The Avoidable Conflict at the Intersection of Project Management & Monitoring, Evaluation, and Learning

Practical Strategies for Alignment and Decision Making.

Clarify Decision-Making Up Front: Map all partners (funders, implementing partners, government, communities) and explicitly define: Who decides on budget, timelines, and scope changes; Which decisions require consensus vs. advisory input; How disagreements will be resolved.

• Done By Whom: Project Management and MELA team.

• Why it matters: Misunderstandings about decision-making are often at the root of conflicts between PM and M&E. Experienced PMs call this the “RACI for conflict avoidance.”

• Example: In a multi-country education program, agreeing on decision rights upfront prevented three months of delays when a mid-project funding shortfall occurred.

Negotiate the SOW and KPIs Before Execution: Treat the Statement of Work (SOW) as negotiable until the first payment is made. Identify non-negotiable vs. flexible KPIs; Build contingency plans for missing or delayed data; Agree on what constitutes success for all parties.

• Done by Whom: Project & MELA Director

• Why it matters: Conflicts often arise when monitoring and evaluation expectations are misaligned with the project plan or among partners. Locking key performance indicators (KPIs) in too early can lead to chasing unachievable metrics.

• Example: A health program revised KPIs after an initial field assessment, aligning expectations with on-the-ground realities.

• Pro tip: This isn’t always easy! Factors influencing implementation often change during the procurement process. But spending time upfront to align the PM team, MEL team, and partners on expectations and deliverables significantly reduces confusion and sets the project up for success.

Segment M&E Into “Must-Have” vs. “Nice-to-Have”: Focus on metrics that matter most for accountability and learning: Essential: Required by funders or key decisions Optional: Useful for internal learning, but not critical

• Why it matters: Trying to monitor everything creates friction with project management — teams spend more time reporting than implementing.

• Example: A youth empowerment project cut optional survey questions by 60%, resulting in faster reporting and more meaningful learning.

Bottom Line: The tension between project management and M&E doesn’t have to derail your program. By clarifying decision-making, negotiating KPIs, and focusing on what truly matters in monitoring, you can navigate the intersection successfully and set your project up for real impact.

“The Pitt” and the patient: Reflections on Empathy and Health Systems

I may be late to the proverbial “party” on this one (as usual), but I recently watched The Pitt, (a show set over one 15-hour hospital shift in a hospital’s ER in Pittsburgh Pennsylvania), and given my work history in healthcare, some of the themes really hit home. I’ve never worked in a hospital, but I was struck by how the show pulls the viewer into every small moment, every decision, every bit of exhaustion and empathy that defines a day in healthcare.

Having spent much of my career on what’s often called the “admin side” of health, I found myself reflecting on the tension between clinicians and administrators that runs through the story. Though The Pitt is based on the U.S. system, I know the challenges and tensions aren’t unique to the United States, it’s something often felt in Canada as well.  Whether tracking performance indicators or caring for a patient in crisis, everyone’s under strain.

In the show, Dr. Robbie lashes out at hospital leadership for being too focused on quality scores.  Those macro-level KPIs can seem detached from the person needing immediate care, but as someone who’s worked in health system operations, I couldn’t help but think: it all matters. The metrics, the money, the moments are all part of the same ecosystem.  The challenge is aligning them and balancing them with the same goal.

Most of my own work has been in what I would call the “private but not private” side of healthcare — leading integrated medical centres that bridge universal coverage and patient-paid services. It’s a space that doesn’t always fit neatly into policy conversations or appeals for funding or support, but it’s where I learned that if we are truly to solve our healthcare crisis, we need to recognize the unique role that all providers and organizations play in the patient's journey. Healthcare truly does depend on effective collaboration, humility, and respect across every level.

In the end, The Pitt reminded me that no health system is immune to stress and conflicting demands. Yet amid all the pressure and complexity, one truth that connects everyone working in healthcare: the patient is the reason for the work.  Whether a physiotherapist supporting a post-op patient in a private setting, a nurse working a night shift or the head of a health authority, we must ensure that the patient never gets lost between the spreadsheets and the stretchers.  As Canada’s health system becomes increasingly disjointed, spanning public, private, non-profit, and hybrid arrangements, it is imperative to keep the patient at the centre of it all and begin looking at the system from this higher level lens - not simply the universal system or with the hospital lens.

The patient journey doesn’t end when the patient leaves the hospital.  As care becomes more distributed across public, private, and community settings, improving that transition is critical and offers a huge opportunity to improve the patient’s journey and outcome.

If you work in allied health or integrated care and also recognize a huge opportunity to improve the patient journey, lets connect and exchange ideas.

Using Systems Thinking to Bridge the Gap between Family Medicine & Allied Healthcare

One of the challenges with our Canadian healthcare system is how disjointed it can be at certain points in a patient’s care journey. Within the hospital system, roles exist to examine and resolve these handoff points, but one area I’ve grappled with throughout my career as a leader of health centres is the disconnection between Family Practice and allied health practitioners. When patients are referred for services such as physiotherapy, chiropractic, or pedorthics, they often leave the clinic with a prescription or referral and must then navigate insurance coverage, find an appropriate provider, and hope their GP receives feedback to close the loop and support better chance for healing.

This disjointed patient experience creates several challenges: patients end up coordinating their own care, communication gaps emerge between providers and patients, and the overall patient experience suffers. This challenge has been near and dear to my heart: how to ensure patient compliance once they “exit” the universal system, close the communication loop with external providers, support follow-up despite service costs, and measure outcomes? Finding answers to these questions is central to delivering effective, patient-centered care. Improving the connection between GPs and allied health practitioners not only enhances patient outcomes but also strengthens the healthcare system overall.

At first glance, this may seem like a simple referral problem. Yet when we apply systems thinking, it becomes clear that the issue is far more complex—a structural gap affecting patient outcomes, clinic efficiency, the effectiveness of GP-allied provider relationships, and ultimately a missed opportunity for improving patient care and experience.

Systems thinking allows us to look beyond surface-level symptoms and examine interconnections, feedback loops, and leverage points contributing to the problem. In this scenario, the system includes:

• The Family Practice clinic – the public-care hub, coordinating care and capturing patient outcomes.

• Allied healthcare providers – physiotherapists, chiropractors, pedorthists, and massage therapists operating largely in private streams.

• The patient – navigating insurance, scheduling, and essentially forced to be the hub of their own continuity of care.

Feedback loops are critical: delayed or missed physiotherapy can lead to repeat GP visits, additional strain on the public system, and frustration for patients. Small changes in the system can produce outsized benefits—but only if we address underlying structures rather than isolated symptoms.

So, what’s the solution? While fully shared EMRs can help, the reality is that fully integrating EMR systems across all private and public providers in the province is unlikely in the near term. Instead, here are some practical alternatives:

• Referral Tracking Dashboards – Internal trackers combined with patient follow-up can measure the percentage of referrals successfully booked within a set timeframe.

• Patient Navigators – Clinic staff can help patients navigate insurance, recommend vetted physiotherapists, or pre-book appointments. Measurement: completion rates and patient-reported ease.

• Relationships with Allied Health Providers - Relationships with trusted providers streamline scheduling and feedback. Measurement: time-to-first-appointment.

• Feedback Loops from Allied Providers – Short progress notes returned to the GP allow clinics to close the loop and track patient outcomes. AI can help highlight relevant notes for physicians during the next patient visit.

These interventions are measurable, implementable, and strengthen the GP’s role as the hub of patient care. Of course, physicians’ EMRs must be configured to properly track these activities.

For allied healthcare providers: it pays to get to know the Family Medicine physicians in your catchment area. In a previous post on LinkedIN, I discussed marketing tips for physiotherapists and other allied health providers; this one is a winner. Improving these systems doesn’t just help GPs and patients—allied healthcare providers also benefit:

• Reduced lost patients/no-shows, improving revenue predictability.

• Clearer communication, minimizing duplicated assessments and aligning care plans.

• Enhanced reputation and patient experience, generating referrals and trust.

My suggestion: start small, with 5–6 Family Medicine Clinics. After years of developing relationships with Family Medicine physicians to support better referral pathways, I can attest that this approach works.

Things are progressing; we have seen some pockets of innovation in Canada. Certain Health Authorities, Divisons of Family Practice (Primary Care Networks), and Collaborative Service Committees are exploring ways to better integrate the patient journey between Family Medicine and allied health providers. However, much of this work remains localized, leaving many clinics fragmented.

The GP-to-allied health referral gap illustrates a broader principle: systems thinking is not just an abstract concept—it is a practical tool for improving outcomes, efficiency, and patient-centered care. By mapping interconnections, identifying leverage points, and implementing feasible, measurable solutions, clinics can strengthen both public and private care streams, creating a healthcare ecosystem that truly serves patients, providers, and communities alike.

If you are an allied health or family medicine clinic looking to improve referral pathways, enhance communication, and strengthen patient outcomes, Afya Consulting can help. Or, if you’re also super passionate about this topic - I would love to chat more. Let’s work together to transform how your clinic coordinates care across the patient journey. 

Volunteer Engagement isn’t “free” - but it’s Essential.

So many of today’s non-profits are stretched thin. With limited budgets, rising demand for services, and constant pressure to diversify funding streams, staff often find themselves juggling too many priorities.

For many organizations, robust volunteer engagement programs are not a “nice-to-have” — they’re a key way to run the diverse fundraising and community programs needed to survive and thrive.

A common belief exists that volunteers are “free.” But anyone who has managed volunteers knows that effective engagement requires systems and processes for:

- Recruiting and screening,
- Orientation and training,
- Ongoing support and recognition,
- Clear roles and accountability.

Without these, volunteers can end up feeling sidelined or confused about how to contribute - and organizations miss out on the value volunteers could provide.

A few years ago, someone I know started a small weekly non-profit event. She was passionate about it, but she was also struggling with the realities of not only keeping it going but growing it.

I helped her a few times with day-of logistics, organization, and promotion. We were the only “staff.” She did most of the pre-work, and I could tell she was overwhelmed — and hesitant, because she wasn’t sure how to use me without creating more work for herself or wasting my time.

I suspect that hesitation is common for leaders and drivers in resource constrained situations:  inviting people to support but worrying about the lack of clear role - and let's face it - without a clear role - it can take extra work to supervise.

I’ve been there too. I’ve had people offer to support the organizations I’ve led, and without a specific plan or structure to support outside volunteers, I’ve either turned them down or let them languish waiting for my response.  It felt easier in the short term, but looking back, I realize it was a missed opportunity.

Then came the day I messaged her to confirm the next date and ask whether she needed any help ahead of time. I didn’t get a response. On the day of the event, I checked in again: did she still need me? Her reply: “You don’t have to come if you don’t want.”

The moral of the story? When a volunteer offers to help, you find a job for them. Even if it’s small. Even if it feels easier to do it yourself. Because every time you turn a volunteer away, you risk losing not just their time — but their commitment, energy, and connection to your mission.

Why does it Matter? Volunteers are catalysts. They bring skills, energy, and community trust that money alone can’t buy. They amplify staff capacity, open doors to networks, and often become some of the most committed advocates for the mission.

This isn’t only true for traditional non-profits. Community health centres and clinics can also benefit from engaging students or early-career professionals seeking work experience. With the right structure in place, these individuals can meaningfully contribute while gaining valuable exposure to the sector.

Developing and implementing a robust volunteer engagement isn’t easy — it requires intention, structure, and investment. But in today’s resource-constrained environment, it’s one of the smartest strategies an organization can pursue.

At the end of the day, if someone offers their time and talent to help your cause, the answer should always be: Yes — and here’s how you can make a difference.

If you would like help linking your resource development plan to your organization’s strategy, or with designing and implementing a volunteer engagement plan - reach out!

AI Is Here (and it’s not going away!): How Canadian Non-Profit Leaders Can Use It—Safely and Strategically

Practical Ways Non-Profits Can Use AI Right Now

Save Time on Admin & Reporting Tasks

The most obvious way to “dip the proverbial toe” into the AI game is to use it to save time on administrative tasks.  AI tools like ChatGPT, Microsoft Copilot, and Google Duet can help draft board reports, donor letters, grant applications and internal communications.  I’ve found it to be especially helpful for taking meeting notes and creating meeting minutes. 

Resource:  The Project Management Institute has many courses focused on using AI to manage projects. 

Improve Fundraising and Donor Stewardship

For larger non-profits who maintain a CRM system, Canadian tools like Fundraising KIT use AI to analyze donor behaviour, suggest optimal outreach timing and personalize messages at scale.  Evan for smaller organizations who want to increase their resource development activities, it’s worth taking a look at the technology as it develops, because it changes quickly. 

Resource: Fundraising KIT has several free resources on their website – take a look and give one of them a try!   

Strengthen Volunteer Management and Engagement

AI can help smaller non-profits by automating volunteer coordination tasks such as scheduling shifts, sending reminders, and tracking volunteer hours. Some AI tools even analyze volunteer data to identify engagement patterns and improve retention.

Resource:  Check out online systems such as Sign Up Genius and Track it Forward – both systems use AI for components of their analysis. 

Risks to Watch Out For:

Reproducing Bias or Exclusion in Program Delivery

AI systems can unintentionally reinforce systemic inequities—especially when built on biased data or applied without community input. For example, an AI chatbot that only “understands” formal English might exclude newcomers, youth, or people with disabilities. One way to mitigate this risk is to involve those with lived experience in testing the tool and asking “who might this tool leave out?”. 

Data Privacy and Compliance

Uploading sensitive data into free AI tools may violate Canadian privacy laws or funder agreements. Using AI often means uploading data to third-party platforms—sometimes outside of Canada or outside your control. This can expose sensitive donor, volunteer, or program participant information to unintended use. To mitigate this risk only use PIPEDA-compliant tools and ensure that staff is trained properly on what data can and cannot be entered into the system.  Finally, it’s important to communicate transparently with stakeholders about AI use and privacy. 

Overuse and/or Staff Resistance

I’d bet that nearly everyone on your team already has an opinion about AI. Some are likely using it already—quietly drafting emails or brainstorming with ChatGPT—while others may view it as a threat, not a tool, and avoid it altogether. There’s a wide spectrum of engagement levels taking place in the non-profit sector right now. The examples shared in this article are intentionally low-risk and supportive—but even these can raise concerns. To reduce resistance, leadership should be clear and proactive:  AI is here to support your team, not replace it. Involve staff in exploring how these tools can be used safely and meaningfully in your context. When people feel included and informed, they’re more likely to lean in than push back.

Three Things EDs Can Do Right Now to Set the Tone for Safe, Strategic AI UseBottom of Form

1. Pilot Something Small.  Try using AI to draft a policy, write a thank-you letter, or analyze a survey.  Invite a few members of the team to also join and provide feedback. 

2. Create internal guidance. Who can use AI, and for what? What data is off-limits?

3. Connect with peers. Ask colleagues in professional groups what they are doing and how they are using AI in their non-profit.  There are many resources on the internet that can also help. 

Three Questions Every Non-Profit Board Should Be Asking About AI Right Now

1. Are we already using AI tools—and how?
   You might be surprised what staff have already started testing.

2. Do we have the right governance in place?
   If not, start with light-touch principles: equity, privacy, transparency, mission-alignment.

3. Are we supporting strategic innovation?
   AI should be a board-level conversation—not just a back-office experiment.

AI may not be a silver bullet for your non-profit – but it can be a smart tool in the toolbox.  Start small. Stay strategic. And above all, make sure the use of AI strengthens – not sidesteps – the organization’s mission and values. I’m here to help! If you need help looking at how to integrate AI into your non-profit, or developing your AI policy and procedures, reach out to chat!

Is a “good” organizational culture the answer to everything in the workplace?

I’m not an organizational development specialist and let’s face it – people like Adam Grant have been writing about topics like this for years, and it seems there is no black and white solution – because humans (and organizations) are complicated.  That said, do we just throw our hands up in the air and not try to define or improve on organizational culture?   

I – like many of us – have experienced workplace culture from multiple angles. I’ve worked as an employee across a wide range of organizations: large and small, nonprofit and private sector, local and international. I’ve also led teams, projects, and entire organizations—responsible for shaping culture while navigating the day-to-day realities of getting people aligned and moving in the same direction. This diverse experience has given me a broad perspective, and yet, despite the differences in context, the challenges, unsurprisingly, are often remarkably similar.

As I start to unpack this complex topic in my own mind, I thought it would help to start with the basics.  While workplace culture is complex, decades of research consistently identify several foundational factors that reliably contribute to healthier, more productive organizations.  If you’re a leader, and don’t know where to start, I suggest spending some time reflecting on these areas: 

Psychological Safety - A team climate where individuals feel comfortable expressing ideas, admitting errors, or asking questions without fear of retribution.

Trust in Leadership - The extent to which team members believe their leaders act with integrity, openness, and concern for their well-being. When employees believe in the integrity and consistency of their leaders, outcomes such as engagement, retention, and discretionary effort improve.

Fairness and Inclusion (Organizational Justice) - How equitable an employee perceives outcome distributions (distributive), decision processes (procedural), and interpersonal treatment (interactional/informational).  The perception of fairness—whether procedural, distributive, or interpersonal—drives job satisfaction, commitment, retention, and citizenship behaviors.

(Note: This is a big one for me, and one I’ll delve into in future articles.)

Clarity of Purpose and Values - Clear understanding of organizational mission, team purpose, and behavioral expectations (norms). Aligned values and shared purpose give a clear framework for behavior—and reduce conflict caused by misalignment.

Recognition and Feedback - Timely, specific acknowledgment of effort and progress, and authentic, constructive feedback for growth. Consistent acknowledgment and constructive feedback reinforces positive behavior, signals value, and helps people grow. 

If you’re like me, and you buy-into the idea that culture isn’t necessarily the answer, but is the container for everything, these nuanced points can be a bit overwhelming.  If, as a leader you want to prioritize building or improving your organization’s workplace culture – where would you start? 

Here are a few places I would focus:

Be Explicit About Culture During the Hiring Process

Start early. Culture clarity begins before someone joins the team.  Ask yourself: are we hiring for alignment, or only for technical skills?

• Define your organization's values and how they show up in daily work—not just aspirational statements.

• Incorporate behavioral questions during interviews that test for alignment with those values.

• Be honest about what it’s like to work in your organization—don’t sell a culture you don’t have.

Create Space for “Failing Forward”

Everyone says they support learning—but do you have structures that make it safe to fail?

• Build in moments for debriefs and reflection after projects—even when things go well.

• Normalize talking about mistakes without blame.

• Consider hosting regular “fail forward” sessions where teams share learnings from missteps.

Model It From the Top—Even When It Hurts

If leaders want a culture of trust, they must be the first to show vulnerability and take accountability. And this is a tough one – because sometimes protecting your culture means being willing to lose short-term opportunities to preserve long-term trust.  (Hint: this is where a great executive coach comes in!)

• When a leader makes a mistake, own it publicly.

• If a client relationship, funding opportunity, or public image suffers as a result, accept that cost. The alternative—pretending it didn’t happen—undermines everything you're trying to build.

Make Values Visible, Not Just Verbal

Culture is what you tolerate, reward, and ignore.  If your culture really matters, people should see it, feel it and hear it – in every interaction every day. 

• Celebrate behaviors that reflect your values—don’t just post them on your website.

• Address misalignment early, even if it’s awkward.

• Elevate "culture carriers" across the organization—not just senior leaders.

Measure and Revisit

It’s not possible to improve what isn’t assessed.  Culture should be treated as something actively being shaped – not something that just happens. 

• Run regular culture or engagement surveys—but go beyond the numbers.

• Hold listening sessions, staff retrospectives, or anonymous feedback rounds.

• Use what you hear to adjust—not just to defend the status quo.

  Culture matters – even for smaller teams. But for leaders and entrepreneurs immersed in daily operations - especially during start-up - it’s not always easy to step back and assess workplace culture with objectivity. If you're leading a small business, non-profit or health clinic and trying to intentionally build or improve your organization's culture, I can help. Let's book a complimentary 30 minute chat about what's challenging you, and how I might be able to support. If I can't help with the solution, I'll point you in the direction of someone who can!

Diversifying Revenue for Non-Profits in Today’s Economy: Why It Matters More Than Ever

In today’s uncertain economy—where government funding is tightening and competition for grants is intensifying—non-profits are under growing pressure to think beyond traditional sources of funding. For many, grants have become the default (and often only) source of revenue.

Take healthcare as an example: in British Columbia, many “independent” primary care centres rely heavily on grants from health authorities. And while political will currently supports these services, we also know that governments are under increasing pressure to demonstrate fiscal restraint. That means even long-standing funding sources are vulnerable to policy shifts or budget cuts. Grants, while necessary, rarely provide the kind of long-term financial resilience that non-profits need to thrive.

One of the most effective strategies? Revenue diversification.

But before we dive into that, let’s talk about fund development—and why it’s a strategic imperative.

What Is Fund Development, and Why Does It Matter?

Fund development is more than just fundraising. It’s the intentional, long-term process of building relationships, systems, and strategies to generate ongoing financial support. This includes individual giving, grant writing, donor stewardship, fundraising campaigns, and sponsorship development. When approached strategically, fund development becomes a cornerstone of organizational sustainability—not just a task added to someone’s plate when time allows.

Importantly, fund development is not the same as revenue diversification—though the two are closely connected.

Fund development focuses on philanthropic income streams (such as donors, foundations, and fundraising activities). Revenue diversification, on the other hand, is a broader financial strategy that includes all types of income: philanthropic, earned, contractual, and investment related.

In short: fund development is how you build and grow your philanthropic income. Revenue diversification is what your overall funding mix looks like. Together, they support long-term financial resilience.

What Does Revenue Diversification Actually Mean?

At its core, revenue diversification means intentionally developing multiple streams of income, so your organization isn’t overly reliant on one or two sources. This increases financial stability, supports long-term planning, and—critically—frees the organization to innovate and grow.

Many non-profits operate in a constant state of survival, focused on securing the next grant, which is understandable - grants are often the most accessible and substantial source of funding, especially for organizations without a strong fundraising culture or infrastructure. But operating in survival mode can be draining for leadership and the team.  Diversifying the revenue base allows a shift from crisis response into a more empowered, future-focused approach.

What Can Non-Profits Do to Start Diversifying?

Here comes the point where everyone wants to know what to do – what are the list of activities I can do to diversify my organization’s revenue?  As important though are some of the less discussed components that lend themselves to long-term success.  Which is why I’ll talk about those:

Culture Comes First

Perhaps the most overlooked element of fund development and revenue diversification is organizational culture. Non-profits that succeed in this work embed financial sustainability into their DNA. That means:

• Leadership understands fundraising is part of mission advancement—not separate from it.

• Staff see revenue as a shared responsibility.

• The board champions financial health and actively contributes to it.

• The strategic plan names fund development goals alongside programmatic goals.

Culture shift takes time—and intention. But it lays the foundation for everything else. To get started, consider these three strategies:

1. Integrate Fund Development into Staffing Plans

If your organization doesn’t yet have a dedicated fundraiser, start by assigning fund development responsibilities to a team member as a formal part of their role. This should be a supported and intentional shift—not an informal add-on to an already full workload. Fund development needs structure, time, and clear expectations.

When resources allow, invest in professional fundraising capacity. Even a part-time or contract fundraiser can lay essential groundwork: building systems, cultivating relationships, and developing a donor strategy.

That said, fund development shouldn't live in isolation. Team members across the organization should understand that fund development is part of everyone’s job—just in different ways. This doesn’t mean every staff member needs to solicit donations, but it does mean they recognize how their role contributes to the organization’s financial sustainability. Whether it’s sharing impact stories, participating in donor visits, or simply understanding how their work aligns with funder priorities, everyone has a role to play.

To make this approach work, expectations must be clearly defined and properly resourced. Staff need the tools, training, and leadership support to participate meaningfully. When embedded into job descriptions thoughtfully and reinforced through organizational culture, this shared responsibility model strengthens fundraising outcomes and reinforces long-term sustainability.

2. Prioritize Board Engagement

Boards don’t need to be made up of fundraisers to support revenue growth. What they do need is a clear understanding of their role in advancing the organization’s financial health—and appropriate support to do so. This may include:

• Introducing prospective donors

• Participating in stewardship activities

• Advocating for the organization with funders or community leaders

Strong boards also ensure that fund development is embedded in strategic planning and that fundraising practices align with the organization’s values.

3. Explore New Revenue Streams

Once fund development is embedded and the board is actively engaged, the organization is in a much better position to creatively and strategically explore new income sources. This could include:

• Individual Giving Programs: One-time or monthly donations

• Social Enterprise: Mission-aligned ventures that generate income

• Fee-for-Service Models: Offering services at a cost or on a sliding scale

• Corporate Partnerships: Sponsorships, in-kind support, or employee giving

• Membership Models: Recurring revenue in exchange for value-added offerings

It’s highly recommended that leadership teams create a comprehensive fund development plan that includes intentional exploration of alternative revenue streams.

Final Thoughts

Fund development and revenue diversification aren’t quick fixes—they’re long-term commitments. But they are essential if we want our non-profits to thrive, not just survive. Grants will likely remain a key piece of the puzzle, especially in healthcare and other publicly funded sectors. But they shouldn’t be the whole puzzle.

Building a resilient, mission-driven, and financially sustainable organization takes time, intention, and collaboration. In today’s economic climate, that work isn’t just important—it’s urgent.

Is Your Clinic Ready for AI?

Practical Tips to Consider

Disclaimer: I’m not a legal expert or privacy regulator.  This article is to help distill key themes and offer some practical starting points for clinic leaders.

We Create a LOT of Data—But Who’s Using It?

As humans interacting with phones, wearables, and digital health systems, we create copious amounts of data every day.

• The average person generates hundreds of gigabytes of data daily—and potentially terabytes per year (IDC & Seagate, 2020).

• In healthcare, even where patient records and imaging contain rich insights, only 3–5% of this information is actively used to improve care (IBM Watson Health, 2021; Deloitte, 2023).

• A 2023 Canadian Medical Association survey found that only 20% of Canadians feel confident they understand how their health data is being used.

And the truth is—many health providers don’t either.

As AI tools enter clinics and data volumes grow, these transparency and trust gaps are only getting more urgent.

Canada’s AI Momentum in Healthcare

AI is reshaping healthcare in Canada—from drug development and diagnostics to administrative workflows, telehealth, and triage. We're seeing new technologies emerge across research, clinical, and operational functions.

That’s not necessarily a bad thing.

When implemented ethically and safely, AI can help scale research, detect patterns in patient populations, reduce clinician burden, and improve care coordination. It can even enhance administrative efficiency through automated note-taking and scheduling.

But it’s not all smooth sailing.

• Federal AI-specific legislation (like Bill C-27) is still in progress.

• Provincial regulators are updating privacy guidance in real-time.

• And EMR vendors or AI startups may use data in ways clinicians and patients don’t expect—or consent to.

The Privacy & Security Reality for Clinics

Privacy and data security are among the top concerns in AI adoption across Canadian healthcare.

• Only 21% of Canadian physicians feel confident that AI tools can protect patient privacy (CMA, 2023).

• The sector has experienced over a dozen high-profile cyberattacks in recent years—including attacks on SickKids Hospital and Newfoundland’s provincial health system.

• Canada’s privacy regulators are actively investigating how data from clinics is used by vendors, including for AI model training.

For small- to mid-sized clinics, this can feel overwhelming. But you don’t need to be a privacy lawyer to take meaningful action.

What Can Clinic Owners Do?

Here are five practical actions to consider:

1. Conduct a Privacy & Security Review

• Read your EMR’s Data Processing Agreement (DPA) or Terms of Service. Confirm that they won't use any of the data without explicit consent from you and/or the patient.

• Ask whether data is stored in Canada (this affects legal jurisdiction).

• Ensure the vendor isn’t using patient data for AI model training or analytics—unless you’ve explicitly agreed to it (see the first bullet above).

2. Ensure Informed Consent

• If you’re using AI tools (like note-taking assistants), be transparent with patients.

• Explain how their data is used, whether it’s stored, and if it’s shared.

3. Appoint an AI/Privacy/Security Designate

• This could be you as the clinic owner, or a clinic manager.

• Someone who has clear expectations and is empowered to become informed in a quickly-changing landscape.

4. Track Evolving Regulations (see point #3)

• Stay informed about provincial laws (like PHIPA, PIPA, Law 25 in Québec).

• Monitor updates from the Office of the Privacy Commissioner, CMA, and your own professional college or association.

5. Create an AI Policy for Your Clinic

• Even a one-pager outlining how you use AI and manage patient data builds accountability and trust.

Communicating With Patients

Trust is the foundation of all healthcare relationships.

Clearly explain how digital tools and AI enhance care—from reminders and record-keeping to personalized recommendations—while emphasizing your commitment to protecting personal health information.

A Final Note for Patients (really, all of us!)

If you’re a patient reading this, I encourage you: ask questions. You have a right to know:

• What data is being collected

• Where it’s stored

• Whether it’s being used for anything beyond your care

Read the forms you sign when you start with a new clinician. Healthcare is becoming more digital and data-driven every day. The more informed we all are, the better choices we can make—for our care and our privacy.Don’t worry about sounding professional. Sound like you. There are over 1.5 billion websites out there, but your story is what’s going to separate this one from the rest. If you read the words back and don’t hear your own voice in your head, that’s a good sign you still have more work to do.

Be clear, be confident and don’t overthink it. The beauty of your story is that it’s going to continue to evolve and your site can evolve with it. Your goal should be to make it feel right for right now. Later will take care of itself. It always does.

Navigating the Rise of Corporate Care: Support for Independent Veterinarians and Health Practitioners

The Canadian health landscape - for both humans and animals - is changing.

Veterinary medicine and many human allied health services in Canada traditionally had something in common: they were independently owned and operated by the professionals who provided the care. These practices weren’t just businesses—they were cornerstones of their communities. Personalized, relationship-based, and practitioner-led. But in recent years, we’ve seen a growing trend toward corporatization. From urban veterinary hospitals to physiotherapy clinics to multi-disciplinary health centres, large investor-backed groups are consolidating the market.

The Data: A Snapshot of a Shifting Landscape

• Veterinary Clinics: Today, about 1 in 5 veterinary clinics in Canada is corporate-owned, and nearly 40% of veterinarians now practice within these models. (Competition Bureau Canada, 2024)

• Physiotherapy Clinics: Though private practices still dominate, corporate-backed regional chains—like LifeMark (owned by Loblaw/Shoppers Drug Mart)—are expanding rapidly. As of 2025, there are approximately 18,600 physiotherapy businesses in Canada. (IBISWorld, 2025)

• Chiropractic Clinics: Roughly 69% of chiropractors in Canada still operate as sole proprietors, meaning approximately 31% are now part of multi-site or corporate-owned operations. (Canadian Chiropractic Resources Databank, 2024)

What This Means for Independent Clinics

If you’re running an independent clinic, these shifts are more than just headlines.

You might be:

• Feeling pressure to match corporate pricing or hours.

• Struggling to recruit or retain staff.

• Wondering how to plan for growth—or succession.

• Working harder than ever but feeling unsure how to compete.

The truth is, independent clinics still form the majority in most sectors. But the rise of corporate care is advancing—and fast. That creates a strategic imperative for small, practitioner-led clinics to adapt smartly, without losing what makes them special.

Why Independent Clinics Still Matter

Corporatized clinics may offer standardization, access to capital, and marketing muscle—but they can’t replicate the deep community ties, continuity of care, and values-based service that independent providers deliver every day.

Your clinic doesn’t need to become corporate to thrive.  But it does need to be clear, focused, and supported in how it operates, grows, and evolves.

I work with independent clinic owners in both human and animal health—from physiotherapists to veterinarians—who want to stay small, local, and practitioner-led without burning out or falling behind.

Together, we tackle:

• Strategic planning and business model refinement

• Team building and staff retention

• Operational efficiency and process improvement

• Sustainable growth—or right-sizing for peace of mind

I support your clinic’s goals with clarity, calm, and strategy—while always centering the values that led you into care in the first place.

Let’s Connect

If you're an independent clinic owner feeling the weight of change, I’d love to connect. And if you're thinking about starting a practice in today’s competitive landscape—veterinary, physiotherapy, or any of the allied health sectors—but feel uncertain about how to stand out, let's talk.

Together, we can strengthen and protect what makes your vision meaningful, while building the clarity, structure, and strategy your clinic needs to thrive in a changing market.

Send me a message or book a FREE 30 minute conversation. I’m here to support your success.

Is Bigger Really Better?

Why Corporatization Isn’t Always the Answer—for You or Your Practice

It seems these days that everywhere we look, things seem to be getting bigger—bigger brands, bigger businesses, bigger mergers. From grocery stores to healthcare, the trend toward consolidation is accelerating. We’re being lulled into a familiar narrative: bigger is better. More efficient. More secure. More successful.

But is it really?

When it comes to healthcare—whether you're running a veterinary clinic, a physiotherapy practice, or a chiropractic office—bigger isn't always synonymous with better. The rise of corporatized care in Canada is accelerating.  Investor-backed clinic chains are offering standardized services, scalable operations and growth at speed.  It’s easier to be lulled into the “bigger is better” narrative – but is it? 

The real answer: It depends on your values and career goals.

The Financial Picture: What Do Independent Clinics Really Earn?

Understanding the income potential of independently owned clinics is an important part of this conversation. After all, with the rising cost of living, even a $150,000 salary doesn't stretch as far as it once did. While actual revenues vary based on specialty, location, clinic size and other factors, here’s a general snapshot of average earnings across Canada:

🐾 Veterinary Clinics

• Independent vet clinic owners typically earn $150K–$300K+ annually.

• Larger or highly efficient clinics can yield over $500K, monthly revenue - especially in multi-vet models.

• By comparison, associates in corporate-owned clinics may earn $95K–130K, with fewer opportunities for profit-sharing or equity.

🧍‍♀️ Physiotherapy Clinics

• Full-time independent physiotherapists can gross $180K–250K, depending on location and caseload.

• Clinic owners with multiple therapists often generate $500K–1M+ in annual revenue, with margins ranging 10–30%.

• Corporate employers offer steady salaries (~$85K–110K) and benefits, but there are limits to independence.

🌀 Chiropractic Clinics

• Sole practitioners report grossing $400K–600K annually in well-established clinics.

• Profit margins average 25–35%, especially where overhead is tightly managed.

• Corporate-affiliated chiros may earn less, but benefit from less administrative burden.

Corporatization: Pros & Cons

There’s no single right answer when it comes to clinic ownership or affiliation. But there are real differences to consider:

✅ What Corporate Models Offer

• Administrative Support: HR, billing, compliance, and marketing are handled centrally.

• Capital Access: Easier investment in new equipment, renovations, or new sites.

• Recruitment Power: Ability to attract staff with competitive salaries and benefits.

• Scalability: Rapid growth is possible, especially in urban centres.

❌ What You May Sacrifice

• Clinical Autonomy: Corporate policies can dictate treatment protocols, pricing, and appointment times.

• Flexibility: Less control over scheduling, staffing models, or client care decisions.

• Values Alignment: The culture may prioritize efficiency and profitability over personalization.

• Community Connection: Large, multi-site clinics often lack the deep roots of local practices.

Sooo….Is Bigger Actually Better - FOR YOU?

Ask yourself:

Consideration	Independent Practice	Corporate Clinic
Autonomy	High—complete control of care and operations	Limited—must align with corporate policies
Income Potential	High (with risk)—owner profits & equity	Moderate—stable salary, limited upside
Lifestyle & Flexibility	Tailored to your preferences	Standardized; less freedom
Support Infrastructure	DIY or outsourced	Built-in systems and teams
Career Growth	Entrepreneurial—build your own legacy	Managerial track within larger system
Values Fit	Mission- or care-driven	Business- or system-driven

It’s Not Black and White

Let’s be clear: running a small, values-driven practice doesn’t mean turning your back on performance or efficiency.

Independent doesn’t mean disorganized. In fact, most thriving independent clinics do monitor their key performance indicators—things like revenue per visit, patient retention, and staff productivity.

They do invest in better systems, smarter workflows, and clearer processes to grow sustainably and reduce burnout.

The question isn’t:
“Do you want to improve your operations and increase revenue?”

The real question is:
“Who do you want that improved profit to serve?”

In a corporate model, those gains often flow to shareholders or head office.
In an independent clinic, they stay with you—your team, your patients, your community.

So no, it’s not a choice between doing things “the hard way” or “the smart way.” It’s a choice between scaling your practice in a way that aligns with your values—or scaling someone else’s business instead of your own.

The Bottom Line: Choose What Aligns

Corporate care is not inherently bad. For some, it offers relief from the burden of ownership, along with structure, benefits, and career security.

But if your goals include autonomy, community leadership, or crafting a patient/client experience rooted in your own values—staying independent may be worth the extra complexity.

There’s no one-size-fits-all answer. The key is alignment.

🤝 Support for Independent Owners

If you’re reflecting on the right model for your next career chapter—or trying to strengthen your existing clinic—I can help.

Whether you want to:

• Clarify your business model

• Improve efficiency or staff retention

• Plan for growth or succession

• Stay small but sustainable

Let’s build a strategy that reflects your vision—not someone else’s bottom line.

Reach out to book a free 30 minute introductory call. I’d love to hear where you are—and where you want to go.