How to Start Your Own Medical Practice
Have you ever thought about being your own boss?
Not just dreaming it, but actually building it. Starting a private practice can feel like both a leap and a calling. We know, because we’ve done it.
Dr. Pamela Mehta bought an existing practice and made it her own. Dr. Natalie Crawford built hers from the ground up. There’s no one right way, but there is a way that’s right for you.
We created this guide to walk you through it, step by step. From choosing your model to managing finances and figuring out how to market your services, we’re breaking it down so you can stop wondering and start building.
But before anything else, pause and ask:
Why now?
Why this dream?
Why not just stay employed?
Starting your own practice requires clarity. On the hard days, your ‘why’ will matter more than your ‘how.’ Take a moment to reflect - what kind of life do you want? What kind of care do you want to give?
Private practice offers autonomy, deeper patient relationships, financial growth, and more flexibility. It also requires courage.
But that vision you keep coming back to? It's possible. Let’s build it.
About Private Practice
A private practice, by definition, is owned and operated by a physician or a group of medical professionals. In some states, nurse practitioners can own their practice independently or with a physician collaborator.
Choosing a Practice Type That’s Right for You
While most private practices are owned and operated by physicians or other healthcare providers, your practice can have several different structures.
As you read, consider your target patient population and your specialty. Different models may work better for different patient populations and specialties.
Insurance-Based
Pros: Larger patient pool, familiar billing structure, predictable revenue, more accessible to patients.
Cons: Insurance paperwork, delayed reimbursements, less agency on treatment options, lower per-visit revenue.
Best for: Traditional practice settings and/or multiple partners, and those looking for familiarity with volume-based care.
An insurance-based medical practice contracts with insurance companies to provide care at pre-approved rates, making services accessible to a broad patient base.
After the visit, the practice submits claims for reimbursement, though rates are typically lower than private-pay fees. Patients may owe co-pays, deductibles, or coinsurance, with the insurer covering the rest. This can be a little complicated for a new or solo provider, but works well long-term when used strategically!
Direct Primary Care (DPC)
Pros: No insurance hassles, closer doctor-patient relationships, predictable revenue, smaller patient panel.
Cons: Requires marketing efforts to attract and retain patients, difficult in solo practice to take time off.
Best for: Physicians who prefer a subscription-based model, primary care providers, and other providers whose patients require multiple visits a month or year.
Direct Primary Care (DPC) is a patient-centered model where patients pay a monthly, quarterly, or annual fee for comprehensive primary care services. These include routine checkups, annual exams, chronic disease management, and minor procedures like EKGs, biopsies, and joint injections.
DPC typically offers longer appointments, quicker access to providers, and often greater availability outside traditional office hours.
Most DPCs charge a fee between $50 and $100 a month, and the average DPC panel size is 413 patients. In transitional practice models, physicians usually have 2,000-2,500 patients.
“Direct primary care is a concept that’s actually been around for quite a while. Many physicians have decided they do not want to work for “the man” anymore and want to take back ownership of medicine. Direct Primary Care is a flat-fee monthly health care membership; It’s like the Netflix of health care.
Because I am a one-woman show, you can call, text, email, come see me in person, visit me over telehealth, and everything else. But people just pay once a month, like any membership.”
Note: You do not have to be a primary care provider to have a DPC-style practice. Many specialties, such as dermatology, rheumatology, and psychiatry, are moving towards direct pay practices (“Direct Specialty Care” or DSC).
You may have heard about concierge practices that sound very similar. Concierge practices generally cater to wealthy patients looking for additional services, like longer visits, home care, 24/7 physician access, and tailored preventive care.
This model uses annual or monthly fees, ranging from $1,500 to $20,000, depending on the practice and clientele. The practice may or may not continue to bill insurance.
The DPC model tends to be more accessible for a variety of specialties and patients, particularly those with chronic conditions who want to save money on their monthly fees.
Telehealth
Pros: Low overhead, flexible hours, wider reach across regions, good for psychiatry, dermatology, and endocrinology.
Cons: Limited hands-on care, licensing constraints, limited scope for procedure-based specialties.
Best for: Providers focusing on virtual consultations, and those who already have national reach via their social media or website audience.
Telehealth medicine is an emerging model gaining traction among independent practices. While it’s been popular in fields like psychiatry, more providers across specialties like dermatology, endocrinology, primary care, urgent care, and integrative medicine are switching.
However, there are two key limitations to consider:
Limited physical exams – This can be challenging, especially in specialties like surgery, where hands-on assessments are crucial.
State licensure – Each state requires a separate license to practice, and while Interstate Medical Compact Licensure can help reduce costs, it’s still expensive, especially if you’re licensed in multiple states.
Despite these challenges, telehealth offers flexibility and a growing opportunity for providers to reach patients beyond traditional settings.
Note: Telehealth does not have to be exclusive to a telehealth-only practice. You may also choose to incorporate telehealth visits into any of the above types of practices.
How to Start a Medical Practice
Market Research
Understanding your market is key to creating a thriving, patient-centered practice. Here’s how to gather insights and position yourself for success:
Listen to Your Patients
Send out quick, engaging surveys via email or social media to learn what services patients want. Are people asking for evening appointments, shorter wait times, or more wellness options?
→ Look for trends and use this data to shape your offerings and stand out.
“One reason that I decided on direct primary care is because I needed more time with my patients.
My patients have complex issues. They have diabetes, they have thyroid disease, they have a lot of things going on in their lives that lead to chronic healthcare problems.
So they need support, and they need access to their doctors, and they don’t need me to push them out the door.”
Study Your Competitors
Explore local practices. Analyse their website, booking process, and patient reviews for insights. What can you do better?
→ Take inspiration from their strengths but make your unique value clear.
Define Your Ideal Patients & Market Position
Understand local age groups, income levels, and healthcare priorities using demographic tools. Do they lack telemedicine, holistic care, or specialized services?
→ Identify underserved communities and tailor your services to fill the gaps.
By strategically researching your market, you can create a practice that meets patient needs and thrives in a competitive landscape. Know your audience, refine your offerings, and confidently step into your healthcare leadership role.
Legal and Regulatory
Disclaimer: Legal and regulatory information is based on the US system.
Choosing the Right Business Structure
Your business structure impacts taxes, liability, and operations. Common options include:
Sole Proprietorship – Simple but leaves you personally responsible for debts.
Partnership – Shares risk and rewards if working with other doctors.
LLC (Limited Liability Company) – Popular for physicians, offering personal liability protection, tax flexibility, and ease of management.
Note: None of these protect against medical malpractice, so malpractice insurance is a must. Consulting a tax lawyer or accountant can help you choose the best fit.
Registering Your Business
Once you’ve chosen your structure, the following steps help make your business official. :
Register with state/local authorities
Choose a business name & file for an EIN (Employer Identification Number)
Obtain required licenses & permits based on your services and location
Check zoning laws & local regulations for medical offices
Consult a business attorney to ensure compliance before opening
Securing the Right Insurance
Protect yourself, your practice, and your employees with essential coverage:
Malpractice Insurance – Costs vary based on procedures performed.
General Liability Insurance – Covers injuries, property damage, and legal fees.
Additional Coverage to Consider:
Property Insurance
Workers’ Compensation
Business Interruption Insurance
Umbrella Insurance
Health Insurance
Employee Practice Liability Insurance
Taking these steps ensures your practice is legally sound, financially secure, and well-protected – giving you peace of mind as you grow. Plan wisely, protect yourself, and build with confidence!
Setting Up Your Medical Office
Setting up your medical office can be overwhelming unless you have a plan. Here, we break down the process into a few categories to help it seem more manageable.
When deciding on an office space, consider:
Location: Choose an office space in a relatively popular area and/or near a main road. Ensure convenient parking for patients, staff, and yourself. Also consider accessibility for patients of different mobility statuses.
Lease terms: A long-term lease can protect you from rent increases, particularly if you invest significant money into renovations. A shorter-term lease option may be better if you think you want to expand or move.
When selecting an office location, it is essential that you choose a location that is accessible for patients of different mobility statuses. Make sure to note if there are stairs, ramps, elevators, or chair lifts, and difficulties you may face.
Note: Check if the building offers services such as nightly cleaning and maintenance as part of your lease terms. If they don’t, these could be additional expenses you must account for.
Furnishing and Equipping Your Office
When it comes to furnishing and equipping your office, there are quite a few factors to consider, such as:
Furniture: exam tables, desks, chairs, etc. for yourself, staff, and patients
Computers/electronic medical records/other technology
Medical devices and supplies (scale, blood pressure cuffs, syringes and needles, procedural supplies, vaccines, Epi-pens, etc.)
Technology and Systems
Technology is key when starting your practice. But how do you decide what you need?
You'll need an Electronic Health Record (EHR) system at minimum. Scheduling tools are essential to keeping appointments organized and reducing no-shows, while billing software helps keep your finances on track.
When starting out, look for an all-in-one solution that integrates these features, allowing for seamless communication between your team and patients.
Marketing
Marketing is key to developing a successful business. Here are the key parts of a strong marketing strategy.
Building a Brand
The concept of “building a brand” is often talked about, but what does it really mean? Creating a brand is about building a strong foundation of how you want your practice to be viewed, from visual media to reputation.
When building a brand, think about your vision. What do you want your practice to look like? This includes your signage, advertisements, and even office aesthetic. From font to colors to logos, consistency increases recognizability.
Next, consider your mission. What do you have to offer your community to attract patients to? Are you filling in a gap in local care availability? Do you have a niche specialty?
“It’s important to increase diversity in all spheres of healthcare so that patients can find a provider they can connect with and get the care they need.
Some people may not even go to the doctor if they don’t have someone like them, so I have so many people that come to me for that reason. I’m one of the only female neurosurgeons in Georgia, so people come from hours away just to see me.”
Some people may not even go to the doctor if they don't have someone like them, so I have so many people that come to me for that reason. I'm one of the only female neurosurgeons in Georgia, so people come from hours away just to see me.
Lastly, think about your values:
What is your priority in this practice?
Do you want to be known for flexible hours, where patients know they can reach you at any time?
Do you want to be known for long visits with extensive patient education?
Website & SEO
Whether you’re just starting out or growing a thriving practice, your website can quietly work in the background to build trust, communicate your values, and connect you with the people you’re here to serve.
A website with strong search engine optimization (SEO) can become one of your most powerful marketing tools. This may mean partnering with an SEO expert or agency that can create tailored service pages, educational blog content, and local SEO strategies that help new patients find you.
Tip: Don’t skip your Google My Business page. It’s what allows you to show up when someone searches for “OB/GYN near me” or “functional medicine in [your city].” Creating a profile for your practice (and each provider, if needed) also opens the door for gaining reviews and increased visibility.
“The number one thing I would encourage clinicians and solo practitioners to do is to invest in their Google My Business profile and start to develop a review request strategy.”
Social Media
Creating a social media presence is becoming more and more important as time goes on. It is harder to find someone who is NOT on social media than someone who is.
Developing a social media presence can be complicated. In our social media marketing guide, we break down how to choose which platform(s) you utilize and how to leverage social media for marketing and maximize your impact.
Networking and Referrals
Networking and building a referral base are under-discussed ways to help grow a new practice. Networking can include:
Attending local events
Joining online communities (ex. Facebook Groups, LinkedIn, Pinnacle Education Network)
Meeting with local physicians to develop professional relationships
All of these things can increase your visibility, helping to spread awareness of your practice by word of mouth or by developing a relationship with a local physician, who now thinks about sending you a patient who is looking for your specialty.
Hiring Staff
Finding the right staff is just as important, if not more, than finding the right location for your practice.
Good, supportive, kind staff who “get” you can make or break a practice. If you find staff who match your energy and understand your goals, you can create a positive work environment that patients will feel the moment they walk through your doors.
Things to consider:
- Decide when and whom to hire – do you want MA’s, nurses, receptionists, x-ray techs, etc.?
- Establish clear communication and accountability.
- Create a culture with safe spaces for feedback, for yourself and for others.
- Use onboarding checklists and manuals for standardization.
- Know when it is time to add more staff. Listen for signs of overwork or burnout in your staff, and know how to help them.
Finances
Strong financial management is essential to running a thriving practice, and clear, consistent billing ensures you get paid for the value you provide. Set patient-friendly policies from the start so expectations are clear.
There is also room to dream big here. You want to fully embrace the entrepreneurial mindset. This means looking beyond just the day-to-day and considering opportunities to scale and innovate.
Your approach will depend on your practice type – DPCs may outline membership terms, cash-based practices often collect upfront, while insurance-based practices navigate delayed billing. Decide whether to accept insurance and which providers to contract with, aligning with your goals.
Startup Costs
Launching a practice may seem overwhelming, but breaking it down makes it manageable.
Plan for Startup Costs: Budget for office space, equipment, licenses, insurance, marketing, and staff – costs add up fast.
Track Revenue & Expenses: Income comes from patient visits, insurance reimbursements, and additional services, while ongoing costs include rent, salaries, and supplies.
Build a Financial Cushion: Establishing steady patient flow takes time, so set aside funds for the first few months.
Stay Proactive: A clear financial plan helps you stay in control, ensuring long-term success and stability.
| Expense | Estimated Cost |
|---|---|
| Office Lease | $2,500-$10,000 per month |
| Medical Equipment (exams, diagnostics) | $5,000-$15,000 |
| IT Set Up (EMR, computers, billing) | $10,000-$30,000 per year |
| Marketing and branding (website, social media ads, brochures) | $5,000-15,000 |
| Licenses and insurance (malpractice, liability) | $10,000-$150,000 depending on speciality & location |
| Salaries (first three months for office staff) | $0-$15,000 |
| Miscellaneous (supplies, furniture) | $6,000 |
| Total | $40,000 - $250,000 |
Budget
Now that you have cash flow, how do you make the most of it? A strong budget is the foundation of a thriving practice. Outline essential expenses—staff salaries, office supplies, and realistic income projections—while tracking spending closely.
A spreadsheet of accounts can help you stay organized, and setting aside funds for unexpected costs will keep you prepared. Most practices analyze their budget quarterly, using variance analysis to spot discrepancies and adjust as needed. Consider working with an accountant to streamline this process.
Profit & Growth
Profitability isn’t just about covering costs – it’s about optimizing revenue, managing expenses, and thinking bigger. Embrace an entrepreneurial mindset by exploring ways to scale and innovate.
You deserve to get compensated for the care you are providing. Part of that means making a profit. Ultimately, making a profit comes down to optimizing the things we’ve already discussed: how you're bringing cash in, what your expenses are, and how closely you are sticking to your budget.
It’s natural to prioritize patient care over payments – but remember, your expertise and time are valuable. Patients choose you because they trust your skill and dedication.
Reinvest in your business and yourself. Growth isn’t just about finances – it’s about evolving as a provider and leader. Make bold, strategic decisions that ensure long-term success while allowing you to thrive.
Final Thoughts
You’ve made it to the end, but this is just the beginning.
If you're dreaming about starting your own practice, or even just beginning to explore what that could look like, we hope this gave you a clearer path forward. It’s not easy, but it is possible.
We’ll be diving deeper into each of these topics in upcoming posts, breaking it all down so you can make informed, empowered decisions.
Starting your own practice is bold. But with the right mindset, strategy, and support, you can absolutely build the kind of career (and life) you’ve always imagined. One that’s on your terms.