Before
Dr. Quatro Ott approved scheduling, hiring, and every exception. Growth stalled at the limit of one calendar.
What we did
The engagement applies the F.R.E.E.D. framework: finding where decisions terminated with the founder, moving authority and accountability together into named seats, and engineering the schedule, standards and escalation path into systems. The engagement is ongoing and outcomes are still being tracked.
After
Hiring came off her plate as a process and came back to her as a choice. The structure does the routing and the screening, so the decision is hers to make rather than hers to chase. The schedule, the standard, and the escalation path are documented and in use by the team. Whether the practice holds without her is still being tracked.

What has shipped
A complete operating library, now at version 2.0 and in daily use by the practice team. It covers standard operating procedures, the employee manual, the operations manual, the HR and onboarding system, performance frameworks, and a structured hiring system.
What is running now
I built and operate the practice’s hiring function, including structured interview packets, panel scorecards, operational case studies, 30/60/90 presentation rubrics, and a brief-to-physician decision template. Two roles filled through that process, one front desk and one medical assistant, both within 60 days. The leadership search is in its final stages.




