At Management Directions, we have more than 50 years of experience in leadership roles with physician practices, managed care organizations, academic practice plans, and closely held companies. All of our associate consultants bring special skill sets in their areas of expertise. As a client of Management Directions, you can be assured that one of our principals will be thoroughly engaged in your business and will serve as your primary contact.

Richard Spires, CPA, CMPE
Richard Spires is a Certified Public Accountant and Certified Medical Practice Executive with more than 20 years of financial management experience. He previously served as the director of physician practice management for the Dallas office of a multi-state physician management company. His clients range in size from solo practitioners to large physician organizations. He has developed and represented group practices, physician networks, Management Service Organizations (MSOs) and Independent Physician Associations (IPAs). He also served as the chief financial officer for a multi-million dollar service company and has public accounting experience with a Big Five firm.

John Candelaria CMPE
John Candelaria is a Certified Medical Practice Executive, and Vice President of Management Directions, Inc. with more than 5 years of medical management experience.  He is an active member of the Medical Group Management Association (MGMA) and his clients range in size from solo practitioners to large physician organizations. He has developed and represented group practices, physician networks, Management Service Organizations (MSOs) and Independent Physician Associations (IPAs). 

Mark Engler
Mark Engler has 12 years of experience working with physicians and physician groups in the Dallas/Fort Worth area. He is an active member of the Medical Group Management Association (MGMA). He serves in a business development role for the Medical Clinic of North Texas (MCNT) where he developed and manages the organization's skilled nursing program, which generates ancillary income for the physicians. He also served as the director of contracting and director of network development for two large IPAs in the Dallas/Fort Worth area. Together, these IPAs comprised more than 2,000 physician members. Mark played an instrumental role in negotiating and maintaining more than 30 managed care contracts on the members' behalf.


Our clients include:

  • Solo Practitioners
  • Physician groups (variety of sizes)
  • Management Services Organizations
  • Independent Physician Associations


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