What Starting an Independent Practice Actually Involves
As part of the second post in our New Clinic Start-Up series, we want to take a deeper look at what starting an independent practice actually involves. The goal of this article is to remove some of the mystery behind opening your own clinic, set more realistic expectations, prevent rushed decisions, and reinforce the value of thoughtful planning.
This post is designed for providers who are seriously exploring independent medicine, early planners who are looking six to eighteen months ahead, and providers who may underestimate the timelines and complexities that come with opening a practice.
Starting your own practice is exciting and highly motivating. The idea of building something of your own is powerful. However, it is important to understand that starting an independent practice is not quick. It is not a single task or decision. It is a multi-phase process with overlapping responsibilities, decisions, and timelines.
Ultimately, starting a clinic is a sequence of decisions, not a checklist you can complete in a weekend.
One of the most common misconceptions we see is the belief that opening a clinic can be completed within a week or even a month. Throughout this series, you will hear us emphasize one key message repeatedly: understanding the process early and planning ahead leads to better outcomes.
A High-Level Framework for Starting an Independent Practice
To help make this process easier to understand, we want to provide a high-level framework for opening an independent clinic. The process can be broken down into three main phases.
The first phase is planning and preparation.
The second phase is setup and approvals.
The third phase is launch and early operations.
These phases often overlap and build on one another. Progress is not always linear, and trying to skip steps or rush through phases often creates delays and complications later on.
Phase One: Planning and Preparation
The planning and preparation phase is where the foundation of your clinic is built. This is where ideas begin to turn into a clear vision.
During this phase, providers should consider questions such as when they want to open, where the clinic will be located, what specialty or services will be offered, and what type of practice they want to build. Other important considerations include whether the practice will start with just the provider or with administrative support, what business structure the clinic will operate under, and what type of culture the clinic will prioritize.
It is also important to think about the patient population you want to serve, the care model you want to provide, your personal and financial readiness, your risk tolerance, and how flexible your timeline can be.
This phase is where your vision becomes reality. Decisions made here affect nearly everything that follows, including staffing, systems, and contracting. Rushing through this stage can lead to costly changes and delays down the road.
At Integrity Health Network, we have seen clinics succeed when they take this phase seriously, give themselves time to plan, and clearly define what they want their practice to become.
Phase Two: Setup and Approvals
The second phase involves a wide range of administrative and operational tasks that must be completed before a clinic can open.
This includes developing human resources policies, securing liability insurance for both the clinic and providers, submitting contracting applications, completing credentialing applications, obtaining licensure, selecting and implementing systems such as EHR, billing, and scheduling, and planning staffing and workflows. Clinics must also secure a physical location, purchase medical equipment and supplies, and determine how things such as medical waste will be handled.
The setup process includes many more details than can be fully listed here. There are also dependencies within this phase. For example, business formation, licensure, liability insurance, and a physical location need to be established before contracting can begin.
Many steps happen simultaneously, but delays are common when planning starts late or when applications are rushed. For example, if contracting applications are submitted with missing or incorrect information, processing timelines reset each time corrections are required.
Rushing through important business forms or approvals often creates larger problems later, including delays in opening and revenue generation. Taking the time to complete this phase accurately is critical.
Phase Three: Launch and Early Operations
The third phase begins once the clinic opens and starts seeing patients. This phase often comes with new realities that providers should be prepared for.
Revenue does not arrive immediately. Even after a clinic is fully set up and open, it typically takes three to five weeks for the first payments to arrive. Revenue often begins to stabilize around weeks six to eight as claim denials decrease.
In many cases, the full timeline from securing a space to seeing patients ranges from nine to fifteen months when there are minimal delays.
This phase is also when workflows, staffing, and systems should be evaluated. Once real-world operations begin, it is common to identify areas that need adjustment. After the first month or two of operations, it can be helpful to assess whether systems and staffing structures are working as intended or need refinement.
Clinic owners must also evaluate the balance between patient care and administrative responsibilities and determine whether additional support is needed.
Timelines That Matter More Than Most Providers Expect
Many steps in the setup phase have long lead times, and delays can compound when processes are started late, rushed, or completed incorrectly.
Contracting and credentialing are two timelines that often surprise providers. For a clinic to obtain its own individual health plan contract, the process can take ninety to one hundred twenty days for a clean application. This timeline may be longer for health plans that require Medicare or Medicaid approval first. When an application is submitted incorrectly the timeline starts over.
Credentialing can take thirty to forty-five days for a clean application. In Minnesota, there is a law requiring a thirty-day turnaround time, but this applies only to clean applications and does not guarantee an effective date within that timeframe. The effective date is what determines when a provider can safely bill.
Other important timelines include obtaining a Tax Identification Number from the IRS, which can take seven to eleven weeks, or longer during peak tax season. In Minnesota, a facility medical license can take up to ninety days to process. Finding or building a clinic space can take anywhere from one to six months or more before the space is operational.
Understanding these timelines early helps reduce stress and financial strain.
Common Challenges When Planning Is Skipped or Rushed
When planning is rushed or skipped, we commonly see challenges such as expecting immediate cash flow, underestimating contracting and credentialing timelines, and hiring staff before workflows are clearly defined.
These issues are often preventable with early education and planning.
Support Throughout the Process
Opening an independent clinic does not mean doing everything alone. Many providers benefit from support from organizations like Integrity Health Network that work with these processes regularly and have years of experience guiding clinics through start-up.
Support can be immediate or phased and flexible depending on where help is needed. Guidance is a valuable investment that helps ensure informed decision-making rather than guesswork that can set a clinic back.
The goal of support is not to take over decisions, but to help providers make choices that benefit their clinic long term.
Looking Ahead
Throughout this series, we will continue breaking down the process of establishing an independent clinic so you can feel more informed when deciding whether this path aligns with your professional and personal goals.
Feeling overwhelmed is normal. In fact, we would be more concerned if you were not. Every clinic we have supported has experienced some level of uncertainty. Learning the process early provides more control and confidence.
In our next post, we will break down the legal, business, and structural basics involved in starting an independent practice.
