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Who this is for

When you need the call, not another opinion.

Strategy-only CMOs hand you a plan. We make the call and own the outcome. Embedded with your team, accountable to revenue.
01 Profile

Founders without a CMO

You've grown past the point where you can run marketing on instinct. A full-time CMO is a salary you don't need yet. We're the strategic layer with execution behind it.

02 Profile

Physician-led practices scaling past the founder

The clinic works because you built it. Marketing runs on whoever has time. You need someone who understands both the medicine and the math.

03 Profile

Operators stuck in the weeds

You're a CEO or COO running marketing by default. Every week loses hours to decisions that should be made by someone whose whole job is making them. That's us.

The work

Where we make the executive calls.

Every decision tied to a financial outcome. Every workstream auditable. No tactics without direction, no direction without numbers.
Foundation

Offer and positioning

Tighten what you sell and to whom. We pressure-test your offer against the market, your pricing against your value, and your ICP against your actual close data. Not against a deck.

  • ICP refinement using Hubspot close data
  • Offer architecture and pricing review
  • Positioning and messaging hierarchy
Acquisition

Paid media direction

We don't just run ads. We direct them. Channel mix, budget allocation, creative direction, and feedback loops that tie spend to closed-won revenue rather than clicks.

  • Channel mix and budget allocation
  • ROAS targets and revenue feedback loops
  • Creative direction and landing page strategy

8.45x return on ad spend, up from 3.73x. $12,889,452 in closed revenue from paid search on 4.8% less spend. MedSchoolCoach, 2025.

Retention

Lifecycle and retention

Acquisition without retention is leaky scaling. We map the full customer lifecycle, find where revenue leaks, and build the email, nurture, and upsell work that compounds what a customer is worth.

  • Lifecycle journey mapping
  • Email and nurture sequence strategy
  • Lifetime value modeling and target setting
Reporting

Forecasting and executive reporting

Numbers your CFO will defend and a buyer will trust. Pipeline coverage, weighted forecasting, cohort analysis, and a monthly cadence that turns marketing reporting into an asset.

  • Weighted pipeline forecasting
  • Monthly executive review cadence
  • Reporting a buyer can read in sixty seconds
The engagement model

Embedded partnership. Not a deck and a dial tone.

Weekly

Founder strategy cadence

A 60 to 90 minute working session each week. Not a status call. Where the executive decisions get made, together.

Monthly

Executive review

Pipeline, ROAS, lifecycle metrics, forecast versus actual, and next month's priority calls. Same template every month.

Quarterly

Strategy reset

What worked, what didn't, what changes next quarter. Tied to your actual revenue trajectory.

How clients pair this

Growth Decisions works best when paired.

Most common pairing

Revenue Architecture

Direction without clean data is opinion. Direction on top of clean architecture is leverage. Most growth clients pair the two in the first 90 days.

See Revenue Architecture →
Common PAIRiNG

AI Visibility + AEO.

If your buyers research with AI before they ever land on a sales call, AI visibility is part of your acquisition strategy, not a side project. We layer AEO in when buyer behavior demands it.

See AI Visibility + AEO →
Founder FAQ

Common questions, blunt answers.

No. A fractional CMO is one person who advises. We're two co-founders, one making the executive calls and one building the systems those calls depend on. You get the direction and the operational work to execute it.
We make them with you. We bring the data, the recommendation, and the financial case. You sign off. After 90 days, most founders trust the cadence enough to delegate most calls — but the authority stays with you.
Strategy consultancies hand you a deck. We hand you decisions, executed, measured, and reported on. The output isn't recommendations — it's revenue you can defend in front of your board.
Most engagements start with a paid diagnostic. Build work is quoted at a fixed price. Retainers are monthly. Most clients invest five figures to start and four to five figures monthly after that.
90 days. Strategy doesn't move the financial needle in 30. After 90, most clients renew quarterly. Some go on annual after the first year because they want budget predictability for their board.
45 minutes. We diagnose where revenue is leaking — Hubspot, attribution, paid media, or AI visibility — and you leave with a clear read on your Financial Fragility Score, what's working, what's broken, and what to fix first. No pitch deck. No discount games.
Your next step

Who is making the call right now?

A 45-minute call with a founder, not a salesperson. We look at where your marketing direction is leaking and tell you honestly whether this is the right next step or whether something else comes first.

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45 minutesFounder-ledNo obligation
What we'll diagnose
Offer + positioning Audit
Channel mix Review
Forecast confidence Score
Engagement fit Honest
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