promises.
The Operator
Built it. Scaled it. Exited it.
I'm Will Barton. I founded Options Medical Weight Loss and built it as a true corporation — corporate-owned clinics, a home office, and the C-suite structure to run them — then franchised it on top of that, building the FDD and franchise system alongside legal counsel. It grew into one of the largest privately held medical weight loss companies in the U.S. before I exited to private equity.
That's why a fractional engagement with us isn't theory. I've sat in the corporate seat you're hiring for — and the systems I install are the same playbook that ran a national company, adapted to your business and handed to your team.
Read the full storyQuestions Owners Ask
Fractional leadership, answered straight.
What does "fractional" actually mean here?
You get a senior operator with defined authority inside your business, without hiring a full-time executive. The COO engagement runs on an agreed cadence of onsite and remote time; the full CEO/COO engagement is a heavily involved role with day-to-day operating control, including extended onsite time at the start to make sure the foundation is built correctly.
How do engagements start?
Always with the audit — a full 360° review of the funnel, operations, financials, vendors, marketing, technology, staff, and client experience, conducted onsite and virtually. It ends in a written findings document and a prioritized action plan, and everything after is built off it.
How long am I committing for?
Engagements run on short minimum terms with notice from either side — no forced long lock-in, because the work should earn its place every month. Longer contracts are available if you prefer the stability, and exact terms are put in writing before anything starts.
Do you build our training, or install yours?
Both are on the table. We can build a custom training system around your model, or install our own system — refined over 20 years and the same playbook that scaled a national company — under a separate license. The audit usually makes clear which one fits.
What happens when the engagement ends?
Your team keeps running the system. The training build ends in a train-the-trainer program that certifies someone internal to own it going forward, and every flow chart, script, and SOP is documented and licensed for use at the locations you own and operate.
Will you work with our existing team and software?
Yes — and we never force our people or vendors on you. Your people, our processes is a perfectly good outcome. The audit assesses every position and the full software stack first; where the stack can't show you the business at the click of a button, we manage the evaluation and conversion to one that can, end to end, including call tracking and a live KPI dashboard.
What don't you do?
Legal, accounting, and tax stay with your own counsel — and where the audit surfaces corporate-practice-of-medicine exposure, we scope the issue and bring in attorneys who specialize in it rather than offering an operator's opinion. We also only take on a few engagements at a time, by design.
What does it cost?
It depends on the level of engagement and the number of locations. Scope and rate are put in writing before anything starts — tell us about the business and we'll have that conversation directly.
Need an operator, not another opinion?
Request a consult
Tell us about your business and where it's stuck. If we're a fit, the first step is a conversation — and we only accept a few engagements at a time.