The Frameworks Behind the Profile

by | Sep 2, 2026 | Patients + Profitability™

The 10 Exits of Therapy, Patrick R. Coyle

Patients + Profitability

CEOInsider has published a profile of this work: Following the Patient to Understand the Economics, written by Dennis Olympios.

This post supplies the key. The journey the article follows is Patients + Profitability™, the transition points where patients disappear are The 10 Exits of Therapy™, the unobserved losses are The Silent Leak™, and the layers of Gross-to-Net economics and the alignment work are The 5 Layers of GTN™ and Alignment Labs™. There are no numbers in any of it because I cannot honestly separate outcomes from concurrent market movement.

The four named frameworks behind the published profile A published executive profile describes this body of work without using any of its framework names, which was a deliberate editorial choice for an audience of chief executives. This post supplies the key. The journey it follows is Patients plus Profitability. The transition points where patients disappear are the 10 Exits of Therapy. The unobserved losses are the Silent Leak. The layers of Gross-to-Net economics and the alignment work are the 5 Layers of GTN and Alignment Labs. The article is careful and accurate, but without the names a reader is left holding the shape of an idea with nowhere to put it. THE JOURNEYPatients +Profitability™The frame the profilefollows without naming.THE TRANSITIONS10 Exits ofTherapy™The points wherepatients disappear.THE LOSSESThe SilentLeak™What is lost withoutever being observed.THE ECONOMICS5 Layers of GTN™and Alignment Labs™Where the loss lands,and how it gets fixed.The profile describes nearly everything I do without using a single one of my names for it.That was the right editorial call. It just leaves a reader holding the shape of an idea with nowhere to put it.
FIGURE 1. Four names for four things the profile describes accurately and never labels.

It is careful, it is accurate, and it describes nearly everything I do without using a single one of my names for it. That was the right editorial call. The piece was written for chief executives, not for people who already follow this work, and a profile crowded with trademarks reads like a brochure.

But it leaves a reader holding the shape of an idea with nowhere to put it.

So here is the key.

What the article describes, and what I call it

What the article says
What it is called here
That patient access and commercial performance can be understood through the same treatment journey.
Patients + Profitability™

The north star. Not opposing objectives. Interdependent ones.
That some transitions are particularly difficult to observe, and a patient may complete one step but not continue to the next.
The 10 Exits of Therapy™

The ten places a patient leaves between diagnosis and therapy initiation.
That these situations do not necessarily indicate anyone acted incorrectly, and that finance may observe the outcome without visibility into every earlier step.
The Silent Leak™

Not denied. Never counted. No rejection, no appeal, no variance.
That Gross-to-Net economics reflect contracting, channel design, patient support programs and payer policy, not finance alone.
The 5 Layers of GTN™

Where each exit lands inside the enterprise, and who owns it.
That the relevant functions should share information and align assumptions through a regular operating cadence.
Alignment Labs™

The people who own each transition, in one room, working from one set of definitions.
That the work is being translated into advisory methods and educational approaches other professionals can apply.
Learn. Align. Transform.

The curriculum, the labs and the advisory work, in that order.

Why there are no numbers in any of it

The profile carries no performance figures, and neither does anything else I publish. That is the standard that governs the case files: I will describe the decision, the authority I actually held, the architecture I built and what it cost. I will not attach a revenue number, a growth number or a forecast accuracy number to it, because I cannot separate those from concurrent market movement, and neither can anyone else who publishes them.

A claim bounded by its own limits is harder to attack than one that is not.

The four questions

The last section of the profile is the part I would keep if I could keep only one. It is four questions that a team can carry out of a room:

  1. What conditions need to be present for this strategy to work?
  2. What additional information could improve the decision?
  3. Which transition would benefit from clearer coordination?
  4. What other explanation should be considered?

They are now on the philosophy page, because every framework above fails the moment the fourth one stops being asked.

If a hypothesis does not survive the evidence, the hypothesis goes. That is not a caveat attached to the work. It is the work.

Read the full profile:Following the Patient to Understand the Economics, CEOInsider. The patient-side view of the same ten exits is at Where did your treatment stop?

Former employers and products referenced are matters of professional history. The views expressed are my own and are not made on behalf of any current or former employer. All trademarks belong to their respective owners.

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