Each demo looked perfect. Each implementation revealed the same pattern: works beautifully for one scenario, completely breaks for the eleven other ways that same situation actually happens in your practice.

The vendors promise flexibility. The reality is rigid workflows that assume "this always works this way."

After testing 25-30 platforms over ten years, Ernie and Debbie Beltz finally understand why there’s no single system that works for practitioners, and how the future might help provide a solution.

Little Land operates as a hybrid model: pediatric therapy services alongside family entertainment and education programs. Classes, camps, birthday parties, clinical work.

That complexity means founder Ernie Beltz has experienced virtually every way healthcare technology can fail – and he’s not the only owner out there that runs a nuanced independent healthcare practice.

Lost revenue for four months due to a payment misdirection bug. Platforms that work perfectly during demos but collapse under real-world workflows. Systems priced for business models his practice doesn't have.

Over ten years, he's tested somewhere between 25 and 30 technology platforms, because there hasn’t been anything built for his specific practice model.

What has he learned?

Healthcare technology fails because developers design for static scenarios while many different types of independent practices face dynamic, constantly changing operational realities.

"You've got software developers building technology to support clinics to fix a problem they've heard about," Ernie explains. "But without the nuances of actually running the business or working in the business, it's really easy to think that things are one static way."

A platform might handle appointment scheduling beautifully—until a clinic needs to account for additional, highly specific details, like particular insurance authorization windows. Little Land, for example, needs to record parent / guardian details and keep a pulse on equipment usage to avoid double booking sessions.

The system assumes one workflow. The practice encounters eleven variations daily.

"They solve the problem, and maybe it can work," Ernie notes. "But the other 11 ways that problem comes up, there's no way to fix it."

Little Land’s specific hybrid model has driven them to run two separate systems, as no single platform addresses their needs for both therapy and entertainment programs. Because of this, "We have no way to analyze our customer value in an easy way," Ernie says. "We don't have aggregated data about what historical customers have done."

The flexibility gap extends across the industry. "A lot of this technology isn't flexible," Ernie observes. "You have to do everything in a tight little box, and you can't do anything else."

In other industries, developers would call these "edge cases" or outliers, creating systems to handle these multiple needs. In reality, this is the daily business model for a lot of independent practices with niche or specific services. 

After a decade testing rigid platforms, Ernie sees AI as fundamentally different.

"AI has helped a lot in being able to push data in and get reports out," Ernie explains. The technology bridges disconnected systems and translates clinical work into business intelligence.

AI learns from variation instead of requiring repeatability. It adapts to specific workflows instead of forcing conformity to predetermined processes.

The question is whether it can finally bridge the developer-operator disconnect that's plagued healthcare technology for decades.

A breakdown of what in the name of AI you should actually be paying attention to.

2026 healthcare AI trends from industry experts

The real opportunity isn’t replacing clinicians; it’s augmenting them. AI shines as a copilot for documentation, coordination, and admin tasks. It’s most effective when it includes governance, privacy, and human review. Trust and safety are still the gating factors for scale.

Verdict: ✅ Worth paying attention to

Building off of last year’s success, we’re hosting more Practice Independence dinners where we gather a small group of clinic owners to share insights on growth, scale, and preserving independence.

Do you run a multi-location practice in Florida? We’re organizing a dinner near you in February – reply to this email if you’re interested in attending.

Not located in Florida but interested in hosting or attending a dinner in your city? Reply to this email with your location, and we'll make it happen.

Thanks for joining us for another edition of Practice Independence — we’ll see you in 2 weeks!

Take care, Indie

PS: Ready to revolutionize your practice? Talk to us.

Indie is on a mission to improve the quality of life for rehab providers and their patients by combining technology with world-class rehab therapy. 

Join the waitlist. We have limited spots available!