55. Clinic Strategy 101: Understanding the 5 Market Forces Shaping Your Clinic’s Success

You opened your clinic because you wanted to practice medicine differently.

You wanted more autonomy, more time with patients, and the freedom to build something that reflects your values. But once you’re actually in the business of running a clinic, the reality can feel a lot more complicated.

Suddenly, you’re not just thinking about patient care. You’re thinking about competition, rising vendor costs, new clinics opening nearby, telehealth companies advertising directly to your patients, insurance dynamics, and whether people understand why your care is worth choosing.

It can feel like the market is constantly shifting around you, and you’re stuck reacting to whatever comes next.

That’s where a strategic framework can help.

In this post, we’re taking a trip down memory lane to my very first day of business school, where I was introduced to Porter’s Five Forces. Yes, it sounds a little nerdy. But this framework can completely change the way you think about your clinic.

Instead of guessing why your market feels hard, Porter’s Five Forces gives you a practical way to evaluate the pressures shaping your business, spot where you’re vulnerable, identify where you have leverage, and make more intentional decisions about how to position your clinic.

1. Competition: who else is trying to serve your patients?

The first force is competition, or competitive rivalry.

This is the question of how hard different businesses have to compete in the same marketplace. In a clinic setting, that might include:

• Urgent care clinics within a few miles
• Corporate-backed practices in your area
• Specialty clinics targeting your niche
• Hospital-owned outpatient clinics
• Other independent physicians offering similar care

At first, that list might feel intimidating. But the point is not to spiral about who else is out there. The point is to get clear about what makes your clinic different.

Are you competing on price? Patient experience? Specialization? Accessibility? A more personal relationship with patients?

If you do not define your position, the market will do it for you. And when your clinic looks too similar to every other option, patients are more likely to compare you based on price alone.

This is where your niche matters.

The more clearly you can articulate who you serve, what problem you solve, and why your way of practicing medicine is different, the less likely your clinic is to be treated like a commodity.

2. New entrants: what happens when someone new shows up?

The second force is the threat of new entrants.

In plain English: how easy is it for new competitors to enter your market?

For healthcare, this could look like:

• Telehealth startups expanding into your state
• Hospital systems launching new outpatient clinics
• Other physicians leaving employment to open their own practices
• New direct care clinics serving the same patient population

This is not always bad news.

A new independent physician in your area does not automatically mean less opportunity for you. In some cases, it can actually expand the pie. More independent practices can help educate the local community that there is another way to receive care outside of corporate medicine or the traditional insurance-based system.

Still, you want to be intentional.

If new clinics can open easily in your market, ask yourself what makes your clinic hard to replace. This is where patient retention matters. The stronger the relationship, experience, trust, and sense of belonging you create, the less likely your patients are to leave the moment another option appears.

Instead of treating every new clinic as a threat, use it as a prompt to look more closely at your own patient experience. What are patients getting from your clinic that they would have a hard time finding somewhere else? 

3. Suppliers: who has leverage over your business?

The third force is supplier power.

Suppliers are the people and companies your clinic depends on to operate. In healthcare, this might include:

• Your EMR
• Medical supply vendors
• Medications or in-office products
• Staffing
• Accountants and bookkeepers
• Technology platforms
• Landlords
• Laundry, janitorial, or other operational vendors

Every dependency you create in your business gives someone else potential leverage.

That does not mean you should avoid vendors. You need support to run a clinic. But it does mean you should be thoughtful about who you choose, what you are paying, and whether the relationship still serves your needs.

For example, when choosing an accountant, it is tempting to go with the first recommendation someone gives you. But it is much better to speak with a few different people, understand what they offer, compare pricing, and make sure their style works for you.

The same applies to your EMR, your tech stack, and your vendors.

A useful question to ask is: When was the last time I reviewed this relationship?

If you have not price shopped, compared options, or evaluated whether a vendor is still meeting your needs, this may be a good place to look for opportunities.

Flexibility is the name of the game. The more options you have, the less dependent you are on any one supplier.

4. Buyers: how much power do patients have?

The fourth force is the bargaining power of buyers.

In most industries, this refers to the customer’s ability to influence price, expectations, and service. Think about Amazon. Customers can instantly compare products, read reviews, and make decisions based on price, convenience, and perceived value.

Healthcare is more complicated.

Insurance companies have distorted the relationship between patients, clinicians, pricing, and value. In the insurance-based system, patients often do not see the true cost of care, physicians do not control many of the prices, and both sides are stuck dealing with a middleman.

In direct care, the relationship is different.

When the middleman is removed, patients may have more direct awareness of what they are paying. That can make pricing conversations feel uncomfortable, especially if you are used to practicing in an insurance-based system.

But here is the important reframe: patients are not only evaluating price. They are evaluating value.

They are asking, consciously or not:

• Will this clinic actually listen to me?
• Will I get more time with the physician?
• Will the care be more comprehensive?
• Will follow-up be clear?
• Will this experience feel less frustrating than the system I am used to?

This is why your messaging matters.

If patients have multiple options, you need to clearly communicate why your clinic is worth choosing. Online reviews, testimonials, patient experience, and social proof all play a role in shaping how people perceive your value.

The more clearly patients understand your model, your approach, and the experience they can expect, the less likely they are to reduce the decision to price alone.

5. Substitutes: what else could patients choose instead?

The fifth force is substitutes.

A substitute is any other way a patient might try to solve the same problem your clinic solves.

In healthcare, substitutes might include:

• Google
• ChatGPT
• Urgent care
• Retail clinics
• Telemedicine
• Direct-to-consumer health services
• Waiting it out
• Doing nothing

That last one is easy to underestimate. 

For many patients, the easiest option is to delay. They may search online, second-guess themselves, hope the problem resolves on its own, or avoid making an appointment because the whole process feels overwhelming.

That means your clinic is not only being compared to other healthcare options. It is also up against confusion, hesitation, fear, and the mental load of taking action.

This is where the patient journey matters. The clearer, warmer, and easier the first step feels, the more likely someone is to move from thinking about getting help to actually reaching out.

That might mean making your website clearer, explaining what happens after someone reaches out, reducing friction in the booking process, or creating a patient experience that feels warm and reassuring before they ever walk through the door.

You are not just competing with other healthcare options. You are competing with confusion, hesitation, fear, and delay.

Use the framework to make better decisions

When your market shifts, it is easy to react quickly. A new competitor opens, a supplier raises prices, a telehealth company starts advertising, and suddenly everything feels urgent.

Porter’s Five Forces helps you pause long enough to see what is actually creating pressure. Is it competition? Supplier costs? Patient expectations? Substitutes? New entrants?

Once you can name the pressure, you can decide what to do next. Maybe that means refining your niche, reviewing your vendors, strengthening patient retention, clarifying your messaging, or making it easier for new patients to reach out.

You cannot control every change in the market. But you can build a clinic with a clearer strategy, a stronger position, and more freedom to practice medicine the way you want.

If you want support thinking this strategically about your clinic, applications are open for the September cohort of Female Founders Accelerator.

This is a high-touch, 10-month small group program for female physicians who want to build the clinic of their dreams and practice medicine the way they want, without compromising their values or personal lives.

Inside, we cover business concepts like this so you can build with more clarity, confidence, and show up as the most empowered CEO version of yourself.

There are just a few spots left. Learn more and apply at www.amandasabicer.com/femalefounders