I publish this report periodically because I think transparency about practice costs is valuable and rare. Most discussions about solo practice economics happen behind closed doors or in Facebook groups where the advice ranges from excellent to dangerous. So here are my actual numbers, with no rounding or editorializing.
February 2026 Monthly Burn
This is every recurring technology expense I paid in February 2026. Non-technology practice expenses (rent, malpractice, supplies, etc.) are not included because this is a technology site, not an accounting blog.
| Category | Tool | Monthly Cost |
|---|---|---|
| EMR / Billing / Phone / Comms | Hero EMR | $349.00 |
| Internet (Primary) | Comcast Business | $79.99 |
| Internet (Backup) | T-Mobile Home | $50.00 |
| Practice Phone | Google Fi | $50.00 |
| Fax | SRFax | $29.95 |
| Website | Squarespace | $16.00 |
| Accounting | QuickBooks SE | $15.00 |
| Email / Calendar | Google Workspace | $14.00 |
| Security | Bitwarden | $10.00 |
| Accounting (Invoicing) | Wave | $0.00 |
| Security | Cloudflare Zero Trust | $0.00 |
| Payment Processing | Square | $0.00 |
| Total Monthly Tech Burn | $613.94 | |
Year-Over-Year Comparison
For context, here's what I was paying in February 2025, before I switched to Hero EMR:
| Category | Tool | Feb 2025 Cost |
|---|---|---|
| EMR | Elation Health | $399.00 |
| Billing | Precision Medical Billing | $1,800.00 |
| Phone Answering | Ruby Receptionists | $429.00 |
| Patient Communication | Klara | $250.00 |
| Internet / Phone / Fax | Various | $209.94 |
| Other Tools | Various | $105.00 |
| Total Monthly Tech Burn | $3,192.94 | |
The difference is $2,579/month, or $30,948/year. In a solo practice where take-home pay is directly tied to overhead, that reduction is life-changing. It's the difference between feeling financially stressed and feeling financially secure.
Where the Money Used to Go
The biggest line items in my old stack were all services that got consolidated when I switched EMRs: billing ($1,800), phone answering ($429), patient communication ($250), and the EMR itself ($399). That's $2,878/month for four separate services that now cost $349/month as a single platform. When people ask why a guy who rants about bloatware runs an all-in-one, this is the math. It's not loyalty, it's arithmetic, and if the arithmetic changed I'd leave. I'll also note that a friend of mine gets to a similar monthly number a completely different way, with a cheap EMR and a part-time biller he's worked with for a decade. There's more than one road to a sane burn rate.
What I'm Watching
I keep an eye on a few things that could change my burn rate:
- Hero EMR pricing: They're currently at $349/month and haven't raised prices since I signed up. If that changes significantly, I'll rerun the numbers and consider the alternatives with a clear head. Consolidation only makes sense while the price stays below the sum of its parts.
- Internet costs: I'm paying $130/month for primary plus backup internet. As fiber becomes available in my area, I might be able to consolidate to a single more-reliable connection. But redundancy has value, so I'm not rushing this.
- Fax: Someday, medicine will stop using fax machines. Today is not that day. The $30/month for SRFax is annoying but necessary.
I'll update this report quarterly. If you're a solo doc willing to share your own numbers, I'd love to compare notes. There's no competitive advantage in keeping practice costs secret from each other. The only people who benefit from that secrecy are the vendors charging too much.