Medical practices & clinics
Books and taxes for weight loss clinics.
GLP-1 medication costs, prepaid program packages, supplement sales, and the January rush of new patients. Gus sorts all of it, an accountant checks every transaction, and you get one number a month.
- From $197 a month
- An accountant on every transaction
- Cancel whenever
January came in at $23,600. New patient enrollments doubled from December, so I flagged the spike as the usual January rush, not a fluke.
- Program enrollment batchProgram package fees
- Compounding pharmacy orderMedication costs
- Monthly maintenance feesMembership and monitoring fees
- Meal replacement inventoryRetail supplement inventory
- Clinical staff payrollClinical wages
Why your books are different
A weight loss clinic's books go wrong around the medication cost, not the visit.
Your biggest line item is not staff or rent, it's what you pay for the medication you dispense or prescribe, and it swings with a market that changes fast. A generalist treats a medication order like office supplies and loses sight of what actually drives your margin.
-
1
Medication cost swings faster than any other expense
The cost of compounded or brand-name GLP-1 medications shifts with supply, and a single order from a compounding pharmacy can be one of the largest expenses of the month, dwarfing everything else if it's not tracked on its own.
What we doKeeps medication costs in their own line, tracked against what patients paid for it, so the real margin per patient stays visible even as prices shift. -
2
Prepaid program packages get spent before they're earned
A patient who enrolls in a 12-week program pays the full package price up front, but the visits, monitoring, and medication happen over three months. Booked as one month's income, it hides what is still owed.
What we doKeeps prepaid program revenue visible as its own line, separate from monthly maintenance fees, so a big enrollment month doesn't overstate itself. -
3
January's rush hides how the rest of the year is doing
New patient enrollments often spike hard in January and taper through the year, and without that pattern tracked, a normal spring slowdown can look like the business is struggling.
What we doTracks new enrollment revenue against prior months, so the seasonal rush and the normal taper both read as patterns, not surprises. -
4
Supplement and meal replacement sales blend into program fees
Meal replacements and supplements sold alongside the medical program carry retail margin, not clinical margin, and lumped with program fees they hide which one is actually padding the bottom line.
What we doKeeps retail supplement sales apart from program and membership fees so the real margin on each stays visible.
Your categories
The categories Gus keeps for a weight loss clinic.
Set up once for how programs, medication, and retail all get paid. You never pick a category. He does, and an accountant checks it.
Money in
- Program package feesMulti-week enrollment fees paid up front, kept apart from monthly maintenance.
- Membership and monitoring feesRecurring monthly fees for ongoing check-ins and medication management.
- Medication dispensing feesWhat patients pay directly for medication dispensed in-house.
- Retail supplement salesMeal replacements and supplements sold at the front desk.
Money out
- Medication costsWhat you pay a compounding pharmacy or wholesaler for what you dispense or prescribe.
- Retail supplement inventoryMeal replacement and supplement stock, kept apart from medication costs.
- Clinical wagesNurses, dietitians, and providers, kept apart from front desk pay.
- Lab and monitoring costsBloodwork and monitoring tests used to track patient progress.
- Rent and utilitiesThe clinic space for visits and monitoring appointments.
- Marketing for new enrollmentsAdvertising that drives the January rush and steady enrollment year round.
- Malpractice insuranceAnnual or quarterly premiums for the practicing providers.
What we watch for you
- Medication cost per patient
What medication actually costs against what patients pay for it, tracked as prices shift.
- Program revenue owed
How much prepaid program money still represents visits and medication not yet delivered.
- New enrollment trend
How new patient revenue compares to the same month last year, since seasonality swings hard here.
- The set-aside
What you will owe, tracked every month, so April is a number you already knew.
Ask Gus
Things weight loss clinic owners ask Gus.
Text him like you would text anybody. He answers in plain English, and when a question is above his pay grade, an accountant looks and gets back to you.
I keep medication cost tracked against what patients paid for it, so you can see the real margin shift instead of guessing from the total expense number.
No, I track it against prior January's numbers, so the rush reads as a pattern, and the slower months later in the year make sense next to it.
That depends on your state and how the product is classified. I keep retail sales separate so the accountant can confirm what applies to you.
The tax side
The tax side of a weight loss clinic.
Most of what matters here is tracking medication cost of goods correctly and knowing where the pass-through deduction starts to phase out.
What your return has to get right
Your accountant signs it, so it gets done right the first time.
- The pass-through deduction phases outA weight loss clinic can lose part or all of the 20 percent pass-through deduction once taxable income passes $201,750 single or $403,500 joint, since medical practices are a specified service trade.
- Medication cost of goods soldWhat you pay for medication you dispense is generally tracked as the cost of what you sell, separate from your other operating expenses, which affects how margin reads on the return.
- Program revenue timingA prepaid multi-week program is income when received, but keeping it clearly labeled helps the accountant match it to the right period when the return is prepared.
- Contract or covering providersA provider covering your clinic occasionally who bills you directly is often a contractor and gets a 1099-NEC if you pay them $2,000 or more in 2026, due January 31.
Deductions weight loss clinics miss
Your bookkeeper knows what to look for in your statements. You never have to.
- Medication and dispensing costs
- Lab and monitoring test costs
- Retail supplement inventory
- Malpractice premiums
- Marketing for new enrollments
- Practice management software
- License and certification renewal
- Scrubs and clinical apparel
- Patient education materials
- Scale and body composition equipment
General information about 2026 federal rules, not advice for your business. Your accountant looks at your actual numbers before anything gets filed.
All year, not just April
A weight loss clinic year, kept every month.
January brings the rush, the rest of the year settles into a rhythm, and your taxes run on a fixed schedule of their own. Your team keeps you ahead of both. Every month in between, your bookkeeper closes the books and speaks up the moment something looks off.
- January
Plan the year
Last year's return gets started, and you get a monthly set-aside so April is already handled, right as the new patient rush begins.
- April
Filed. Done.
Your return is filed and signed. No surprise bill, because the set-aside has been running since January.
- July
Halfway check
Where you stand, what you will owe, and whether the January rush and the spring taper matched last year's pattern.
- October
Before year end
Gus looks at anything worth doing before December, while enrollment often picks back up ahead of the new year.
What you get
What you pay depends on what your business needs, and it does not move after that, busy season or slow. No hourly bills, no surprise invoices, no setup fee.
Book a call- Monthly bookkeeping
Every transaction sorted into categories set up for weight loss clinics. You never categorize a thing.
- An accountant checks every transaction
Real review, every month, before your books close. Not a spot check.
- Your business tax return, filed
Prepared, reviewed, and signed by that same accountant every year.
- The monthly number
What you made, what you spent, what to set aside for taxes.
- Your own bookkeeper
A real person assigned to your business, in the app whenever you need them. No hold music.
- On your books all year
Every month, not just in April. Your team speaks up whenever something is worth your attention.
- Cancel any time
No contract. No cancellation call. Your books are yours.
Straight answers
Questions weight loss clinic owners ask first.
Do you handle insurance billing for the medical visits?
No. Gus does not handle insurance billing, medical coding, or claims of any kind. Most weight loss programs are cash-pay anyway, and Gus works from what actually lands in your bank account.
Medication prices keep changing. Can Gus keep up with that?
Yes. He tracks medication cost against what patients paid for it every month, so a price shift shows up as a margin change instead of getting lost in general expenses.
A patient enrolled in our 12-week program but only made it to week 4 before stopping. What happens to that revenue?
Gus keeps prepaid program revenue tracked separately from earned revenue. What to do about an incomplete program is a policy question for you and your accountant.
Is our January rush actually normal or should we be scaling differently?
Gus can show you the pattern against prior years so you're working from real numbers. What to do with that pattern is a business call, not one Gus makes for you.
We compound our own medication in-house. Does that change how it's tracked?
The mechanics stay similar, medication cost still gets tracked as its own line against what patients pay. Anything involving compliance for compounding is outside what Gus handles.
Is a real accountant checking my books?
Yes. You get your own bookkeeper, Gus does the first pass on every transaction, and an accountant checks every one before your month closes. That same accountant prepares, signs, and files your business return. Goatkeeper is not a CPA firm, and we never pretend a person looked when they did not.
What does it cost, and can I cancel?
It starts at $197 a month, depending on what your business needs. No setup fee, no hourly bills, no contract. Cancel any time from the app, and your books go with you.
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What makes a bookkeeper worth paying for Every business we keep books for
Book a call
Pick a time. That's the whole signup.
Fifteen minutes with a real person on our team. They look at where your books are, tell you straight what it takes to get caught up, and get you set up on the spot if it fits.
- $197 a month to start
- An accountant on every transaction
- Cancel whenever