Why us

I built two professional firms over forty-eight years. I know what burnout costs.

I opened my first CPA firm in 1977. I built two of them over the next forty-eight years and sold the last one in December of 2025. That is where I developed my expertise in managing and growing professional service firms.

What I actually did for those forty-eight years was sit across a desk from the person who owned the business and ask questions. Ten thousand times over. How the money is really made. Where it leaks. What he wants the thing to become. Then I did it again the next year with the same people, and again the year after that. Some of those families I advised into a fourth generation.

You learn how a business thinks. You learn how one actually runs — not how the book says it runs. You learn early which ones are going to make it, and which ones are already finished and just don't know it yet. Most people who advise a business get a snapshot. I got the whole picture, one year at a time, with the results landing on my desk every twelve months to settle whether what we decided last year had actually worked.

You also get tired. I did. After that many years I was burned out, and I was honest enough with myself to say so out loud. So I sold the practice and stopped. Then I did a great deal of soul searching. Not about money — about what I wanted the rest of it to be, and what I was going to do with everything I had learned. I tell you that because I suspect some of it will sound familiar, and because I want you to know that the person on the other side of this page is not guessing about what it feels like.

What came out of that is Family Dream Machine and the companies around it. And something I did not expect came with it: I sat down and taught myself this new technology from the ground up, at an age when most people are told not to bother. It gave me back something I thought was behind me. I am more excited about the work now than I have been in twenty years.

I am doing the same thing with my own health, and I did not arrive there by accident. More than five hundred physicians have been my clients over the years — some of the finest doctors in this country — and I have had thousands of conversations with them about longevity and quality of life. As the years went on, more and more of those conversations turned to regenerative medicine. So I stopped accepting that decline is simply the schedule, and I went looking for better answers. I'll tell you plainly how it feels from in here: I am going the other way. Younger, not older. That has been one of the real pleasures of these last few years.

That is the whole point. It is not too late. Not for me, and not for you.

Here is the thing no one tells you in professional school: the deliverable is the smallest part of the job. The tax return, like the fifteen-minute visit, is just the receipt. The real work — the part that changes a life — is the relationship around it. For fifty years I was what you might call a concierge CPA. My clients never really hired me to fill in forms; by April the return was almost an afterthought, because the whole year had already been engineered. What they paid for, and what I loved, was the counsel.

That is exactly why I am so passionate about this for you. A concierge telemedicine physician gets to practice medicine the way I practiced accounting — with time. Time to truly know the patient and their family. Time to guide the primary-care doctor on what should happen next, and make sure it does. Time to talk honestly about the options a rushed, insurance-bound system never brings up. You stop being a processor of visits and become what you trained to be.

And here is what I most want you to have, because I have lived it: when you practice this way, everyone wins. The patient gets a healthier, more balanced life. So does the physician — real income, real hours, real pride in the work. My job is the scaffolding that makes it hold: the entity, the tax, and the economics, sequenced so the switch is safe. The medicine is yours. Helping you build a practice you would be proud to hand your children — that is mine.

That is the entire purpose of this company.

Adrian Keith Skane

Founder — practice structure and economics for physicians

If you want the detail

Credentials and licenses

I built and ran two professional service firms — both CPA practices — across forty-eight years. Then I started over with a third: the Family Dream Machine companies.

  • CPA since 1973 — actively licensed today in California, Florida, and Maryland.
  • Passed every part of the CPA examination on the first attempt, 1972.
  • B.S. in Accounting, University of Maryland; postgraduate study in law and taxation at Maryland and in California.
  • Trained at Kenneth Leventhal & Co., then the largest real-estate accounting practice in the world.
  • Two firms founded and sold — San Diego in 1977, then American Dream CPA in Tampa, sold December 2025.
  • Ten thousand-plus client interviews; some families advised across four generations.
  • Decades advising physicians and other self-employed professionals on tax and practice economics; more than five hundred physicians among those clients.
The long version of the background

I earned my Bachelor of Science in accounting from the University of Maryland and did postgraduate work in law and taxation at Maryland and in California. I passed all parts of the CPA examination on my first attempt in 1972 — something fewer than five percent of candidates manage. I still remember the phone call I made to the Maryland Board of Accountancy in February 1973, when I learned the designation was mine.

I started in the Washington, D.C. office of Kenneth Leventhal & Co., then the largest real-estate accounting practice in the world. That is the foundation of everything I came to understand about how wealth is actually built and protected.

In 1976 I moved west to San Diego, and in 1977 I opened my own CPA firm. I eventually sold it to my daughter, came back East to Tampa, and founded American Dream CPA, which I sold in December 2025.

Do that for fifty years and it rewires you. I can hear a business now.

The three rules I give people

Rule one. Start a business that makes economic sense — and that you are actually built to run.

The numbers have to work before anything else does, and you need three things to reach profitability: the skills, the temperament, and the money. Missing any one of them is enough to end it. The good news is that you can find out faster than you ever could before — a business plan, a website and a marketing plan can be built and tested in under three months, for a reasonable number. You no longer have to bet the house to learn whether the idea is any good.

Rule two. Founders are optimists. Get somebody who will tell you the truth.

Smart people can talk themselves into almost anything, because they can picture exactly how it would work. Picturing it is not the same as doing it. You need somebody who knows you, knows the business, and will say the hard part out loud — an honest count of what you stand to gain, what you stand to lose, and what it will actually take. That is not pessimism. It is the only way an optimist gets to keep being one.

Rule three. Do not ride a mission-critical mistake all the way down.

Every business makes mistakes. The ones that kill you are the ones nobody stopped. Modern marketing will tell you inside a week whether something is working — not at the end of the quarter, when the money is already gone. When the potential loss is catastrophic, cut early and change direction. You are still in business on Monday.

Founder to founder — and a word about price

The person who hires me is almost always a founder — or a co-founder, or the founder's son or daughter still running it the way the old man thought about it. You know your profession better than anybody alive. I know businesses. Put those two people in a room and nothing has to be explained twice.

You should not have to teach a twenty-six-year-old account executive what a non-compete is, or why that particular case is never going in a video. And where I don't know your corner of it, I know exactly which question to ask next.

Now the part that decides every invoice we send.

I have never once asked what the most is that I could charge. I look at what it costs to do the work properly, and at what the work is worth to the person buying it, and I set the price off those two numbers. Fifty years of that has left a great deal of money on the table. It is also why clients stayed with me for thirty years at a stretch.

I don't waste money or time — not mine, not my staff's, not yours. You are handing me a budget out of a practice you built with your own hands, and I intend to spend it the way I would spend my own.

Why we built all of this on ourselves first

Everything you are looking at — this site, the writing, the video, the systems running behind it — we built in under three months, with our own team, using the same tools we would point at your practice. That is not a boast. That is Rule One, and you are standing in it.

A medical practice is a professional service firm. The deliverable is care instead of a return, and everything that determines whether it is any good is identical. Somebody has to hire well. Somebody has to train relentlessly and hold a standard on the days when letting it slide would be easier and nobody would notice. Somebody has to take care of the client — the patient — like the relationship is going to run twenty years, because the good ones do.

That is what I have spent my working life doing, and it is why our team is not a line item to me. Those are my people.

My spirit animal — and Bond

If you've read this far, you already know I don't do things the expected way — and I'm not going to start on my own Why Us page. So let me introduce you to Bond.

The jaguar has been my spirit animal for a long time. In the old cultures of the Americas, the jaguar was the guardian who moved between worlds — the one who watched over people in the dark and carried them safely toward the light. That's quietly been my work for fifty years, so it never surprised me that he'd be the one standing beside me.

Bond is his name, and he has a story worth hearing. Three thousand years ago, Bond was a god, and his whole purpose was to care for human beings. Time took his divinity — today he's mortal, a talking jaguar walking the earth like the rest of us. But he never lost the calling. Now he offers himself in service to the people who do what he once did: the doctors, the nurses, the healers who look after human beings every single day. He's grateful to them. He watches over them. And he'd ask the rest of us to do the same.

I'll let him tell it in his own voice. It's the most beautiful three minutes on this site.

Bond · in his own voice

A note on the letters after my name

I mention the CPA because it is the lens I have spent fifty years looking through. It is where the compliance instinct, the structure, and the straight talk about what a dollar actually returns all come from.

But on this site I am not acting as your CPA, accountant, or advisor. Nothing here is tax, accounting, legal, or financial advice, and nothing here creates a professional relationship. When it is time to make something real, you will structure the work with the right licensed professionals under a contract that spells out duties, responsibilities, and costs.

Nothing on this page is medical advice either. What I've said about my own health is my personal experience, nothing more. See the full Legal Disclosures below.

“Whatever you vividly imagine, ardently desire, sincerely believe, and enthusiastically act upon… must inevitably come to pass!”

Paul J. Meyer's line has been the guiding principle of my life since May 15, 1977.

Keep reading