Your Advocate in Practice
Mission and Margin
are not in conflict.
You went into healthcare to help people, serve your community, and build a life you're proud of. But today's healthcare landscape makes that harder every year, especially for the small practice owner. I'm here to change that.
Experience & Credentials
- Founder, Kynetex — Multi-State Chiropractic Practice Network
- Master's in Population Health Management — Johns Hopkins University
- Doctor of Chiropractic (DC)
- Private Equity Certificate — Wharton Online
- Faculty — Dominican University, Public Health & Kinesiology
- Board Certified — Neuromusculoskeletal Medicine (DIANM)
Who's advocating for you?
You became a healthcare professional to be a relentless advocate for your patients. You show up every day for them. But as a private practice owner, you carry a weight most people will never see or understand.
Insurance companies have their lobbyists. Hospital systems have their boards. Practice coaches serve their own narrow niches. But who is truly in the corner of the independent owner? We as healthcare providers need advocates who understand both the importance of the clinical world and the brutal reality of the business world.
I wrote Mission AND Margin and created the Seven Peaks of Practice Optimization to solve this exact tension. My team partners with you on this strategy that high-performing businesses use to thrive — without sacrificing their soul.
My team and I will be your advocate — providing the structural business and financial foundation, the Margin, you need so you can focus on your Mission: caring for your patients. Together, we can change the status quo of today's healthcare landscape and make a meaningful impact in our patients' lives.
Let's talk →The Foundation
Why I built this around a mission
Most healthcare providers are never taught how to run a business. They graduate with clinical excellence and a genuine desire to serve their communities — and then they spend the next decade working harder than anyone they know, with less financial security than they expected, and no clear path to building something lasting.
I've lived this. I built Kynetex from a single practice into a multi-state network. Through that journey I stayed deeply rooted in the communities I serve — embedding myself as a neighbor, giving back to the people who supported me, and never losing sight of who I was really there for: my patients, my neighbors, the people in my community. Despite the pressures the healthcare system placed on me, I refused to accept that financial success required abandoning my mission. I had to learn new skills, seek out the right people, and spend years developing a system that makes it possible to maintain financial security while staying true to why I became a provider in the first place.
The healthcare industry tells you that financial success requires compromise. That margin comes at the expense of mission. I've spent my career proving that's a false choice — and now I help other practice owners see and build that path for themselves.
"It's time to build the practice you envisioned — one that fulfills your mission and rewards your investment."— Dr. Michael Ingui
The Difference
Great leaders start with coaching.
We take it further.
Coaching is a powerful tool. A good coach helps you step back from the day-to-day, challenge your assumptions, and develop the ability to see your business through both an objective and a subjective lens. That skill — learning to hold both perspectives and make clear decisions from that vantage point — is foundational to leading any organization well.
But healthcare businesses carry layers of complexity that go well beyond what leadership development alone can address. Reimbursement structures, revenue cycle management, clinical operations, workforce dynamics, regulatory compliance, community trust — these aren't soft challenges. They require specific industry knowledge that most coaching frameworks simply weren't built to handle.
That's where advisory partnership is different. Working with me, you'll develop your leadership and strategic thinking — that's non-negotiable, and we work on it together. But we won't stop there. I'll partner with you across every dimension of your practice, bridging the knowledge gap between running a business and running a well-managed ambulatory care practice specifically.
Good leadership is critical. It's also just one of seven peaks a successful practice must climb. I developed the 7 Peaks framework from the best practices of some of the most successful healthcare businesses in the country — because I saw what happened when owners had great vision but weak systems, or strong financials but a broken team culture. Each peak matters. And when all seven work together as an ecosystem, the result is a practice that's not just successful today — it's valuable and sustainable for years to come.
This isn't motivational coaching. It's something more specific, more integrated, and more demanding — because your business deserves that.
Leadership Coaching
Develops the
Decision-Maker
A structured process for building self-awareness, strategic thinking, and the ability to view your business through both objective and subjective lenses.
The Common Ground
Advisory Partnership
Develops the Decision-Maker
AND the Business
Everything coaching provides — plus the healthcare-specific industry knowledge, frameworks, and hands-on partnership to build a thriving ambulatory care practice across all 7 Peaks.
Why Small Practices Can't Wait
The landscape has changed.
Most providers haven't adapted.
Independent healthcare practices are facing headwinds unlike anything the prior generation dealt with. The practices that survive — and thrive — will be the ones that operate like businesses, not just clinical offices.
Reimbursement Compression
Insurance reimbursements have stagnated or declined while overhead costs have climbed. The margin squeeze is structural, not temporary. Practices that don't proactively diversify revenue models are watching profitability erode each year — often without realizing it.
The Consolidation Threat
Private equity and large health systems are acquiring independent practices at an accelerating pace. What looks like an attractive buyout offer is often a permanent exit from ownership. Independent practice is a competitive advantage — but only if it's run well enough to compete.
The Workforce Shift
Recruiting and retaining quality clinical staff has become one of the most expensive operational challenges for small practices. Without the right culture, systems, and compensation structures, independents lose talent to larger groups that can outbid them on salary alone.
Patient Acquisition Has Changed
Referral networks and word of mouth still matter — but they're no longer sufficient. Patients are consumers who research, compare, and choose. Practices without a deliberate community presence and digital strategy are invisible to the patients they most want to serve.
Value-Based Care Is Coming
The shift from fee-for-service to outcomes-based payment models is accelerating. Practices that haven't built measurement systems and population-health thinking into their operations will struggle to compete — or even participate — in tomorrow's payment landscape.
The Technician Trap
Most practice owners are brilliant clinicians who were never taught to be entrepreneurs. They work in their business — treating patients, managing staff, putting out fires — rather than on it. Without stepping back to lead strategically, growth plateaus and burnout follows.
What Providers Are Saying
Providers who've made the shift
Dr. Ingui's expertise has been an absolute necessity in my journey from being an employee to becoming a business owner. He has pushed me to think critically about business decisions in a way that has made my practice thrive — all while keeping my work/life balance intact.
He showed me that running an efficient, independent practice is still absolutely possible in today's complex environment... he has a way of navigating the hurdles of practice management with a level of insight that is rare to find.
Dr. Ingui played a key role in guiding my early career — from associate to independent practice owner. He has been instrumental in my growth as a clinician, manager, and business owner. An invaluable mentor, a trusted colleague, and a true visionary in the field.
The Framework
The 7 Peaks for
Practice Optimization
Every independent practice has seven core domains that determine whether it grows, stagnates, or fails. Most owners are strong in two or three and unaware of the others. Advisory partnership means building strength across all seven — in the right sequence, at the right pace.
These seven domains form the architecture of every engagement I take on. They're drawn from a decade of building and operating multi-site practices — and from the population health principles I studied at Johns Hopkins applied to the individual practice level.
Peak 1
Understanding Value in Healthcare
Before anything else, a practice owner must understand how value is defined, delivered, and perceived — by patients, payers, and the community. This foundational lens changes every other decision you make.
Peak 2
Financial Fundamentals
Most providers don't read their own financials. This peak covers revenue cycle management, expense control, cash flow discipline, and building the financial visibility that every owner deserves to have.
Peak 3
Systems & Measurement
You can't manage what you can't measure. This peak focuses on building the right clinical and operational systems, along with the dashboards and KPIs that tell you exactly how your practice is performing — without drowning in data.
Peak 4
Marketing & Community Engagement
Authentic community investment — not paid advertising — is the most durable patient acquisition strategy. This peak builds your visibility, referral networks, and community programs in ways that feel genuine and generate lasting return.
Peak 5
Operations & Automation
Every hour you spend on a repeatable process that could be systematized is an hour you're not spending on growth or patient care. This peak eliminates operational drag and creates the infrastructure for scaling without chaos.
Peak 6
Workforce Development
Your team is your practice. This peak covers recruitment, onboarding, culture-building, retention strategy, and building a staff that performs at the highest level because they believe in what you're building — not just because they're employed.
Peak 7
Growth, Development & Working ON Your Business
The hardest transition in every practice owner's career is moving from technician to entrepreneur. This peak is about building the personal discipline, strategic time, and leadership capacity to work on your business — not just in it. It's where Mission AND Margin come together.
The Book
Everything I know.
In one place.
After a decade of building practices, making mistakes, and figuring out what actually works, I wrote it all down. Mission AND Margin is the book I wish had existed when I was starting out — a practitioner's guide to building a financially sustainable practice without losing sight of why you went into healthcare in the first place.
The book walks through every domain of practice ownership: understanding value, mastering your financials, building systems that scale, engaging your community, developing your team, and ultimately making the shift from clinician to true business leader. It's structured around the same 7 Peaks framework that underpins every advisory engagement I take on.
Written for all healthcare practitioners, practice owners, and anyone with an interest in private practice — not just chiropractors. If you own, lead, or are building a practice, this book is for you.
The Intensive
Mission AND Margin
2-Day Intensive Seminar
This isn't a conference. It's a working session. The Mission AND Margin Intensive is a small-group, two-day in-person experience designed for healthcare practitioners and their staff who are serious about transformation — not just inspiration.
We keep groups intentionally small so every conversation is real, every example is practical, and every participant leaves with a clear, actionable plan built around the 7 Peaks framework. You'll be in the room with high-performing clinicians and their teams who share your ambition and your challenges — the peer learning alone is worth the trip.
What makes this different: no generic business advice, no motivational fluff. Just two days of focused, healthcare-specific strategy, peer exchange, and hands-on application with practitioners who are building exactly what you're trying to build.
Seven Peaks Advisory Services
Seven Peaks Advisory Services is my firm, built to partner with independent healthcare practice owners to build stronger, more sustainable businesses. Our engagements are intentionally focused to ensure genuine partnership, not volume. If you're ready to elevate your practice, let's talk.
About
Michael Ingui
DC, MAS, DIANM
Healthcare Entrepreneur, Educator & Advisory Partner
I didn't start in healthcare — I came from the corporate world, where I worked as a healthcare consultant before deciding I wanted to be on the clinical side of the equation. I graduated from the University of Bridgeport College of Chiropractic in 2014, opened my first practice in 2015, and haven't looked back since.
What started as a solo practice in New Jersey has grown into Kynetex, a multi-state chiropractic network with over ten locations. Building it taught me everything the classroom didn't — how to manage revenue cycles, build teams, navigate payers, and grow a practice without losing sight of why I got into this in the first place.
Along the way I pursued a master's degree in Population Health Management at Johns Hopkins University and completed executive business training at Wharton Online. These weren't just academic programs — they put me alongside top healthcare executives, private equity leaders, hospital administrators, public health researchers, and health tech companies pioneering value-based care. The frameworks I built came directly from the people reshaping how healthcare is delivered and financed at the highest levels.
I want to be clear about something: I'm not a private equity guy. I pursued that training deliberately — because I wanted to understand how they think, how they analyze businesses, and how they drive financial performance. But without the part where they sometimes strip a company of its soul in the process. There is real value in the way a private equity professional looks at a business. The mistake is applying that lens without the clinical and population health perspective sitting right next to it. I've spent my career learning to hold both — and that balance is exactly what Mission AND Margin is built on. I am, and always will be, patient first.
I also teach. At Dominican University I developed and instruct courses in Public Health and Kinesiology, because the next generation of providers deserves better preparation than most of us received. And I've had the privilege of pioneering chiropractic integration into a federally qualified health center in New Jersey — bringing evidence-based care to underserved communities.
I served as a certified EMT for years, not as a credential, but because showing up for your community is part of the job. That belief is baked into everything I build.
I work in Ramsey, New Jersey, where I continue to practice, teach, and partner with healthcare practitioners who are ready to build something lasting.
"I am, and always will be, patient first."
— Dr. Michael InguiBackground & Expertise
Work With Me
Let's start a real conversation.
I work with a limited number of practice owners each year. If you're ready to build a practice that serves your community and builds your wealth — reach out. Every engagement starts with a direct conversation.
Before you reach out,
know this:
I don't do discovery calls designed to sell you something. When we talk, we'll have a real conversation about your practice — where it is, where you want it to go, and whether I'm the right partner for that journey. If I'm not, I'll tell you.
Advisory partnerships through Seven Peaks Advisory Services are built for practice owners who are serious about growth, willing to do the strategic work, and ready to invest in a real partnership. If that's you, I want to hear from you.
Send a Message
Your message goes directly to me. I'll respond personally.