Opening a Medical Practice: A Detailed Checklist for Healthcare Leaders

Starting your own medical practice is a bold move, and one that requires much more than clinical expertise. Whether you’re a physician aiming to move out of a hospital system or a group looking to create a patient-centered specialty clinic, launching a medical practice means balancing compliance, strategy and infrastructure.

We’ve worked with healthcare leaders who wore many hats while navigating startup challenges. This checklist walks through the phases of opening a practice with clarity and structure. From defining your vision to opening your doors, these steps are designed to help you avoid costly oversights and open with confidence.

Phase 1: Your Specialty and Market Viability

Before you buy furniture or print a logo, step back and ask the most important question: Is this practice viable?

This early phase is about business clarity. First, define your clinical focus. Are you a family medicine doctor with a loyal following? A specialist with expertise in dermatology, gastroenterology or behavioral health? The type of care you’ll provide shapes everything from facility size to staffing ratios.

Next, study the local market. If your community already has three urgent care clinics and no pediatric providers, that’s a signal. Look at payer data, population demographics and regional health trends. The U.S. Census Bureau and local health departments can provide valuable insight into community needs. Competitive analysis is just as essential; understand where gaps exist and how you can fill them.

Once you see opportunity, move into business planning. This includes:

• Structuring your entity: Will you operate as an LLC, S corporation or partnership? This decision affects your taxes, liability and growth options. If you’re not sure where to start, we recommend working with professionals who understand healthcare entities specifically.
• Financial forecasting: Include startup costs, monthly expenses, patient volume projections, billing cycles and break-even timelines.
• Future partnerships: Even if you’re launching solo, think ahead. Will you eventually bring on partners, add locations or expand services? Structure your entity and ownership terms to accommodate those future goals without a major overhaul.

This phase is also where you should create a draft budget, start defining your brand values and consider how you want to be perceived in your market.

 

 

Phase 2: Name, Branding, and Federal Registrations

Once you’ve confirmed your idea has traction, build your identity and check the legal boxes.

Start with a name that reflects your brand and clinical focus. It should be easy to pronounce, available across domains and social media, and clear of any trademark conflicts. Once you’ve selected it, file your name with your state and secure your website domain immediately.

Next, apply for an Employer Identification Number (EIN) through the IRS. This number is required for tax filings, hiring employees and opening a bank account. You’ll also need to register your business entity with your state and obtain a National Provider Identifier (NPI).

Here’s what else belongs in this phase:

• Logo and brand design: Your logo should reflect professionalism while being easy to use across signage, digital media and printed materials. Hire a designer who understands medical branding, or choose a firm that has worked in the healthcare space.
• Business bank account: Open a dedicated business bank account. This separates personal and business finances and simplifies tax filings, reimbursement processes and bookkeeping.
• Secure your web presence: Even if your website isn’t finished, buy your domain, set up professional email accounts and establish placeholder pages online. Having a basic web presence early helps with indexing and local search engine optimization (SEO).
• Communication tools: Set up a dedicated phone system, voicemail and email infrastructure for patient intake and support.

If you plan to use telehealth services or patient portals, begin evaluating HIPAA-compliant software now. Many options integrate with EMRs later, so consider your long-term tech stack even in this foundational stage.

Phase 3: Compliance and Credentialing

This is where skipping a step can cost you in fines, delays or even license suspension. Compliance is not optional, and it begins well before you open your doors.

Start with understanding your state’s licensing requirements. Each state’s medical board outlines specific steps like physician licensure, facility registration, controlled substance permits and more. Some states require certificate of need (CON) approvals depending on the services you plan to offer.

Next comes HIPAA and OSHA compliance. HIPAA governs how you collect, store and share patient health information. (The U.S. Department of Health and Human Services has clear guidance on HIPAA compliance for medical practices.) OSHA regulations cover workplace safety standards. Consider conducting a HIPAA security risk assessment now so that your workflows, software and staff protocols are set up properly from day one.

Here’s a checklist to guide this phase:

• Apply for malpractice insurance: This should be in place before your first patient encounter. Work with a broker experienced in your specialty and location.
• Establish legal agreements: This includes employment contracts, partnership agreements, independent contractor agreements and vendor contracts. Each should be reviewed by a healthcare attorney.
• Enroll in insurance plans: This includes Medicare, Medicaid and major commercial insurers. Credentialing can take several months, so begin early and follow up regularly.
• Apply for CLIA certification: If your practice will perform lab testing, you may need Clinical Laboratory Improvement Amendments (CLIA) certification.
• Obtain DEA registration: If you will prescribe controlled substances, you must register with the DEA.

Credentialing with insurers is particularly time sensitive. If you delay this process, you may open your doors only to find you cannot bill major payers. You can start this process even while build-out is happening to avoid reimbursement gaps.

Phase 4: Building the Practice Itself

Once your paperwork is in motion, it’s time to bring the practice to life. This is often the most visible and expensive phase. Your decisions here influence not just how the practice looks, but how patients and staff experience your space.

Location strategy is critical. Start by weighing whether to lease, buy or build. Each path carries different risks and benefits. Leasing can reduce your upfront investment and offer flexibility. Look closely at lease terms (especially clauses about property improvements, signage and exit strategies).

Buying gives you control over the property and may build long-term equity. However, it also requires a larger initial investment and ongoing maintenance. Building from scratch allows you to tailor every square foot to your specialty. This option typically requires the most time and capital.

Also, make sure you evaluate zoning regulations, traffic flow, parking, proximity to hospitals or referral partners, and accessibility standards under the Americans with Disabilities Act (ADA). Patient experience begins at the front door, so your physical layout should be efficient, calming and compliant.

Other key decisions in this phase include:

• Design and construction: Work with a general contractor familiar with healthcare requirements. Medical gas lines, radiology shielding and ADA compliance are just a few of the nuances that require industry-specific knowledge.
• Furniture and equipment: Budget for medical exam tables, diagnostic equipment, waiting room seating and admin desks. Don’t forget essentials like phone systems, printers and break room appliances.
• Permits and inspections: You’ll need a Certificate of Occupancy before you can open. This often includes fire marshal inspections, electrical clearance, and plumbing sign-offs.

Your space is a long-term investment in your brand. Poor planning here can create bottlenecks later. Your team should include an architect, a general contractor and (ideally) a healthcare-specific project manager to keep everything moving on time and on budget.

 

 

Phase 5: Operational Infrastructure

With your space coming together and your registrations underway, now is the time to install the backbone of your practice operations. This phase is where healthcare delivery meets day-to-day logistics. Overlook it, and your practice may be functional but inefficient. Handle it well, and you will position yourself for smooth workflows, accurate billing, and happy patients.

Start with your electronic medical records (EMR) and electronic health records (EHR) systems. This is more than just choosing software. It affects patient experience, clinical documentation, reporting and compliance. You’ll want a system that integrates with your billing software, supports e-prescribing and meets HIPAA privacy and security rules.

Some practices choose all-in-one systems, while others build their own tech stack with separate platforms for EMR, billing, patient communication and analytics. Either path is viable, but consistency is key. Your technology should talk to each other, and your staff should be properly trained on it before your first patient visit.

Here are core items to implement in this phase:

• Practice management software: Use this to schedule appointments, manage front desk workflows and collect copays.
• Accounting and payroll systems: Whether you outsource bookkeeping or keep it in house, your accounting software should match healthcare-specific needs like chargebacks and payer reimbursements.
• Cybersecurity tools: Protecting patient data is non-negotiable. Invest in encryption, access control systems, endpoint security and regular backup protocols.
• Telehealth platform: Even if you don’t’ plan to use virtual care initially, having a platform in place can help you stay competitive and serve remote patients when needed.
• Revenue cycle management tools: From pre-authorization to collections, your systems should be optimized to ensure claims are submitted accurately and paid promptly.

Next, focus on staffing. Build a team that reflects both your clinical model and your operational needs. This typically includes:

• Front desk and intake staff
• Billing and insurance coordinators
• Licensed clinical support (LPNs, MAs, RNs)
• Practice manager or administrator
• Optional: IT support, HR coordinator, marketing professional

Hiring should be strategic; think beyond today’s needs and plan for future growth. Many practices benefit from bringing in an interim practice administrator to help with setup, especially when internal experience is limited.

For practices looking to tighten back-end operations, our Healthcare Advisory Services team can help with payroll systems, expense categorization and financial reporting structures tailored to medical environments.

Phase 6: Patient Acquisition

Acquiring patients requires a thoughtful approach that combines digital visibility, strong referral networks and a community reputation. Marketing in healthcare is about trust, access and clarity. The people you want to reach are often in vulnerable situations. They’re looking for providers they can connect with quickly and comfortably.

Start with your online presence. Your website should clearly outline your services, credentials, insurance plans accepted and scheduling options. It should load quickly, display well on mobile devices and include an easy way to contact your team. Set up a Google Business Profile to appear in local search results and map listings. Ask satisfied patients to leave reviews when appropriate.

Digital marketing tactics to consider:

• Search engine optimization (SEO): Use keywords related to your services and geography to help patients find you online.
• Social media presence: Establish your practice on platforms your audience uses. For primary care and pediatrics, this may include Facebook or Instagram. For specialties like orthopedics or behavioral health, LinkedIn or Google Ads may be more appropriate.
• Email marketing: Offer appointment reminders, health tips and practice news through a HIPAA-compliant email platform.
• Online scheduling and patient portals: Convenience can be the deciding factor in a patient choosing your practice.

Offline, referral relationships still carry weight. Connect with primary care providers, hospitals, local employers, and other specialists. Let them know you are open, accepting patients and available for consults. Community involvement also matters. Attend local health fairs, speak at school or employer events and consider offering open houses to help people learn about your services.

When you create a marketing plan, make sure it includes performance tracking. Whether it’s call volume, website traffic, appointment conversions or cost per lead, use real data to adjust your outreach strategy.

For guidance on digital tools and marketing technology in medical practices, visit HealthIT.gov, which provides excellent resources on improving patient engagement through secure and compliant technology.

Final Phase: Opening Your Doors

Now comes the most important part: launching with clarity and confidence. Opening a medical practice is a commitment to serve your patients, build something sustainable, and create a place where care meets trust.

If you’re serious about launching or scaling a healthcare practice, work with experienced advisors who understand both the business side and the regulatory framework of healthcare. From entity selection and compensation models to billing infrastructure and real estate strategy, the right partners make the complex more manageable.

At James Moore, we support healthcare organizations at every phase of their growth. Contact a James Moore professional today to create a medical practice that is structured for success.

 

 

All content provided in this article is for informational purposes only. Matters discussed in this article are subject to change. For up-to-date information on this subject please contact a James Moore professional. James Moore will not be held responsible for any claim, loss, damage or inconvenience caused as a result of any information within these pages or any information accessed through this site.