How to Start and Grow Your Practice (for Clinicians, not MBAs!)

Starting and growing an integrative medical practice is a transformative journey that requires careful planning, commitment, and adaptability. Often, integrative and functional medicine providers are great clinicians when it comes to helping their patients, but feel inadequately prepared to run the business side of their practice. Dr. Linda Matteoli, at Origins Incubator, has the solution to this conundrum, walking physicians through the process to increase confidence, maintain authenticity, and achieve outcomes. The strategies they share in this article are valuable for all of us. – DrKF

 

The Four Stages of Practice Growth

Through my experience building my own practice to a waitlist and through mentoring more than 100 physicians at Origins Incubator through the same process, I have identified four essential stages of practice development:

1. Research
2. Act
3. Refine
4. Grow

Within each stage there are five areas of the business—Focus, Foundation, Roles, Systems, and Targets—that must be addressed before progressing to the next stage. Ignoring any of these can lead to weak links or challenges later on. Interwoven throughout each stage are principles of clinical management, customer service, legal compliance, and financial management–each evolving in alignment with your vision for your practice.

Moving through these stages in order creates a strong foundation, and also ensures that the practice you are building reflects your own vision and authenticity most accurately. At the end of the day, your practice should reflect your own vision of how medicine could and should be. And the way you treat patients, the way you develop relationships with patients, the way you impact their lives and the lives of their families, is unique and should be honored.

What follows is a stage-by-stage roadmap to help you visualize your current stage, help you recognize that some of these growing pains are common to most practices (you aren’t alone), and visualize the targets to hit that will allow you to graduate to the next stage. This roadmap should help you identify and focus on the most impactful tasks to help you get to the next stage. Of course, every practice is unique, and you may identify with portions of each stage. The point of this exercise is not to feel “behind.” You’re right where you should be. The point is to identify your stage and help you prioritize your most precious commodities: your time and attention. Let’s go!

If you’d like a downloadable PDF with visuals and checklists, download the Stages of Growth Roadmap here.

 

Stage 1: Research

Overview

This is the exploratory phase where clinicians typically assess whether they want to establish their own practice. It involves researching other models, brainstorming ideas, and consulting with close contacts. In other words: you don’t have a business yet, but you want to start testing the waters.

Focus

• Conduct 5-10 initial low-cost or free consultations with friends and family in exchange for feedback and testimonials.
• Learn about patients’ struggles, obstacles, and needs.
• Begin to develop entrepreneurial skills and time management.

Foundation

• Message: Define your “why” to stay motivated and craft an authentic marketing message.
• Appointments: Focus solely on the foundational assessment to identify patient health needs.
• Physician Toolkit: Establish lab and Rx registrations, supplement stores, and intake forms.
• Technology: Avoid costly investments—use free trials and basic tools like Google Suite.
• Marketing: Rely on personal networks.
• Sales: Offer free/discounted services in exchange for feedback.
• Legal: Create a basic patient contract.
• Finance: Set up a business entity and bank account to separate personal and business finances.

Roles

You will wear all hats—clinician, administrator, and patient support—while documenting needed processes.

Systems

• Patient Communication: Use personal phone and email for now.
• Interoffice Communication: Create a system for tracking tasks (to-do lists) and progress.
• Meetings: Hold weekly planning and review sessions with yourself.
• Training: Learn theory and apply business and entrepreneurial skills.

Targets to Move Up:

To graduate to stage 2, you should:

• Set up a legal entity
• Get some patient legal documents in place
• Set up business bank accounts
• Conduct 5-10 initial patient assessments (free or nearly free), and
• Gather patient feedback & testimonials.

 

Stage 2: Act

Overview

This is the stage where you formally commit to your practice. It involves onboarding paying patients, developing operational systems, and refining your offerings based on feedback from the Research stage. In other words: you’ve started your business, and you’re starting to figure things out and get more efficient.

Focus

• Enhance the foundational assessment and develop a membership or longer term care model.
• Onboard the first 10 paying patients into the longer term offering
• Improve time management while balancing other responsibilities.

Foundation

• Message: Define your ideal patient base and their specific needs.
• Appointments: Structure your process with discovery calls, foundational assessments, and membership appointments.
• Physician Toolkit: Acquire essential tools such as an EMR, business cards, and marketing materials.
• Technology: Buy a domain, build a basic website, get business email, and business social media accounts.
• Marketing: Expand outreach within your community, focusing on networking and relationships rather than paid ads (at this point).
• Sales: Transition patients from one-time consultations to long-term care.
• Clinical: Refine testing and treatment plans; seek mentorship for clinical confidence.
• Legal: Develop appointment contracts and telehealth policies. Develop an internal compliance plan for HIPAA, operating agreement, website and online presence.
• Finance: Track expenses and determine a sustainable income model.

Roles

You continue to wear every hat, but should start documenting your tasks to prepare for eventual delegation.

Systems

• Patient Communication: Shift from personal communication to business tools (EMR, business phone).
• Interoffice Communication: Document internal processes for future team use.
• Meetings: Maintain regular planning and review sessions with yourself (you are the team).
• Training: Begin to develop a basic Standard Operating Procedures (SOP) manual for yourself and eventual team members.

Targets to Move Up:

To graduate to stage 3, you should:

• Finalize and refine your practice model,
• enroll 10 long-term patients, and
• establish a rhythm for consistent community marketing.

 

Stage 3: Refine

Overview

This stage is defined by stabilization. Throughout the second stage of business growth, you are really hustling to onboard new patients and you are benefiting from the consistent work you’ve put in. However, as patient volume increases, inefficiencies in the system emerge.

In other words: your hair is constantly on fire, and there isn’t enough time to do everything. Tasks are starting to fall through the cracks. (This is normal, and happens to every business as it grows.)

Focus

• Create Version 2.0 of your practice model based on previous learnings.
• Implement efficient systems, and
• Get help (hire someone to help you).

Foundation

• Message: Clarify your patient base and refine your practice message.
• Appointments: Improve scheduling efficiency and introduce supportive roles like health coaches or therapists.
• Physician Toolkit: Invest in customer relationship management (CRM) tools.
• Technology: Expand your website and marketing tools, incorporating video, newsletters, and automation.
• Marketing: Engage cold leads through email lists, webinars, and ads.
• Sales: Standardize pricing and patient onboarding.
• Clinical: Continue refining treatments and contributing to mentorship networks.
• Legal: Establish employment and contractor agreements.
• Finance: Optimize cash flow management, ensuring proper savings for taxes and expenses.

Roles

Step fully into a clinical and managerial role, hiring an assistant and other patient support staff.

Systems

• Patient Communication: Set clear boundaries for communication through office channels.
• Interoffice Communication: Implement centralized team communication.
• Meetings: Introduce structured team meetings for goal setting and financial tracking.
• Training: Expand and refine the SOP manual for staff training.

Targets to Move Up:

To graduate to stage 4, you should:

• Create a refined practice model with added value,
• Hire administrative support,
• Establish a system for tracking key metrics, and
• Identify long-term financial growth plans.

 

Stage 4: Grow

Overview

At this stage, your practice has reached its full capacity. The focus shifts to strategic growth, which may include expanding services, adding providers, or developing educational content.

Focus

Your goal here is to know thyself, truly. Now that you’ve built this successful practice, you will need to decide your next steps and where you want to put your energy. Stages 2 and 3 are very action oriented, and stage 4 focuses back to you and what you want and need. The primary goal here is to decide in what direction you want to grow. Your mindset is all about understanding yourself and where you want to focus your energy. What is most sustainable for you and your future.

Foundation

• Message: Maintain messaging consistency while considering broader impact.
• Appointments: Add new service offerings, such as group sessions or courses.
• Physician Toolkit: Acquire tools to support chosen growth paths (e.g., podcasting, writing, or teaching).
• Technology: Invest in comprehensive business management software.
• Marketing: Expand reach through speaking engagements, guest appearances, and media features.
• Sales: Convert waitlisted patients to other offerings.
• Clinical: Support new providers and develop content.
• Legal: Develop agreements for partnerships, group services, digital offerings, additional locations, additional providers, and long-term goals of the business.
• Finance: Explore charitable initiatives and reinvestment or expansion strategies.

Roles

Decide whether to continue seeing patients or transition into a leadership and educational role. Expand your team accordingly.

Systems

• Patient Communication: Maintain structured engagement through EMR and business phone.
• Interoffice Communication: Strengthen internal collaboration.
• Meetings: Continue goal tracking and team development.
• Training: Optimize staff training programs.

Targets to Move Up:

To graduate from stage 4 you should:

• Establish a system for managing a full practice,
• Create avenues for sustainable growth, and
• Look for opportunities to better leverage your time.

 

Final Thoughts

If you choose this entrepreneurial path, commit fully—decide from the start that you will give it your all. Expect difficulties and setbacks, but remain steadfast in showing up for yourself and your community. In the end, your dedication will shape a practice you can be proud of, creating a ripple effect that benefits your patients and everyone they touch. Your work is meaningful and vital, and we are here to cheer you on through every stage of growth. Embrace this journey, as it will not only shape your business but also foster personal growth that positively impacts both you and those around you.