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Private Practice How to Start a Medical Practice
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Author: Justin Nabity

Last updated: October 26, 2023

How to Start a Medical Practice

Your Step-By-Step Guide to Start Your Own Private Practice

For many physicians, the decision to start their own practice can be a difficult one. While many physicians understand the rewards, others focus on the risks.

That risk focus leads to doubting if they can launch a successful private practice from the ground up. Opening a private practice is no easy feat, but with guidance and determination, it’s not as hard as you may think. If you’re considering leaving your hospital or healthcare system, here’s how to start a medical practice.


Ready to Start Your Own Medical Practice?

According to the AMA, approximately 46% of practicing physicians own their own practice, 65% of which are in surgical specialties. Of those physicians, 15% of physicians own a solo medical practice (17% of those are in surgical specialties).

From primary care to cardiology, physicians have the option to become their own boss and put their health system days behind them. Yet many fear that they will not be profitable or successful.

Commonly, physicians contemplating going into practice on their own face shared perceived barriers.

Some worry about the start-up costs. Some doubt their ability to draw patients. Others worry about hiring, staffing, medical billing, and how long it will take to see a positive cash flow.

All are valid concerns, but they aren’t roadblocks. They’re simply obstacles that you’ll need to overcome.

Like any small business just starting out, it will take time to get your new practice operating and turning a profit. If you’re thinking about opening your own practice, it’s best to focus on the rewards — yet still consider the risks.

Reasons to Start Your Own Medical Practice

Every physician has their reason for wanting to open their own practice.

1. Autonomy

Some are looking for autonomy and want to have complete control over the decision making for the type of patient care they provide.

As your own boss, you can purchase the kind of medical equipment you want. You won’t have to fill out any request forms or wait for approval from the hospital administration.

As a physician in private practice, you can also adjust the office workflow to how you practice. You have total control over hiring your staff and other medical professionals to support your practice.

You can also provide the type of care you want, such as focusing on underserved populations or providing concierge services.

2. Lifestyle

Lifestyle is another key reason that so many physicians choose to go into private practice. According to Medscape, 49% of physicians would accept a salary reduction in exchange for more free time.

When you own your practice, you can decide how many hours to work, how many vacation days to take, and how much time you want to spend with patients. Work-life balance is more important than ever.

3. Income

Another reason to go into business on your own is the earning potential. As the boss, you have the potential to earn considerably more money than you’ll ever make as an employee for a healthcare system or hospital group.


Not sure if you’re ready to open a practice on your own? There is also the option to go into business for yourself as a partner in a group practice.

If you decide to become part of a group practice, the first thing you’ll need to do is hire a lawyer to draft a partnership agreement between you and the other physician partners. Once that has been signed by all partners, you can proceed with setting up the practice in a way that you all agree on.

If you’re searching for autonomy, a better lifestyle, or higher earning potential, here is our step-by-step guide to opening a medical practice.

See also: Pros and Cons of Small Practices and Large Health Systems.

Step 1: Preliminary Tasks

Before you tender your resignation and lease a medical office, there are some preliminary steps you’ll need to take.

Gather Information

First, spend some time gathering information. The fact that you’re reading this article right now is an excellent indicator that you understand the importance of research. Unfortunately, reading articles online isn’t enough.

It can be beneficial to network with physicians that have already done the work of opening their own practice. Many will be willing to provide advice. Some may even be willing to recommend payroll services and staffing solutions for legal professionals and accountants.

With a bit of research, it will become quite clear that setting up your own medical practice is a complex endeavor. It’s at this point that you should decide if you want to build your business on your own or enlist the services of a start-up expert.

Determine a Location for Your Practice

For many physicians, where to open a practice is one of the most challenging decisions to make.

Besides your personal preferences about where you want to live and work, you should also research the physician-to-population ratio in that specific city, town, or region. For your practice to succeed, you’ll need to work where there is a need for physicians in your specialty.

One way to determine this is to see if local hospitals are recruiting physicians in your specialty. If they are, there is a need.

Another way to determine the supply and demand in a particular region is to assess patients’ average wait time. The longer the wait time, the greater the need.

Secure Financing

The third preliminary task to address is the one that most physicians dread:

Securing financing.

Some physicians choose to take their start-up costs from their personal savings. While others compare lenders and interest rates in the hopes of taking out a small business loan.

Yet, there is one other way to go about securing financing for your new business …

It may be possible to negotiate a contract with a hospital in the area that needs physicians in your specialty and in their immediate vicinity. A local hospital may be willing to guarantee income for your first year or two in business. Or they might make reimbursements for medical equipment and other start-up costs.

Considering the small business loan route? Read: Financing Your Practice: Bankers Healthcare Group Loans Review.


Step 2: Address First Line Tasks

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Once you’ve addressed your preliminary tasks, it’s time to start tackling these first-line tasks:

Make Your Business Legal and Official

First, incorporate your business so that it’s a legal business entity. For a small investment, you can hire an attorney to handle this for you. Within a few weeks, your business will be legitimate, and you’ll be able to get a tax ID number.

Second, select your office space. Necessary forms will likely require your medical office’s address. Prepare to hire a commercial real estate professional to take you on tours of vacant office spaces.

Next, obtain your National Provider Identifier (NPI). Issued by the Center for Medicare and Medicaid Services, its purpose is to identify your office (or you) as an individual physician. You’ll need an NPI for billing purposes.

Open a Bank Account

Open a separate bank account for your business. Most insurers will transfer your payments directly into your bank account. These payments should always go to your business, not to you personally, of course.

You’ll also need to order business checks for those rare cases when you may need to refund a patient for an overpayment.

Select Your Insurers

You’ll need to contact insurers and undergo credentialing to accept patients under different insurance plans.

Medical providers in private practice can decide which insurance companies they want to work with. It’s necessary to go through the credentialing process for each one selected.

Other critical first-line tasks include:

  1. Obtaining malpractice insurance
  2. Filling out forms required by the DEA (so that you are legally allowed to prescribe controlled substances)


There are nearly a dozen preliminary tasks and first-line tasks that you’ll need to address before opening your own practice. For a comprehensive list of all tasks, contact Physicians Thrive now.

Related: Malpractice Insurance Options & Why Physicians Need Malpractice Tail Coverage.

Step 3: Address Second Line Tasks

These second-line tasks are no less important than the first-line tasks detailed above. However, the first-line tasks are separate because they are necessary to complete prior to credentialing.

Business Insurance is a Must

Other than business insurance, you’ll also want:

  • Workers compensation insurance for your future employees
  • Business auto insurance (if you intend to lease a vehicle for your practice)

These are separate policies required in addition to medical malpractice insurance.

Hire an Office Manager

Hire an experienced office manager that can handle everything from human resource concerns to staffing issues to billing and coding. This person will play a crucial role in your business, so vet candidates thoroughly and hire someone with substantial medical practice management experience.

Create Contracts, Determine Salary Rates, and Define Benefits Packages for Your Employees

Before you can start the hiring process, you’ll need to decide how you will pay and provide benefits to your employees.

Determine employee salaries, decide which type of health insurance you want to offer them, and think about any retirement plans or other benefits that you want to extend. From PTO to 401k plans, establish your employee salary and benefits package before you start to interview and hire staff.

When you begin the hiring process, be sure to have employee contracts drafted and ready for new hires to sign.

Decide Which Systems to Use

Choose your preferred payroll system, determine which billing system you want to use, and select a software system for electronic medical records.

At this point in your preparation, you should also start looking for a few key roles to outsource.  Most private practice physicians tend to outsource accountants, attorneys, payroll services or bookkeepers, and financial planning advisors.

Medical equipment and office supplies are also crucial elements to order at this stage of your business plan. You’ll need furniture, computers, copiers, and other essentials set up and ready to go on day one.

There are more than 15 second-line tasks you’ll need to address to open your own practice. For a complete list of all second-line tasks, contact Physicians Thrive now.

Step 4: Address Third Line Tasks

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You’ve set up your business legally, acquired the necessary insurance policies, and made the biggest decisions. Now, it’s time to get into the nitty-gritty details of what you’ll need to run your own practice.

Here is an overview of a series of third line tasks you’ll need to address before you can open your practice:

  • Determine your fee schedule
  • Choose a Clearinghouse service to ensure that your patient billings are “clean”
  • Obtain HCFA 1400 paper billing forms if you’re handling billing in house
  • Order ICD 10 and CPT coding books
  • Set up a system to accept credit card payments
  • Purchase standard medical supplies such as gloves, gauze, and cleaning wipes
  • Get disability insurance if you don’t already have it
  • Hire an answering service to take calls when you’re not in the office
  • Hire a medical waste disposal service
  • Contract with a service to shred documents
  • Create patient forms
  • Develop letterhead
  • Obtain the OSHA policy handbook
  • Display your state medical license and medical school diploma or residency certificate


For a complete list of third-line tasks and ongoing tasks to take into consideration, contact Physicians Thrive now.

Starting Your Own Practice Takes Time and Patience

Whether you intend to work independently with one or two staff members or bring other healthcare providers and physicians onto your team, setting up a medical practice takes time, patience, and dedication.

Establishing your medical practice can be stressful. What’s important to know is that all physicians, regardless of specialty, have to deal with some stumbling blocks along the way.

Yet, there is a way to create your own practice without having to shoulder the burden alone. At Physicians Thrive, we have physicians on staff who have already built successful practices and can help you do the same.

Starting a medical practice can be overwhelming. But if you make it a success, you can enjoy the autonomy of being your own boss. Revel in the freedom to work when and how you wish, and earn more than you ever would as an employee of a hospital or healthcare system.

From walking you through the preliminary tasks to preparing you for opening your office on day one, Physicians Thrive is here. If you’re ready to take the leap from employee to business owner, contact Physicians Thrive now.

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