“It may sound silly, but what are the bare-bones requirements to practice medicine? I plan to launch a small, low-overhead, cash-only practice, but I’m having difficulty finding a clinic or physician to model.”
No surprise that this doc who called me today is having trouble finding a role model. Most physicians work at high-overhead jobs they hate. Happy docs are in short supply.
I’m an expert on bare-bones medical practices. In 2005, I wanted to know how low I could go and still operate a real clinic in America. My start up costs for year one? Less than $3000. I actually launched on day one for only $627. Here’s how I did it delivered in a Las Vegas keynote. I’ve learned a lot of savings strategies since 2005. I’ve helped hundreds of docs launch successful ideal clinics (and one friend actually launched for $85!) So I’m pretty sure you can do better than me. Here are the basics.
Fast Track Your Ideal Clinic (20 hours step-by-step launch kit).
Bare-bones requirements: A state medical license. For cash-only, opt out of Medicare. That’s really it. Optional: If you want hospital privileges or to be a “preferred provider” who’s in-network with insurance plans, complete credentialing forms and sign contracts. Done. Want to be out-of-network like me? Skip it all and you can still take insurance. Do NOT make this complicated guys!
Bare-bones start-up costs: An office (mine: $280/mo in 2005, now $425/mo in 2015). Utilities and Internet (included in my rent). Cell phone (mine $68/mo). Malpractice is cheap (mine $1230 first year, $1978 now, divided/billed quarterly). Laptop (I owned one, you probably own one too). Furniture (chairs, table, decor from Goodwill for $200). Exam table (free to $1500, I splurged at $795, ignore if you’re a psychiatrist). Premises liability insurance (included in most malpractice policies). Supplies (KY, gloves, scalpels, gowns for $300). File for LLC if you want ($50 most states).
Actually to launch on day #1 I only needed $627!
There’s tons of FREE stuff for clinic start-up including free medical equipment from retiring docs/ hospital overstock. Seriously, you can get pretty much anything from morgue tables to NICU incubators for free! I created a free EMR on my laptop. You can get free business cards online. I use a free e-billing clearinghouse (officeally.com) to submit claims—and I get paid in a few weeks. Easy! Labs provide free supplies (Pap collection kits, urinalysis containers). Want more free stuff? Just Google “Free ____” and fill in the blank.
Let’s assume you have your medical license and DEA from your last job. You already have a cell phone and a laptop like most Americans. So if you’re opening a small, low-overhead, cash-only practice, with no staff or on-site lab tests as a sole proprietor, you can do it bare bones for less than $3,000. Even less than $2000. Want to really go bare? Skip malpractice insurance and take off $1000+ per year. Take another $1000 off if you’re a psychiatrist since the only equipment you need is two chairs and your brain.
Congrats! Now invite me to your open house!
Want more cutting-edge business strategies?
Get a copy of my free No B.S. Guide to Launching Your Ideal Clinic.
Need help? Schedule a strategy call with Dr. Wible.
Pamela Wible, M.D., is a physician business strategist who founded the Ideal Medical Care Movement. She was awarded the 2015 Women Leader in Medicine for her pioneering work in medical care delivery and medical student/physician suicide prevention. Photo by GeVe.
I did the same thing. Used our family laptop, added a $10 line to our cell phone family plan, got equipment on Craigslist and comparing prices online, rented a small space in an office building (not a medical one) three blocks from my house. Anyone smart enough to get through medical school can definitely open a practice.
Along the way everyone I talked to was very obliging about explaining everything. I’d never had to handle the business aspect of medicine. My malpractice company explained their billing and discounts. They didn’t provide premises liability insurance so I called the company that I have my homeowners/car insurance and they had a sister company that would do my business insurance. My first furniture was mostly stuff from my house and as I’ve wanted pieces back or they haven’t worked out as well as I’ve liked, I’ve replaced them with “new” from Craigslist or the thrift store.
I just kept reminding myself that if you dropped me off of a plane in the middle of nowhere with nothing, I’d still be a doctor and still be able to help. Everything in addition to me should only be what I need to make my job easier to do well.
Now you’re inspiring me!!! Please mentor medical students. Med schools don’t generally expose students to the low-overhead models.
I contacted the local medical school. We’ll see if they bite or not. 🙂
I got free small business counseling through the county before I opened and the person who worked with me said, “I can’t find anything wrong with your plan but if it really works this way, why isn’t everyone doing it?” I will never forget his response!
“Why isn’t everyone doing it?”
1) Everyone was doing this pre-1965.
2) Divide and conquer works (doctors spend too much time in isolation and competition)
3) Too much money to be made by our predators to stop assembly-line medicine.
4) Near-total lack of mentorship by happy doctors. Excess of cynical depressed docs.
5) No business training in med school…
Those are the top 5.
Others?
I think #4 and #5 are the biggies because if doctors had those two, it wouldn’t matter how much money there was to be made off of them, they could make the leap.
In my case my residency encouraged us to learn to run our own practices and spend time with the office manager at every rotation site. That was huge! And most importantly, I started medical school in August of 2002 and Dr. Gordan Moore’s article in the AAFP had come out in February of that year. Someone had left the journal lying on an end table in the hall at my medical school and I happened to pick it up and read it. I didn’t realize at the time how life changing that was. Through all the mess of training, I always knew that all that complexity wasn’t completely necessary. Someone out there had done it differently.
But opening my own practice just didn’t seem like a real possibility, partly because all the physician-owners I had met were male, older middle aged, and worked too many hours.
But I put my practice together while on maternity leave with my daughter so I learned that it wasn’t just the older male demographic who could do this. 🙂 I didn’t take myself and my ability to run a business seriously so it surprised me that everyone else took me seriously and were willing to do crazy things like lease me an office space.
I did all my planning in a comp book and one of the first pages was a list of every woman I personally knew who ran her own business. I was so unsure!
I did contact my medical school (I still live in the same city as I did then).
The value of a the right mentorship can’t be underestimated. Many medical students have no mentors—doctors who they would want to emulate. I hope you are now out there teaching med students, Robin!
I am so glad I found this! I am graduating IM residency this summer and I am determined to open my own practice and start from the bottom. Recruiters are trying to steer me away and get me to “join” successful pratices with possibility for partnership track! I clearly stated that I have no intention to work for anyone (individual or big company) but it is not registering. I just got off the phone with a recruiter, her last question to me was the following: “how do you intend to make money if your plan is to be in solo practice ?” ??♀️
Don’t fall for their scare tactics. You are more intelligent than the people profiteering off of disempowered doctors.
I started this about a year ago. I bought furniture at Goodwill and Ikea. I have had no problem getting patients who will pay cash. I get to set my own hours which is great for a mom. I even have my teenager cleaning my office for her afterschool job. Win/win! Only downside is a bit of isolation and having to have my phone with me 24/7. Looking to find someone to cover me so I can take some vacation. Also, looking for good phone answering service. You should write a nuts and bolts guide! That would be very helpful. Thanks!
Contact me for a free nuts-and-bolts guide (I could certainly expand the guide).
My husband is a volunteer with SCORE, which is under the Small Business Administration and mentors people wanting to start their own businesses. I’m a retired RN, who worked primarily in the OR from 1969 – 2006, with some time in ICU, teaching, & managed a small day surgery clinic for about 6-7 years before resigning to open a reflexology business in 2007 to help people be more proactive with taking care of their health. I see clients Mon. – Thurs. and take about 8-10 weeks of “vacation” to visit adult children in Alaska, NYC, & Minneapolis. We live in Fargo, ND.
We have an appointment with a lady who wants to open her own medical clinic so I’m searching on-line for information to help prepare for meeting with her and am finding your information interesting. I considered downloading your Nuts & Bolts guide but since I’m not a Dr. & it wouldn’t be for me hesitated to do so.
I am a Physician Assistant in Detroit Lakes. I am looking for a collaborating Physician to oversee my practice in my private clinic. Do you or your Physician friend know of anyone who would be interested? I would love to sit down to talk about options.
I’m not too proud to admit I got one of those two chairs needed for a psychiatrist’s office dumpster diving!
I’ve been a dumpster digger much of my life—just a frugal archeologist at heart. Maybe it started when my dad used to take me into abandoned houses as a child. Anyway, I found myself in a dumpster behind a plasma collection center and found some AMAZING medical equipment!!! Always dumpster dive behind medical office space, but beware of used needles (should be discarded in the red biohazard containers).
Hi Pamela! Love your inspiring message. The only question I had was call. The insurance contracts I signed required 24/7 coverage by the provider. Is that true if you’re an out of network doctor?
OON (out-of-network) no contract required. Just follow the state laws for your medical license and you’re good to go! You do not have to do anything extra to satisfy the insurance companies.
I. WANT. TO DO. WHAT. YOUR. DOING A. HOME. PRACTICE
BUT. HOW. CAN. YOU. STILL. TAKE INSURANCE. AND. DO. YOU. NEED. A COMMERICIAL
ZONING. FOR. A HOME BUSINESS ?? I. REALLY. NEED. TO DO THIS. AS I. AM. SICK OF
HOSPITAL POICTICS. AND I. AM RAISING. MY. GRANDCHID. I. DO. DERMATOLOGY AND
I. DO. INERNAL. MEDICINE. BOY. I LOVE. WHAT. YOU SAY. ITS. JUST. PUTTING IT IN
PRACTICE . DO. YOU. HAVE. ANYONE. I CAN. EMULATE
You can do it Connie!! Please download the guide to launching your ideal clinic on my website. Happy to help. See business strategies on my blog. I have a ton of info online. After you review, please contact me if you still have questions
Also you should REALLY come to our retreat 🙂
Great article. All sounds great. But I am in New York City. Rent alone can kill a budget. Malpractice is the next thing that can take a chunk out of your budget in my locale.
Where are you located?
I’m in Eugene, Oregon. In expensive urban areas can be more challenging to run a low-overhead office, but cost-saving concepts still apply. Have you thought of a house call practice. Take over a few block and have a vertical commute. 🙂
I have noticed that of all different types of insurance, health insurance coverage is the most questionable because of the conflict between the insurance company’s necessity to remain making money and the client’s need to have insurance policy. Insurance companies’ revenue on health and fitness plans are incredibly low, so some corporations struggle to profit. Thanks for the tips you share through this site.
I wanted to open a clinic but I am not a doctor. also I wanted to be able to have employees. is there a way I can incorporate
I help doctors, nurses, therapists and anyone in health care open ideal clinics. I am not an attorney and can not give legal advice on incorporating.
Hello,
I am a Healthcare administerator and came across this page in hopes for advice on opening my own clinic. I have a few Physicians that are willing to work and Bill under there NPI. I have seen it happen before but was wondering if anyone has heard of such a practice and can give me a few pointers?
thanks
This is interesting. How do you make the financials work? For example, how much do you charge on a per visit basis? How did you get patients in your first 12 months? Surely you had to spend money on advertising.
I’ve long thought about doing something like this.
Hi Rush ~ Never, never spend money on advertising. I’ll send you my financials in a private email. Please contact me if you have further questions.
Can a physician assistant open an ideal clinic ????
As a clinic manager or owner in a non-inndy practice state. Or if you can (not sure like NPs) practice independently then YES!!
Please suggest a non-inndy state. Mississippi? New Mexico?
Thank you
John F. Steiner
Not sure I understand the question. What’s non-inndy?
Hello, I am so glad I found this site as it is very informational. I am a nurse practitioner looking to open a house call practice and would like to know if I would use my home address as my business address and practice location.
Thanks
I’m doing this as a physician and I have already started to address this issue. You can get a business address for the purpose of licensing, DEA registration, and official correspondence by using a “Registered Agent”. This is actually a common practice for corporations. It’s relatively inexpensive (about $100 or so per year).
Hello Pam me and my fiance want to open a clinc she is a nurse in the army and once she is out her dream is to open a clinic. I dont have any medical experience she is the one who has the experience. So any advice of how to get started since she is just a nurse? Thanks
Highly recommend that you attend our teleseminar & retreat. Just sent you a 10-page FAQ on how to launch your ideal clinic. Just contact me.
Hi,
Medical student here. I’m wondering, if someone can open up a practice for this cheap, what is it exactly these days that make starting your own practice so expensive? Time and time again preceptors have told me not to go into primary care because it’s so difficult to open up a practice these days with all the start up costs and paperwork. I would love to go into primary care if what is posted here is actually feasible. I’m just wondering where the money trail leads if people keep saying that it’s so expensive these days. It’s really unfortunate that we haven’t had a single lecture in medical school about the business of medicine and I’ve only gotten exposure to this topic through my clerkship attendings.
The money trail leads to the intermediaries who have inserted themselves between doctor and patient. I suggest you review the business strategy blogs on my site and you will start to see the pattern. Essentially primary care is being held hostage to an unsustainable tertiary care model. For a lung transplant you need a 5-story hospital, a helipad, a team, a billing department, valet parking, the list goes on. For an ingrown toenail all that stuff would be in the way. Disintermediation (removing the middlemen) is the cure.
Hello, I know this is a few years old but I was looking for these business strategy blogs and it said page not found. Is it somewhere else?
Business strategy blogs are all archived (see archive section) here: https://www.idealmedicalcare.org/category/business-strategy/
I am a Nurse Practitioner looking to open my own practice. I am in north Atlanta. My specialties are integrative and regenerative medicine. I perform stem cell, prp (platelet rich plasma) and hormone therapy (Bio Te). I am a student of Dr. Charles Runels so I can perform his procedures (priapus shot and o shot). My concerns, like most on here is that the average person pays so much in mandatory insurance premiums that they either do not meet their deductible or cannot afford out of pocket services. I would love to find an MD or DO who would like to work with me.
Holly Ridgley NP-BC
Can you share photos of what your office looked like with used furniture and equipment? Was your computer HIPPA compliant. regulations change, and patient expectations have changed.
I like you are cash only, that is the best if you can survive or start with a strong patent base.
Here are a few photos on this blog: https://www.idealmedicalcare.org/blog/surprise-its-patient-appreciation-day/ Upcoming film on doc suicide has footage of me in my office. Check out the trailer here: http://www.donoharmfilm.com I am HIPPA compliant.
Dr. Wible, Would you be available for a call to discuss what my wife and I are trying to build near Austin TX? I found your information extremely helpful and would love to pick your brain as she ponders how to live a happier life as a practicing physician. Thank in advance for any time you can spare.
I am a nurse practitioner who is looking to start my own clinic and looking to partner with alternative and ancillary providers. I’m looking to be an out of network provider that still can take insurance but want to be cash pay and provide statements so pts can submit. I have an MD to partner with. My question is next steps to get patients in the door. And do you recommend renting space from a medical practice that is already established?
You can do that it you like. Keep overhead low. There are MANY ways to start. Download my guide to launching your ideal clinic on my website to review the various concepts.
We are in the same boat with the office we have open already. We are HEAVILY comp but the medical field is something that our family has been involved with since 1978. We would like to transition to family practice and still do comp as well.
What type of licenses or permits is needed to start a medical clinic?
Medical license if you want to be the doctor or NP. If you just want to own a clinic then you may not need any license other than what is required in your state to run a business (like hair salon, gym, or whatever).
I am international medical graduate
What license I need to open a clinic
Is it just USMLE ?
I am hair transplant surgeon at my country
I know this is unlikely, but what if somebody wanted to open up their own practice after graduating? Do they have to practice under somebody first, or can they open it up as soon as they have a license?
You can DEFINITELY open immediately. Happy to help you. Contact me.
Hi, i m a doctor specilized in homeopathy. I am very interested in starting my own practice. I hv read your blog andam very impressed by your thoughts. I alwts wanted to setup my personal practice. I m planning to start the practice at home, where i hv small study room. I would really aporeciate your thoughts on this. Any advice and recommendation would be highly appreciated.
Hey Sam~ Join my mailing list and I will send you a bunch of info now. Via my contact page.
I figure office space rental cost vary geographically. How many square feet is your office space? Looking to determine reasonable cost range for price per square feet of space. I have never owned a businees/practice and am very excited by the prospect but am just figuring out the very basics. How did you approach the search for office space?
Yes, There is geographic variation (more expensive in NYC, San Fran) however you can always find really cheap space (especially when you start out). If you are dedicated to keeping your overhead low (way better than trying downsize if you bit off too much early on) then always get creative about where you look for space. Craigslist, counseling offices, other medical clinics (rent a spare exam room). I’ve met one doc who has spent as little as $118/mo to rent a room in a nursing facility. Then there are others who have gotten FREE space donated to them from grateful communities. Avoid using a broker or real estate agent. Avoid high-priced real estate in the medical district of by hospitals. When I started I got my 280SF space for $280/mo ($1 per SF) in a wellness center. Over the last 12+ years I’m up to $425/mo now so still a great deal 🙂
Hello
Im trying to find out what are the requirements to open a low-T clinic in Texas (Austin). No Im not a doctor. but am an expert in the field of any aging medicine as it is called today.
For example , I know a doctor needs to be on board to read the blood work etc but what and where would one get forms and the requirements needed to open such a clinic.
an help would be appreciated.Thank You
T.J.
Check with the Texas State Medical Board. Start there.
I am not a doctor but would like to open a free/reduced cost women and childrens clinic. I would like to offer womens breast care, diabetes testing and nutritional classes, mental health services. How do I do this using volunteers and retirees?
Contact me and you are welcome to join our teleseminar: https://teleseminar.beahappydoctor.com/1
I am considering a home health business. Do you think this could be operated from a virtual office? I would need a physical address (other than my home) to be able to have prescriptions issued.
What do you think?
Depends on state law. Check with your state med board.
Came across your website and appreciate your thoughts. left Family Medicine after 7 years because of the rat race and went to ER medicine but now am wanting to go back and do a low overhead clinic…
If I want to start a cash only low-overhead clinic do I have to opt out of medicare and medicaid (and jeopardize my day job) or can I just not see medicare/medicaid patients in my clinic ? It seems like you can go the other way (the DPC folks have it wired how to moonlight in the ER if you’ve opted out) but I cant seem to find the answer…Please point me in the right direction
Hey Joshua, You do opt out if you want to take cash payments but can’t do that while working your day job. Put Mcaid/care patients on a waiting list while you get ramped up, then quit your day job and take folks in your practice as you are able. Happy to talk to you. I’ll email you. My phone 541-345-2437.
What if I don’t want to deal with ins at all, and the client doesn’t disclose they have MCare or Medicaid. I would like to just do cash pay.
Hi Dr. Wible,
Great info, awesome blog. If I wanted to continue onto a fellowship after or during having a cash-only private practice business, would that medicare/medicaid opt-out endanger my future standing as a fellow in a training program?
YES. Your position as a resident/fellow is funded by Medicare so of course you would be exoected to care for Medicare patients within the federal program.
so are you saying a physician asst. can open up a clinic. if its something like just lipotropic b12 injections? Or do you need to work under a doctors license.
I am a nurse and want to open my own small clinic for just injectables. can I use a P.A. or have to have Doctor licensed.
I’m not the expert on who can do what in what state; however, it is my understanding that PAs can not launch independent practices. I know that NPs can in a various states. I also know that some RNs can do independent practices in wound care. Check with your state med board for specific details.
Hi Pamela,
I am very impressed by your blog. I am really interested in starting a low overhead practice (walk-in/convenient care clinic) in a town where there is only one place to seek medical treatment. I am a family nurse practitioner in the state of GA. However, I am clueless as to where to start regarding licensing, insurance, etc. Any helpful suggestions/resources?
I have some free material I can send you to get you started so do email me here: https://www.idealmedicalcare.org/blog/contact/. Also I can place you on my mailing list as I send out business strategy tips weekly or so. I’ve got a startup PDF to share and some teleclasses to start with. Just need your email & ph# (submit on link above)
Hi! You may not be able to help but I am a PA-C with 11 + years of Orthopedic experience and had considered trying to open up a cash only Ortho urgent care type clinic that could save folks from going to the ER. Do you have any experience with PAs doing something like this?
Yep. Happy to help Kelly.
I am not a doctor and have worked all my life in the medical field, I would like to open a pediatric for family practice you think I could?
What if you want to open a practice but don’t have a medical license at all. I would like to open a practice and hire a MD or two or three! I’m familiar with opening business and most of the time you don’t have know or do everything just know or know how to acquire the people that can. So can you open a practice not being licensed and hire someone licensed?
Happy to help you do that. I know others who have lost their medical licenses who now run clinics and hire docs (who they care for very well).
That’s great to know!! I am really truly interested in opening a clinic. Any advice and knowledge would be greatly appreciated!!
Thank you for being an inspiration. I am a FNP that has the dream of opening her own office and after reading your article, I have decided to do all the research and open it.
nd how is it done? I am a FNP.
AWESOME! Yo can do it 🙂 My best advice to get started: Fast Track Course
You shared good experience and effective information. Thanks. I did it once in other country and it was a good start. I need to start sth here in The Woodlands, Tx. Thanks for the reminder and sharing this post.
Wow. I agree. As an ex Paramedic. Something has to give!
Your insights are inspiring. i’m a medical student in Canada. Do you have anything to share regarding how this kind of model would apply to Canada, as the system here is very different. For example, most doctors here are already self-employed. GP practices can be either fee for service or capitation and everything is billed to the government. The fees are set by the government.
Thanks
Oh works in Canada too. Happy to help you. Contact me via my contact form on webpage with details of what kind of practice you’d like to create.
Thanks for a great article. I’m an internal medicine doctor who is interested in starting a practice specializing in medical care of patients with eating disorders. There is a significant need for medical providers in my area (Tacoma, WA) that are experienced in eating disorders. I have a full-time job with some flexibility, so my thought is to do this as a part-time job, focusing on consultations and interfacing with patient’s PCMs and educating them, rather than completely assuming total patient care. I would pursue this full-time in the future if it went well and I found sufficient clients. I’m thinking of doing home visits as opposed to an office, given that many eating disorder patients struggle with anxiety and other behavioral health issues and are most comfortable at home. Any advice?
Hey Beth! I’ll send you an invite via email to our free webinar this Sunday. Will walk you through the steps to get started. Also see this: How I launched my practice for $627 (yep on day 1 seeing patients that is all I spent!)
very inspiring post, thank you for sharing. the clinic I’m looking to open would anesthesia for outpatient procedures so the equipment costs and staffing issues are bogging me down. Having previously only worked in a hospital setting I’m not sure how to set things up to be HIPPA compliant etc. Every step I take forward I find more obstacles. It’s very discouraging.
Oh you should join my free weekly webinar and I’ll walk you through the steps. Contact me here to get the official invite this week: https://www.idealmedicalcare.org/contact/
If you are a medical professional, I would listen to this physician! I’m on the “patient” end, and this field is blooming. Even in my area, (Redding, California) there are about five of these types of practices, and people are starting to run, not walk. Sure, I have Medicare and Anthem Blue Cross insurance. Yet, $100 or under a month to have a doctor actually speak to me is well worth it. To have a doctor (and I really don’t go that often) listen to me without staring into a computer is well worth the money. I would add one thing. If doctors want to combine their efforts of not taking medical insurance, and sharing a staff, Prestige Urgent Care is doing just that in my area. However, I really like the ride the bike to the patient model, ha, ha! Good luck, doctors. You are so valuable! One last thing. And I really don’t want to write this…what are the insurance companies going to do about this model? Yikes!
Thanks Linda! You are so right. People want to be heard, seen, and actually treated like human beings. Impossible in a 7-minute visit.
I am a resident physician in internal medicine and just got my full license in order to do some moonlighting. Have been thinking to myself, “Why can’t I just do house calls on the side?” I already have the basic instruments and a travel medical bag. This article has inspired me to look deeper into it; I think it may be difficult with a limited schedule, as I would not have much income from it, but I can at least do more research.
You can totally do it! I’ll send you an invite to our webinar and walk you through the steps. Way to go Valerie!!
I am currently a Medical Assistant who works on an Anticoagulation clinic. I see a HUGE need for a mobile INR clinic as mobility and transportation issues prevent a lot of our patients from being compliant. I’m wondering if this is something our facility could offer our patients or if I could open a business of my own in the future. (I am in the process of becoming a nurse.)
What are the OSHA compliance required for an office? I looked at an office space in my budget but didn’t have water supply and the rest room was far..
Does a small private practice have to be inspected?
Not usually
Nurse Practitioners need love too… and mentoring. 🙂 As a new graduate, I am finding it incredibly difficult to locate a place that doesn’t require experience. My dream has always been to open up my own clinic but I am in a state that does not have full practice rights for NP’s. It is a little more difficult to open a business without finding a medical director.
Happy to help NPs 🙂
I live in a small rural town in Minnesota, we would LOVE to have an NP open a practice here.
I am not a doctor or nurse, but I have worked in healthcare businesses for most of my adult life. In preparation for retirement I moved to a small, friendly rural community on the edge of the beautiful Driftless Area. The town had a satellite Mayo Clinic when I moved here, but Mayo has since shut it down. They now want us to make the 1 hour drive into Rochester when we need care. Easy for me but not so good for the frail elderly or working parents. I would be happy to offer my business experience to help any doctor or NP set up a practice here and I have the support of my community council to do so. Can you help me connect with interested providers?
Interesting article. I’m researching costs and ways to start a clinic on the cheap. I’m a family medicine resident and plan on opening an after hours clinic in a small neighboring town that has no doctor. If the potential is there I would consider doing it full time after residency. I’d love to listen in on a webinar or get more info.
Happy to help. Tons of free content on my business strategy blog archives. Contact me if you need anything else here: https://www.idealmedicalcare.org/contact/
I will look into it. Thank you for the timely reply.
Hello Pamela, one question, how much do you charge for the uninsured people? We are trying to open a clinic my wife and I but we don’t know what it’s a reasonable price to charge for each visit and to make a profit? We are in El Paso Tx.
Sincerely,
Kevin
915 633 2752
I give 30% for those who pay at time of visit. I have a 3-hour module on how to set your prices and happy to help you. Email me: https://www.idealmedicalcare.org/contact/
I really don’t have words to admire you after reading all this and watching videos on your website. You are simply great and really made my terrible day today. I am switching full time already have place, and structure in place. Going cash only.
Thank you very much Dr. Wible
Hi Pamela!
I was wondering how this would work for an NP in an NP independent state. Would the process be similar? I would like to open a low-cost clinic in rural Washington ($25-$50 flat, basic, no insurance accepted-there’s a HUGE need in the area, the closest “walk in” is 60 minutes away) and this post is SO inspiring to me. Would you happen to know if it would be similar or if you could point me in the right direction?
Thanks!
Yes, it would work. happy to help you. Email me: https://www.idealmedicalcare.org/contact/
Hi and happy new year. I have my degree in Health Administration. I would like to open a clinic specifically for Medicaid patients to serve the underprivileged in my community. I have heard that many medical professionals do not accept Medicaid. Why is this and what are your thoughts on Medicaid?
Happy to help. Contact me here –> https://www.idealmedicalcare.org/contact/
I do visits at personal care and assisted living so don’t have an office or staff which is beautiful. I have the opportunity to have a room at an independent senior living facility apartments to see patients out of. It is small closet lol. What requirements do I need for this to be suitable as a clinic? I order ekg and x ray portable from company. My lab draws labs and supplies and supplies. The location is by their dining hall and gathering area. I live in Ms. I don’t want to miss anything. This would be billed as place of service office by Medicare as I don’t want to do home visits on them like I do for the assisted living. I could also see employees that have Cigna. It is a huge complex. 200 elders. Plus staff. It is a great opportunity but want to be in compliance. Anybody that can help me???
Hi Pamela,
A somewhat similar scenario as others have presented here however will still inquire; I am a clinic manager of two Wellness Centres in Alberta, Canada. I have been doing this for years and feel it’s now time for me to consider opening up a wellness clinic (NDs, Chiro, TCM and RMTs) in the city I live in. I, however,cannot seem to get a straight answer as to if this is allowed or not due to me not being the actual practitioner. Have you any experience in working with Canadians with similar inquiries and do you know if there is a “yes” or “no” answer to my initial inquiry? Thank you for any insight you might be able to share.
I wanted to open my own clinic, I have my doctorate in NP, how hard would it be to open a clinic and to find a collaborative MD?
Hey Raj, I’m a nurse practitioner too hoping to start a mobile medical clinic. Can we share information on how to start. Lets help one another. Thanks.
I’d like to start a housecall business. Can you help me get started?
Sure thing! Join fast track course that walks you through step by step. Happy to help you every step of the way.
What about taking call? You’re on call 24/7 365 days a year? How do you go on vacation? Do you just let hospitalists admit your patients?
You mention you only take cash. Why do you need to submit claims and wait for payment?
I’m interested in doing this as an NP in an independent practice state and I want to make sure I inform myself!
Thanks!
Been on call 24/7/365 nearly 14 years in solo practice and LOVE it. No burden at all. Happy to talk to you via strategy session to help you.
Need to talk to someone like yourself.
Contact me via my website here: https://www.idealmedicalcare.org/contact/
Hey! Wow what a great article! I am venturing into opening my own clinic! I am curious how you made your own EMR and if you had any issues when submitting your EMR to insurance companies.
SOS
Thank you!
Check out my articles on how I created my EMR. 1) https://www.idealmedicalcare.org/how-to-fall-in-love-with-your-emr/ 2) https://www.idealmedicalcare.org/why-i-love-my-homemade-emr/ Super FUN!!
Hi Pam, I’ve been a practicing NP for 10yrs in Colorado looking at starting my own clinic or mobile clinic. Can you send me some information on how to get started.
Hi Pam great blog. You’re inspiring. I am new grad FNP and planning to open my own clinic. My husband is an MD and used to have his own practice but he sold it, since overhead was too much. Is it possible to work as husband and wife in a clinic with low overhead costs, how do you get started?
My thoughts are opening a practice or home health clinic, or cash only.
I just don’t know where to start. ThAnks
Tons of free resources on my website and a 20-hour course that walks you step by step, plus retreats if you want to come.
HI
Your idea is really inspiring but i,m wondering about the pay gap? If you practice in your own clinic how much less % can you make then working in hospitals?
thanks
Hello Pam
Your article is very inspiring this is something I have wanted to do for years. I have been a LPN for over 19yrs working in various medical areas. I want to start a virtual mobile clinic(i guess you can say almost like home health but it would be a virtual clinic visit) will this be good for me as well or would you suggest furthering my education first. Can you contact me via the email I have provided. Thank you
I just finished my mba and I used to sell insulin (pharma rep) I was laid off and 8 months later still looking while I work a $10hr job. I helped a friend start a hormone therapy, weight loss and med spa a few years back.She was a frustrated pharma rep like me . She now makes great money and is a stay at home mom. I want to do this so bad. I would need a doc though and I remember we paid $1500 day for the one we hired. Do you think a bank would lend money for this?
Thank you. I am a FNP and I am looking to start a bare bones practice only providing physicals. At a later time, I may consider DOT physicals, when I want to think about lab services. Your article cut out all of the fluff and was straight to the point.
I have literally $4 in my checking account at the moment as I transition from corporate medicine jobs to telemedicine. My own medical education expenses and forced resignations due to fibromyalgia induced by the medical education have obviously destroyed my finances. I came across this looking to figure out how to start my own telemedicine LLC after I make August rent. I currently work as an independent contractor for one telemedicine company and am starting locums work too, but I’m looking to pick up patients on my own. Great info! Thanks for sharing and for being an inspiration through darker times over the last few years.
Do you have any experience or contacts with small clinics opening labs(hematology and chemistry) on a tight budget?
Happy to help. You can schedule a strategy session here.
Good day doc.
I run a clinic in Liberia. I have been looking for international partners
to help improve service delivery and provide better health services
If I am a Physician Assistant can I still do this? Would I need to hire an MD to sign off on my notes and oversee the clinic?
Hello Pamela,
I am a Personal Assistant for a Dr.in Fl. she has asked me to investigate about starting a very small Medical Pract. She is
very close to leaving the practice she is currently with.
I found your site immediately. Read a lot of the Questions an answers – I am going to check out your site.
She will need hospital privileges – as she is a Surgeon Specialist
Womans Care.
Can you lead me to the correct portion of your site?
Sincerely,
Keni Mills
Happy to help. Just emailed you.
I really love to have a doctor for my medical aesthetics training office, I don’t need for law, but I would love have one!!!
Is it possible for nurses to open an urgent care?
I am a Psychiatric Nurse Practitioner and I want to open my own mental health clinic. Can you give any information
Iam interested, but need to talk to someone to clarify some issues
Hi
How much is the cash visit?
U talking bill insurances & then cash visit??
What that means?
If h work in another hospital or office & Insurence credential u
Can u open ur own office & do cash visit?
I am a Respiratory Therapist but would you open a Children’s Clinic back home in a underserved community. I don’t want to practice of course but I want to own. Can u help point me in the right direction on what I would need to do.
Thank you!! I am an APRN in the process of opening a family practice. I have been a nurse case manager for over 25 years with my own small business. I have always kept a low overhead and wanted to do the same for my family practice. All the information on starting a clinic was discouraging cost wise until I read your article. Thank you for confirming that the type of straightforward family practice setting I am aiming for IS doable and needed.
Can I get some more info from
You? I’m a child neurologist looking to start my private practice
Sure. Schedule a strategy session via my website. happy to help.
Dr. Sincerely, really ? That is morally unethical. Thank you
Hi. Im a APRN in Miami, Fl. The bill just passed that we can practice independently starting july 2020, which I am very excited for and am very interested in starting my own practice.
I just don’t know where to start! I do family practice with a touch of aesthetics.
How did you create your own EMR?
What is your pricing for cash pay patients?
Did you have any staff?
Happy to talk today. You can schedule a strategy session via my website.
I am starting to have some hope seeing this information. I’d like to start an Endocrinology practice in St Paul or Minneapolis, Minnesota. I started out as IM/PEDS (8years), have been in practice as an endocrinologist since 2008. I would appreciate help with setting up my practice and advice from you via a phone or video conversation
Shaban Nazarian, I am a practicing ER Physician Assistant in Detroit Lakes, MN. I am looking for a collaborating Physician so I can open my own private clinic. Would you or anyone you know be interested in talking with me about this opportunity?
I am an NP- Family, please advise me on how to open a low cost private practice in Maryland
As a young adult that wants to open a clinic, where can I find doctors that would want to participate?
Unhappy doctors are everywhere. Should not be hard to find docs open to better working conditions. Happy to speak further.
Based in Baltimore Maryland, where can I find people that would confirm the health issues that I would want to focus on for the clinic.
I do not understand specifically what you are requesting.
I am a board certified FNP here at NV ( used to be a medical doctor in the Philippines). My dream is to open my own private clinic here at Las Vegas.
Dr Wible,
Thank you for remembering our lost students and colleagues and again for the opportunity to be part of the vital panel discussion on your movie web premier a few months back. It has kept the problem very close to mind as I observe my colleagues for signs of stress. And best wishes for you fighting the smoke emergency – you are definitely in the thick of it in Eugene. Tacoma Washington has had its moments as well the past few days.
I also wanted to let you know I am downloading everything I can find from your blog and getting ready to strike out on my own in practice soon. When things calm down I look forward to setting up a consultation to go over some details. Thank you for the inspiration to take back the practice of medicine from the corporations and giving it back to the providers and patients where it belongs!
Stay safe!
If you complete the 7 questions at the end of this keynote and email them to me, I’ll help you with next steps. Secrets to loving your life in healthcare You can do it Brian!
IS this still doable these days? I live in Midwest and looking to see if I can open my practice without too much cost.
YEP! Absolutely. Watch this: https://www.idealmedicalcare.org/keynote-finding-your-bliss-beating-physician-burnout/ then write me back if you need help. Happy to guide you. Contact me here.
Hello, I have a bright idea to open my own private diagnostic clinic. I don’t have a medical license, do I need one to open one?
When covid is under control, can you send someone to set up a cash clinic in orange county, CA?
Will do my best 🙂
Thank for the information. I am Michel Jammeh a Nurse Midwife in the Gambia. I am seeking for funding opportunity to open a Day care Clinic for my community.
Good , evening Dr. Wible. Just finished reading your page, after searching endlessly, on how to open a clinic in pa that does not except , Medicare or Medicaid . I am not a MD, but I want to open a clinic in my community to help. If you can help in anyway, can you please email me, with the steps needed.
Happy to help. Reach out via my contact page & we can talk.
Hi Dr Wible & thanks so much for this advise! I am wondering if I need to apply for ahca exemption (no insurance)…?
ty so much
I have a bachelors in health and an associates in medical billing and coding and a associates in health informatics. I desire to start a nursing home to contract with the government like the VA
Thank you for your inspiring story. I am currently an NP student. I am planning to open my own walk in clinic, cash only. I am in Texas which don’t allow NP to practice. My question to you is can I open it under my wife’s name who is an Obgyn in Texas and I will run the clinic as her employee?
Thanks for your help.
Hello.
My wife and I own an Insurance Agency in Florida. We have experience in all government healthcare programs including Medicare. We run a steady business with good flow of income. However, competition is just everywhere and increasing. We need to look for ideas. I have a friend who is finishing her NP and she has a friend who is an MD with no office. We want to be able to set up our NPI so they can work in our future space. The idea is to rent another place near our office since most customers know our office. How can you guide me in the process?
How to set up an NPI?
Can we just get the office and run it with the MD and NP?
If we are the ones providing the space, do we apply for medical insurance for them or we can just get our liability insurance to run the business.?
We appreciate any assistance.
Thank you.
Happy to help you. Schedule strategy session via my website & will call you within 24 hours and walk you through all the steps.
Hi Pamela,
I am very impressed by your blog. I am really interested in starting a low overhead practice. I am a family nurse practitioner in the state of NC. However, I am clueless as to where to start regarding licensing, insurance, etc. Any helpful suggestions/resources?
Happy to help you. Have a 20-hour step-by-step course. Reach out. Lots of free resources.
Im a Nurse Practitioner . Can I open one of these clinics too?
YES
what about sending PHI and being able to fax/scan PHi through your laptop? How did you handle that?
I turned off my fax and so much happier without one. You could also get a system that is PHI-approved. Ask yourself do you really need all of this?
I am FNP-C in Massachusetts looking to open my own clinic. The state of Massachusetts does have full practice rights for NPs. I am looking to be an out of network provider and cash pay. My question is: how long will it take to get patients in the door?
Depends on your marketing & target demographic. Happy to speak to you via strategy session.
Hello,
Im am an RN BSN and have a ARNP friend. We are looking to open a weight loss clinic. I am in Florida and was told we do not need an MD to oversee since an ARNP can write for scripts etc. I am having trouble finding out what type of license I need for the actual clinic if I even need one. I opened an LLC. Can you help me with that?
I’d need more info. We can talk. Happy to have a strategy session with you.
I just joined membership for zoom calls. But I have been getting ripped off by different credentialing companiesfor provider enrollment. What credentialing company should I use that are legit?
We don’t recommend using credentialing companies. Much better to do your own credentialing (which is easy, cheap, and avoids identity theft, and being totally ripped off)
Just sent you an email Elaine.
Hi!
We have a non medical laser clinic and we want to add IV hydration aka drip lounge.
The medical board in New York says the office must be a medical office or hospital.
What do we need to do to be a medical office?
Extra sink?
Coved molding?
Sharps container?
A NP will order via telehealth and an RN will come run the IV drips.
Please advise
You’ll have to get specifics from the NY Board. They may require a physician.
I need phone no
I am curious how this model has changed with HIPPA complaint software? Thanks!
In the coaching arena there is no change as HIPAA does not apply. I retired my med license last year and strangely have had an increase in income since! In a small practice you may not even be subject to HIPAA rules & regs. Happy to talk further if you need help. No docs in my coaching group (graduated from this course) have experienced problems due to HIPAA-complaint software and several have DIY EMRs (self-made systems like mine). More on that here: Why I love my (homemade) EMR
Have you written anywhere why you gave up your medical license?
I can’t imagine why you would do that other than certain entities were trying to destroy it. 💗 Jan
Why I retired: https://www.idealmedicalcare.org/why-i-really-retired-from-medicine/
I’m no fan of censorship and I am horrified at how psychiatry is weaponized against doctors. I asked to retired 10/1/21 and sent in my notice to Oregon Board. They tried to convince me to stay on. I’m actually able to help far more people in a coaching arena without a medical license—so truly enjoying my life now. VERY busy!
Have you seen what is happening with DOJ investigation of med boards? https://www.idealmedicalcare.org/3-us-senators-demand-doj-investigate-medical-boards/
Hello,my name is Darmeta Bradley.Im a psch and primary nurse practionar in Florida.Im working for a mental health clinic at the time. i got my LLC called DNG health services. I want to start my own small clinic that provide primary and psych healthcare.Trying to find out much info as i could for a start up busines.Thanks and looking foward to your response.
Happy to help. Tons of free resources on my website. Here’s a 20-hour step-by-step course and, of course, I’d be happy to talk to you.
Hi Pamela,
What a fantastic resource you have created. Thank you! I’m investigating opening a male hormone (TRT) clinic as a non-medical professional. Ideally, I would be looking to find and partner with a doctor. I’m an experienced business owner and coach with strengths in marketing and sales. Is this something that would fit with your programs/coaching? If so, I would love to talk.
I just love you and all your help for humanity💗
I share your info as much as possible.
❤️
I am so happy I found this information. I am an RN and CWOCN and I want to open my own wound clinic in Texas. I need the best advice from everyone.