A fractional CMO
worth hiring.
The engagement is how a small number of practice owners hire the growth brain they don’t want to fill a full executive seat for, without getting an agency pitch deck and a quarterly report designed to hide what didn’t work.
The small book.
Current Architects include concierge physician groups, specialty dental practices, and multi-location medspa operators. The engagement is identical. The vertical-specific expertise we bring is different.
The fit criteria are narrow: the practice has found its footing, has a founder-operator who owns the P&L, and has crossed the threshold where the next growth step is systems-and-strategy rather than scrappy effort. Below that threshold, MapsPRO, RankPRO, AdsPRO, and SitePRO are the right answer.
Practices under $1.5M in collections typically belong in the product stack, not in the Architect engagement. That is where the unit economics favor the practice, not us.
What the engagement actually looks like, day to year.
Vince is reachable. The same channel you would use for a question inside your own team. Replies measured in hours, not days, because that is what the role is.
A standing 30-minute sync with the practice owner. No status theater. What moved, what didn't, what decision needs to be made this week.
A written operating review (financials, marketing performance, growth-lever status) with a clear set of decisions the practice should be making next month.
A half-day in-person or video session with the leadership team. Reviewing the 12-month plan, the 36-month plan, and the parts of the business that don't show up in the weekly sync.
Four things that are load-bearing.
The engagement is small by design.
Twelve to fifteen active Architects at a time, capped. Not ten, not a hundred. The cap moves only when a second lead joins; until then, it stays where depth stops being scalable.
The four growth disciplines are included.
MapsPRO, RankPRO, AdsPRO, and SitePRO are all executed under the Architect engagement, at the tier the practice needs, with no separate management fees. The Architect fee covers the strategic brain; the four products cover the hands.
The financial model is transparent.
Ad spend stays pass-through. We don't mark up media, we don't mark up vendors, we don't hide a margin inside a line item. One Architect fee. The rest is what it costs.
The engagement is evaluated annually.
Every twelve months we sit down and ask, together, whether the Architect engagement still fits where the practice is. Some graduate to in-house CMOs. Some downshift to MapsPRO Dominance. Some stay for seven years. All three are the right answer.
One concierge physician.
Eleven, across three locations.
Architect is not theoretical. It is what one engagement looks like over time, on the ground, with a real practice and real numbers. Griffin Concierge Medical in Tampa is the clearest version of the case: a single concierge physician who built into eleven physicians across three locations on the integrated MapsPRO, RankPRO, AdsPRO, SitePRO operating system, with the Architect engagement as the strategic connective tissue throughout.
Each expansion was financed by the pipeline the methodology produced. Each new location opened with the schema graph, local search foundation, and conversion architecture already in place. The relationship is the model: a practitioner-to-practitioner partnership, not a vendor handoff. That is what the Architect cap of twelve to fifteen seats actually pays for.
Every engagement
ships a Strategic Command Plan.
Forty to a hundred pages, rendered in the client portal, specific to the practice. It covers every page, keyword, schema type, conversion path, and KPI before a line of code or content gets written. Clients live in this document for twelve months.
Modern Dermatology
Digital Infrastructure.
Complete digital strategy for a 102-page South Tampa practice. Two board-certified dermatologists, a signature procedure, and a direct-care model.
Physician schema includes NPI, board certifications, medical license identifiers, and granular knowsAbout arrays. No competitor in the market has this depth. Feeds Google’s Knowledge Graph and positions both doctors for AI Answer Engine citations.
The technical floor, non-negotiable, measured, automated.
JSON-LD, server-rendered, validated to schema.org on every build.
LCP under 2.5s, CLS under 0.1, INP under 200ms. No exceptions.
Axe-clean at every heading level. Keyboard-complete. Screen-reader tested.
Geocoded across the practice's full service radius. Delta-reported.
Attribution you can audit. Whisper recordings when the client wants them.
Server-side validation. No PHI in analytics, remarketing, or logs.
70+ healthcare directories, continuously reconciled via BrightLocal.
Practice-voice response management. Cadence set to velocity, not vanity.
Paid campaigns measured past the iOS signal loss. No event theft.
Per-practice Strategic Command Plan rendered in the portal. Watermarked for leak forensics. Updated when project phases complete, not when an agency owns the cadence.
Architect engagements start at $8,000 / month.
That figure includes the product execution across MapsPRO, RankPRO, AdsPRO, and SitePRO at whatever tier the practice needs, no separate management fees stacked on top. Ad spend is pass-through, paid directly to platforms.
Most engagements settle between $10,000 and $18,000 per month all-in once the product mix is tuned. Compare that to a full-time CMO at $280K + benefits + equity and the math is usually obvious. Compare it to an agency retainer designed to survive the client not paying attention and the math is always obvious.
Architect agreements are 12 months minimum, renewed annually. No handshake deals. Every line is in the SOW.
Want the concrete list?
Read the deliverables page.
This page is the positioning. The deliverables page is the sheet. Every artifact the practice receives, every meeting on the calendar, every line item in and out of scope, what Architect is and what it is not.
Start with the audit.
then we talk.
The Practice Audit is how every Architect conversation starts. It gives both sides an honest read on where the practice is, what is actionable, and whether Macbach is even the right fit. Ten questions, three minutes, no sales pitch.