New medical practice checklist: Here’s how to get started

Building a medical practice from the ground up is a big undertaking, requiring significant business decisions and simultaneous complex, multi-step processes. As you go about starting a new medical practice, use this checklist to stay organized and focused. 

Establishing a medical practice involves a meticulous series of steps. You must define your vision and mission, develop an airtight business plan, secure financing, find the right location, hire staff, implement business-critical technology, comply with legal and regulatory requirements, contract with insurance companies, and market your services — and each step is vital to your success. This might seem daunting, but with dedication, perseverance, and organization, you can bring excellent care to your patients and experience the personal and professional benefits of leading a thriving independent practice. 

This article will help you break down the process into manageable and actionable insights and approach each of the following phases with confidence and clarity:

Before you dive into the logistics of establishing your medical practice, develop a comprehensive business plan and define a clear strategic vision. This will require conducting market research, identifying your target patient demographic, understanding the market, and then writing a business plan. 

Outline your mission, vision, and target patient population. A well-defined vision will guide your decision-making as your practice grows, anchor you to your purpose, and ensure the long-term viability of your practice.

Create a comprehensive business plan that includes your practice's goals, financial projections, marketing strategies, and operational details, as well as possible risks. Your business plan should also include your operational framework, professional credentials, staffing requirements, and a plan for addressing competition if the marketplace is already saturated. Work with an experienced healthcare attorney or consultant to make sure your business plan is comprehensive and viable.  

Identify areas of risk related to patient safety, regulatory compliance, financial concerns, and operational vulnerabilities. A thorough assessment will help you put the necessary safeguards in place to protect your patients and practice. 

Consult with an accountant experienced in healthcare management to determine your financial needs and explore funding options, such as government or private loans; federal, state, or local grants; or partnerships with other physicians. Develop a budget that covers startup costs, equipment, salaries, rent, and ongoing expenses. 

Find a location for your practice that aligns with your target patient population and offers convenience and accessibility. Consider factors like parking, proximity to local hospitals, ancillary services, and referral networks. Also consider zoning requirements and whether the space is turn-key or will need costly renovations or updates that could delay opening. 

Research and obtain the required licenses, permits, and certifications to operate a medical practice in your jurisdiction. This may include applying for a new medical license for the state in which you plan to practice, updating your DEA registration, completing Clinical Laboratory Improvement Amendments (CLIA) certification/waiver, and obtaining professional and occupancy permits to comply with local regulations. 

Unless you plan to operate a direct pay model, you must research insurance providers, determine the plans with which you want to contract, and begin the credentialing process. If you plan to bill Centers for Medicare & Medicaid Services, apply to become an approved provider. 

Carefully review and negotiate contracts with insurance companies to ensure fair reimbursement rates and favorable terms. Seek legal advice to make sure you fully understand the contracts.

Protect your practice and healthcare providers by obtaining malpractice insurance. Consult with an insurance provider that specializes in medical malpractice to determine the appropriate coverage and explore your options.

Efficient operations are vital to any medical practice. Designing an effective workflow from the beginning ensures that you can optimize patient care, streamline administrative tasks, and use resources efficiently. During this phase of setting up a medical practice, consider factors such as appointment scheduling, patient registration, medical record management, billing and coding, and communication. Integrating technology, such as electronic health records (EHRs) and practice management software, can enhance productivity and facilitate seamless coordination among the staff.

Invest in a robust information technology infrastructure, including an EHR that is compatible with local hospitals or healthcare systems, secure data storage, network security, and hardware. Consider joining a health information exchange (HIE). Establish a remote picture archiving and communication system (PACS) so you can collaborate with other providers on your patients’ healthcare team. Ensure compliance with patient privacy regulations, on both a state and federal level, and establish protocols for data backup and cybersecurity. Work with an IT consultant to choose software, hardware, and platforms that integrate easily and will scale as your practice grows. Also, set up webcam and telemedicine capabilities. 

Identify the necessary medical equipment, instruments, furniture, and supplies for your practice. Develop an extensive inventory list of medical supplies and source reputable suppliers..

Work with your attorney to ensure that you comply with local, state, and federal regulations regarding healthcare, privacy, safety, technology, and employment. Make a plan to stay updated on evolving regulations so you can adapt accordingly. 

The success of your medical practice depends on the people you choose to be on your team. Assemble a staff of competent and dedicated healthcare and administrative professionals who share your commitment to patient-centered care. Hiring other qualified providers, nurses, administrative staff, and support personnel is the start of creating a cohesive and efficient workplace and fostering collaboration, continuous learning, and open communication. Write job descriptions with detailed roles, responsibilities, and requirements to help guide your search and establish onboarding processes. 

Establish comprehensive policies and procedures for your practice. Include appointment scheduling, patient intake, billing and coding, infection control, crisis management, and quality assurance. Determine how you will train your staff on these protocols. 

Consider how you will encourage and enable ongoing education and training to keep your team updated on the latest medical advancements, regulations, and best practices. Decide to what extent your practice will reimburse for participation in courses, conferences, and professional training. 

Establish relationships with other healthcare providers, specialists, and hospitals to start building your referral network — and community. Attend professional events, join medical societies, and participate in community outreach to connect with others in your industry and spread the word about your practice.

Develop mechanisms to monitor and improve the quality of care your practice provides. Establish how you will conduct regular performance evaluations, gauge patient satisfaction, and enhance patient outcomes and experience.

Create a marketing plan to promote your practice and attract and engage patients. This may include developing a website, creating a brand identity, establishing an online presence, and networking with other healthcare professionals in your community. 

Offering ancillary services, such as laboratory testing, radiology or imaging, or telemedicine, diversifies your practice. You can give patients convenient, integrated care, and potentially boost revenue.

Consider the following benefits and challenges as you decide whether to offer ancillary services:

Increased revenue potential

Ancillary services can generate additional revenue and increase your practice's financial viability. This diversified revenue stream can help offset the costs of running the practice and potentially increase profitability.

Improved patient retention and loyalty

Offering multiple services in one location can strengthen patient loyalty and retention. This can lead to long-term patient relationships, word-of-mouth referrals, and a stronger community presence.

Better care coordination

Integrating these services improves continuity of care, facilitates collaboration among providers, and streamlines the patient experience.

Financial investment and increased operational costs

These services often require upfront and ongoing financial investment. Costs can include equipment, staff, compliance, maintenance, training, and accreditation.

Regulatory and compliance challenges

It's essential to stay up to date with compliance for each service you offer, such as certifications, licensing, and quality control. Staying current on regulatory requirements for each service may require additional staff or resources.

Administrative complexity

Adding services complicates billing and coding, scheduling, records, and insurance claims. It's crucial to have efficient practice management systems to handle the workload.

Market saturation

Assess local demand, competition, and potential saturation to ensure the financial viability of your ancillary services.

Focus and expertise

Assess your capabilities and ensure that you will have resources and skill set for high-quality ancillary services. Failing to provide the same level of excellence in these services as in your core medical practice may have negative consequences for your reputation and patient trust.

If you’ve never worked closely with physician assistants or advanced practice nurses before, you may not be aware of how they can help your practice grow. 

If you incorporate NPs or PAs into your medical practice, you can serve more patients. PAs and NPs are trained to handle a wide range of primary care responsibilities, such as diagnosing and treating common illnesses, prescribing medications, and providing preventive care. Their expertise and autonomy allow for increased flexibility in managing patient loads and can free you up to work with more complex cases or focus on practice management.  

For new practices with limited hiring budgets, PAs and NPs can also be a cost-effective way to expand the healthcare team. PAs and NPs generally have lower salary requirements than physicians, which can help keep staffing costs lower while still providing quality care.  

PAs and NPs are also trained to collaborate with other healthcare professionals and their leadership can help foster a team-based approach to care. This collaborative approach can enhance patient outcomes, improve communication, and facilitate comprehensive care across different dimensions of health.

The degree of supervision required for NPs and PAs varies depending on state regulations and the scope of practice laws. In some jurisdictions, NPs and PAs may need to work under the direct supervision of a physician, which can limit their autonomy and impact workflow efficiency, so research the laws in your jurisdiction. 

Avoiding burnout — for your staff and for yourself — should be one of your top priorities when determining how you will operate your new medical practice. Providers just getting started in independent practice face unique challenges when it comes to handling call responsibilities, vacations, and illness. So consider these common approaches to helping you and your team to maintain a healthy work-life balance and well-being without sacrificing the quality of care you provide:

In a small private practice, handling after-hours call coverage can be demanding. To alleviate this stress, doctors can share call responsibilities with other local physicians. This can involve forming a call group or participating in a call-sharing network, where physicians cover for each other during evenings, weekends, and holidays. These arrangements allow doctors to have designated periods of time off while ensuring patient care continuity.

When planning for vacation coverage or accommodating extended time for medical leave, such as after surgery or the birth of a child, doctors in solo private practice may hire locum tenens physicians. Locum tenens are temporary physicians who fill in for the absent doctor and provide continuity of care for patients. They can be contracted to cover the practice for a specific period, ensuring that patient needs are met while the primary physician is away. Locum tenens physicians can be sourced through agencies or professional networks.

Some doctors in solo private practice establish partnerships with other physicians, creating a small group practice. This allows for shared responsibilities, including around call coverage, vacation coverage, and sick days. In partnerships, physicians can coordinate schedules and provide coverage for each other, reducing the burden of being on call or managing the practice alone. Partnerships require careful planning, legal agreements, and a shared vision for the practice.

In certain cases, doctors in private practice may enter into cross-coverage agreements with neighboring practices or medical groups. These agreements outline arrangements for providing coverage for vacation or illness. By collaborating with other practices, doctors can ensure that their patients have access to care when they are away. Cross-coverage agreements may involve reciprocity, with doctors covering for each other as needed.

Advancements in telemedicine technology have provided doctors in independant private practice with new options for handling call, vacations, and illness. Telemedicine allows for remote consultations with patients, reducing the need for physical presence in the practice. During periods of vacation or illness, doctors can leverage telemedicine platforms to provide virtual care and consultations, ensuring continuity of care for their patients while minimizing disruptions.

Effective practice management can help doctors in solo private practice optimize their workflow and minimize the impact of absences. Implementing efficient appointment scheduling, using an EHR that can be accessed from home, and delegating administrative tasks to support staff can help maintain productivity and ensure smooth operations when the doctor is away. Well-organized practices can handle patient needs more effectively, even during the doctor's absence.

It’s absolutely essential to ensure that your practice model will allow you to take time off for both illness and vacation. Explore multiple ways to leverage resources, form professional networks, and use technology to ensure you protect your mental and physical health. 

The section above briefly outlines the key steps and processes to follow and questions to consider when thinking about opening your own medical practice. Once you’re ready to act, use this checklist for starting a new medical practice to help stay organized and focused.

Your business plan is your road map to the future and should lay out your practice goals, how you intend to achieve them, and how you will measure success.

A strong budget mitigates financial risk and sets your practice up for success. 

Select a qualified CPA with healthcare accounting experience to provide guidance on financial management, chart of accounts, and taxes. 

Work with an attorney experienced in healthcare practice management to ensure compliance with federal, state, and local regulations. 

Consult with your attorney to determine which licenses and permits are necessary for your location. 

Ensure that the location you select for your new practice has everything your team needs to care for patients safely, efficiently, and effectively.

Explore different coverage options and consider group purchasing to reduce costs.

Finding the right people to help you run your practice is key. Determine what staff is essential to open and then add more employees as your practice grows.

Take action to create a brand, attract and retain patients, and grow your practice and professional network.