A Startup Practice Checklist

You’ve decided to start a new independent pediatric practice. If this idea seems overwhelming, you’re not alone! What laws are in your state? How should you get started? Whether you’re a sole proprietor or partnering with others, we’ve made a checklist for startup practices to help you get started.

1. Successful Practices Plan Ahead

Pediatricians envisioning their first independent practices have tons of plans and dreams about how to make it the best practice around. There are plenty of exciting experiences ahead, but one thing that successful practices have in common is that they plan ahead. Let’s look at the steps you’ll need to consider to be financially and logistically stable enough to launch your new practice.

Your plan for a new practice should be more than “I want to set up shop downtown” or “I really just want to run things my way”. Your concept for a new practice should be one that you write down and practice often. Why? The majority of new practices need loans to start a new business venture, and you’ll need to pitch your plan to the bank, as well as to potential partners, employees, and of course new patients!

Your concept doesn’t have to be novel or even novel-length. Think carefully about the patients you want to serve, how you will serve them, and even why you’re a pediatrician in the first place. If you want to serve kids with mental health needs, sports injuries, or have a focus on babies and toddlers, think about how your practice will appeal to those families.

A business plan is “a document that defines in detail a company's objectives and how it plans to achieve its goals”. Your business plan will lay out your goals, and it will have the benefit of having your concept, plans, and timeline available for reference.

A business plan will include financial projections, a budget, and a list of services. Services might include a general description of “pediatric healthcare,” but you could also add other services you have planned, such as  “behavioral health specialist” or “flu clinic” as services that will produce income. Later, this planning will help keep you on track and note any savings or losses you experience with start-up costs.

Susanne Madden of The Verden Group says that she works with practices to ensure they are conservative with numbers – overestimating costs, and underestimating revenue for the first year to keep budgets on track.

Your budget should include the costs you’ll need to cover to set up your new office. From exam tables to file folders and eventually, an electronic health record, having a plan to cover these startup costs can help you save, plan, and project your financial needs for your first years in practice.

Setting Up Shop as a New Pediatric Practice

Some of the steps listed below, such as choosing a location, should be items considered in the planning phase. Once you pay a deposit for a location or begin hiring, however, you’re officially setting up shop.

As The Verden Group’s Susanne Madden often says, location is everything. “It's not just where are the patients at and how to be able to get them in your doors,” she says, “But a variety of variables like, ‘Is there adequate parking? How many steps are there between the parking lot and your office? Do they have to go up an elevator to get to you?’ 

Besides access to your new space, new practices will want to consider variables like proximity and future space plans. Is the location near a school system, a neighborhood, other healthcare facilities, or even other pediatricians? If families don’t have reliable transport, is there a public transit system nearby? Also, consider that over the years, your practice may need additional space – buildings with additional office space could be useful later on.

No matter where in the U.S. you practice pediatrics, there are some common expenses for all-new practices. Here’s a short list:

• Deposit and office space rent
• Insurance (health, malpractice, renter’s, and so on)
• Payroll
• Office supplies
• Costs associated with licensure & credentialing
• Office equipment such as desks, vaccine refrigerators, and exam tables

Depending on how your new practice will be set up, you may also need to pay costs for construction in your new space, incorporating an LLC with your state. If you’re leaving an existing practice, there could be costs associated with a partnership agreement. For more information on migrating patients and breaking away from an existing practice, check out this guide from PCC’s Chip Hart and The Verden Group’s Susanne Madden.

Don’t forget technology! Clinical and administrative technology can help prepare your practice for seeing patients straight away. Some of the items on your list might include:

• A pediatric EHR
• A patient portal
• Billing services (if you do not hire in-house)
• Vaccine scanners, vision screeners, and other clinical devices
• Lab equipment, if applicable
• Health Questionnaire subscription, such as with CHADIS
• Printers, scanners, phones, and wifi

Choosing the right technology partners is critical – these relationships with vendors will be useful not only when there is an issue (such as your wifi going down or a weather emergency) but in everyday practice. Trusted vendors will protect patient and practice data, have great customer support, provide any needed training or assistance with set-up, and come with great reviews.

Pediatricians do not usually have an MBA under their belt, and since starting a business requires a lot of steps, it’s not only acceptable to ask for help, but often necessary. Hiring well means not only hiring nurses and front desk staff that align with your cultural vision and goals but also vendors and services that will honor your mission and are reliable and trustworthy.

In legal and financial situations, your business deserves professional help. Shop for an accountant or financial advisor and a lawyer as carefully as you can, as these are important business relationships that when successful, can last for many years. Other services you might consider include an on-call HR professional, medical billing, EHR, business consultation, or group purchasing organization.

Unsure where to start? We recommend all independent pediatricians join and utilize the many great resources of SOAPM, the AAP’s Section on Administration and Practice Management. There, you’ll find resources and recommendations from other independent pediatricians on both local recommendations for services and outstanding professionals, but also general information on what to look for, such as appropriate costs, experience, testimonials, and more.

You Started a Pediatric Practice! Now What?

PCC’s Chip Hart, Director of Pediatric Solutions, usually recommends startup practices take 9 months to a year to plan and set up a new business. After many weeks of anticipation and planning, your practice is ready to open and welcome new patients! Whether you’re starting with a new population altogether or plan to take patients with you, you’ll need to spread the word to get patients in the door.

Yes, you definitely need a website! Check out our previous post to learn more about how to set up a great website your patients will love.

Some practices prefer to start slowly and take in fewer patients during the practice’s first weeks. Others dive right in with packed schedules. The choice is up to you (and your budget, since payroll and other costs will remain the same no matter how many patients you care for). No matter how many patients you accept to begin with, make a budget and plan for your marketing efforts. You might share videos on social media, distribute business cards, or even place ads in your local newspapers or stores. You can also ask patients to offer you testimonials for your website, or review you positively on review websites like Yelp, Healthgrades, and ZocDoc.

Getting a new practice off of the ground is a milestone worth celebrating! Every year, PCC and our partners in the pediatric industry like The Verden Group and PedsOne help many new practices start their independent practice journey. Want more advice on how to migrate patients from an existing practice and get a new practice started? Check out our webinar, and learn how your new practice dreams are closer to realization than you think.