2. The $40K Clinic Setup Mistake (+ 6 Key Steps to Follow Instead)

You know it's time to leave corporate medicine. But every time you think about starting your own clinic, it feels overwhelming. Licensing. Business structure. Insurance. EMR systems. Where do you even begin?

Most physicians get so bogged down in the process that they either never start—or they hand over $40K to a turnkey service, only to feel just as powerless as they did in their day job. But the truth is, starting your own clinic is far simpler than it seems.

After years of helping physician entrepreneurs launch successful independent practices, I've identified the exact roadmap that works. Not the overcomplicated, expensive route that most people think is necessary—but a lean, focused approach that gets you from employee to practice owner without breaking the bank or your sanity.

The Complexity Trap: Why Smart Physicians Get Stuck

Here's what I see happening again and again: highly intelligent physicians who can navigate complex medical cases suddenly feel paralyzed when it comes to business basics. They assume clinic setup must be as complicated as their medical training, so they either procrastinate indefinitely or throw money at the problem hoping someone else will handle it.

Both approaches are mistakes.

When physicians pay $40,000 for a turnkey clinic setup, they're essentially buying themselves another employee experience. Someone else makes all the decisions, handles all the setup, and hands them a finished product. At first glance, this seems helpful. But what actually happens is that these physicians never develop the confidence to make business decisions for themselves. They end up feeling just as disempowered as they did in corporate medicine (except now they're the ones paying for it).

My Philosophy: Lean, Smart, and Physician-Led

I take a completely different approach with my clients, built on three core principles:

Cash is king. I work with physicians to keep their initial cost structure as low and nimble as possible. That means no long-term contracts until you know your capacity needs, no hiring sprees before you have patient volume, and no expensive commitments that drain your cash flow before you're generating revenue.

Physicians must be involved from day one. The goal isn't just to open a clinic—it's to develop an owner's mindset. When you make the decisions yourself, even the uncomfortable ones, you build the confidence and experience you need to run your business successfully.

Technology has made this easier than ever. Post-COVID changes have revolutionized healthcare delivery. Patients now prefer telehealth options, digital forms, and online scheduling. The technology exists to start lean and scale smartly.

The 6 Essential Steps (And Why This Order Matters)

Step 1: Secure Your Medical License

You're a physician, so you likely already have this covered. But here's where many people go wrong: they think they need licenses in multiple states to have a "bigger reach." Start with one, maybe two states if you live on a border. More states don't equal more money—only effective marketing does that. There are enough potential patients in every single state to fill your practice.

Step 2: Create Your Business Entity

Every state has different requirements for medical practices. Some require PLLCs (Professional Limited Liability Corporations), others accept standard LLCs. This is where I do recommend consulting with an attorney licensed in your state—medicine is a regulated industry and the rules vary significantly. It should be straightforward and not too costly, though attorneys tend to move slowly. Once your entity is registered, you can get your EIN number from the IRS (you can do this yourself online) and set up a business bank account.

Step 3: Choose Your Delivery Model

This is where the post-COVID world really works in your favor. You now have multiple options for how you want to engage with patients—telehealth only, in-person only, or a hybrid model. If you're going telehealth, make sure you understand your state's rules and that all your technology is HIPAA compliant. If you're going in-person, consider starting by renting a small office space with a short lease, or even renting a room from another physician a few days a week. You can grow your footprint as your practice grows—another lean startup principle that keeps costs and stress manageable.

Step 4: Get Your Insurance Sorted

You'll need malpractice insurance, and there are two main types to understand: claims-made policies (cover claims reported while the policy is active, regardless of when the incident occurred) and occurrence policies (cover incidents that happened during the policy period, even if the claim comes later). Many of my clients use brokers to get multiple quotes—you shouldn't have to pay the broker since they're compensated by the insurance companies. Others stick with the malpractice insurance they had in corporate medicine if they had a good relationship with that company. As you build your practice, you'll likely need to add general liability insurance, especially if you're renting office space.

Step 5: Select Your EMR System

This can take time, so start your research early. Some EMR systems are specialty-specific, others are designed for direct-care models, and still others assume traditional insurance billing. Key questions to ask yourself: Do you want everything integrated into one system? (More expensive but easier.) Are you billing insurance or offering direct care? Do you want texting, faxing, and email portals included? What kind of reporting capabilities do you need? For example, if you're running a dermatology practice that offers both medical services and sells products, you'll want an EMR that can distinguish between copay revenue and product sales in your reports.

Step 6: Get Your First Patient

This is my favorite step because it's the moment everything becomes real. Once you've completed the first five steps, all you need to become a functioning clinic is to successfully serve your first patient. That means you've earned revenue and you are officially in business. The fastest way to start making money is to stay focused on creating the shortest path to serving that first patient—not perfecting every system or building the perfect website.

What's NOT on the List (And Why)

You’ll notice that building a website isn't on this core list of steps. Yes, you'll eventually need one, and it would be my next step on the list. But the reason it’s not listed here is I find that many physicians get completely stuck in website overwhelm. They don't understand the technology, they can't decide on headshots, they freeze over webpage architecture decisions, and for those reasons, creating a website should not act as a barrier to opening.

Plus, your first patient is usually someone you know, and they don't care about your website. They're coming to you because they know you or you were recommended. In the beginning, you get patients by talking to people, either in person or on social media. The website becomes important later for your marketing strategy, but initially, it's not what gets you those crucial first patients.

Your Next Steps

This roadmap is designed to be doable and simple. I've intentionally structured it this way so you can cut through the noise and start taking action. The goal isn't perfection—it's momentum toward the independent practice you've been dreaming about.

Remember, the system that's been frustrating you in corporate medicine isn't the only option. You have the skills, the knowledge, and now the roadmap to create something better. Your independence doesn't have to wait for the perfect plan. It just needs the right steps.

Ready to get started? Download my free guide that breaks down each of these six steps in detail and if you want to discuss your specific situation, book a free complimentary discovery call—I'd love to hear about your vision for independent practice.  You can subscribe to The Physician Business Podcast on Apple Podcast or Spotify - or wherever you listen to podcasts - and join our community of physicians building independent practices that actually work.