“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? Less than $3000. I’ve learned a lot of savings strategies since then. So I’m pretty sure you can do better. Here are the basics.
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).
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? Join the next physician teleseminar.
Pamela Wible, M.D., is a physician entrepreneur and 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.