There's no need to be overwhelmed starting a business. Whether you're starting a Direct Primary Care (DPC) clinic or a Direct Specialty Care clinic, the hard part is done: proving the concept works.
If you haven't yet, follow the steps in the article Order of Business: Getting Started Quickly.
Plan on changing plans
As much as you plan out your business, you still don't know what you don't know. Things will come up that force you to make decisions, which might affect your plans. Adaptability is going to be key in setting up your business.
But don't make the mistake of not planning anything and just shooting from the hip. You'll thank yourself later for making some decisions and plans ahead of time.
Hot take: you don't need a business plan
Because you don't know what you don't know, your business plan is bound to change. So why spend all that time putting together a binder full of decisions and projections that will likely change?
I don't think you need an official business plan. At least not like the ones that your local Chamber of Commerce or "business plan competition" hosts would recommend.
You already have a service that everyone needs: healthcare. You already have a model to deliver it: direct to consumer (membership for DPC). And the model is already proven: thousands of physicians are successfully doing DPC around the nation today.
So what do you need? A vision, goals, and a checklist.
Your vision
Start with the big picture. What do you hope your daily life looks like once you've grown your business to its potential?
Are you hoping to keep a "lifestyle" business where it's maybe just you and a couple staff and maybe another physician, limiting your patient panel to a certain size, making great money and limiting responsibility and stress in order to live more of your non-work life?
Or, do you really like the idea of business / medicine being most of your life and want to manage a larger team, build more than one location, and grow as large as possible?
Is it somewhere in between?
Whatever you want your life to look like - write it down. Imagine being in your ideal life - even outside of work.
Now you at least have a picture of where your end goal is today. Just like everything, that might change, but it's a goal to work towards now.
Goals
You need some wins along the way, because starting a business is hard. Goals help you remember to celebrate milestones and remember how far you've come.
Don't make huge goals at first. Keep them simple, then increase the scope the further you get into business:
- File PLLC paperwork
- Treat my first patient
- Onboard my first member
- 50 members by XX/XX/XXXX
- First staff hire by XX/XX/XXXX
- First business group joined
- First business group of 50+ employees
Putting deadlines or dates with your goals will help, too.
Checklist
Your checklist serves your goals. And you need to create a checklist that serves your goals.
We have a launch task manager coming soon - that will include a lot of the details of starting your business. But what it doesn't have are checklist items that will serve your personal goals.
For instance... if you have a goal of 50 members by a certain date. What things are you going to do to get those first 50 members? Here are some ideas:
- Speak at Chamber of Commerce Coffee Club
- Post information on my social media feeds
- Write a Public Service Announcement and send to local radio stations and newspapers
- ... and so many more!
Your task list / checklist should serve your goals.
Keep it updated. When you have new goals come along, update your task list to make sure you're doing things to help you reach those goals.
Some advice from experience...
As you plan your own practice, let me offer a few pieces of advice - or at least perspective...
Don't borrow money - or think extremely hard before doing so
Whether it's from friends or family, from a bank, or a small business loan, borrowing money will amplify your stress and responsibilities enormously.
Because you're offering a service rather than a product, income is naturally going to come more slowly.
Borrowing money might put you ahead a couple months because you now can afford a larger space, maybe a staff member or two, and maybe a piece of equipment or two.
However, those additional purchases don't translate into more memberships or more income (the one exception is perhaps if you're in specialty care and know that a new machine that isn't available locally might bring in additional revenue).
Especially for DPC physicians - you can do so much out of your own home, a shared space, and with limited tools and supplies. Consider building a membership base before investing a lot into things that won't translate into increased revenue.
When hiring family, talk about the hard stuff first
It's really, really fun to work with family. And also surprisingly hard and frustrating.
Before hiring or working with family, talk about the end first. What will it look like when they need to quit or you need to fire them? How will we know whether this is a good fit or not? How open are we going to be along the way?
If you're going the extra step and becoming business partners with family members, put everything in writing. Have an operating agreement and discuss the really hard stuff first. While it seems crazy, it actually opens the door for great communication and sets up expectations ahead of time.
Learn every job first, then hire
If you're going to bootstrap your own small business, I recommend learning at least the basics of every job that you hire for - even if you hire vendors.
Not only will learning each position help you appreciate your staff members, it will help you understand whether they're doing a good job or not, and doesn't make anyone indispensable.
The hard truth is that hiring staff is one of the hardest things that any employer has to deal with. If you choose to hire staff, great people will move on. You'll hire someone that you have to fire (or should have much earlier). Some staff are really great at their job, but hard on the team culture.
You get the picture. If you're going to lead a team, then understanding their job is actually the easy part. You'll thank yourself later for taking the time to learn every position.
Don't just spend money on marketing and sales - measure everything
If you're bootstrapping your business, you want to make sure every dollar counts.
Once businesses hear that you're new in the area, you'll have advertising sales folks knocking at your door explaining how large their reach is and how your business will grow if you just advertise with them.
At first, deny everyone.
They're not all bad - and some of that advertising will work. But you want to setup a way to measure it.
Pick one advertising medium at a time, and measure as much as possible. How many new phone calls came in? How many new website visits? How many seminar attendees did we get? How many new members did we get?
Don't be shy about saying no to sales folks - they're used to it!
Don't let planning hold you up
Starting a business doesn't have to be complicated.
You can start seeing patients right now. You just need a few things to be legal:
- A current, valid medical license from the state where you're practicing
- A legal way to accept payments from patients
- A patient agreement with your State's DPC verbiage included
And in most states, that's it.
Don't let planning hold you up from seeing patients and starting something.
You should start now! Here's how to get started.
Have questions?
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