Starting the “Project”
This week I had theopportunity to talk with another NP about starting a clinic. I have spoken witha number of NPs in the last few years all hoping to open their own “clinic.” Ifind these conversations very valuable to me as I am reminded of the reasons Iwanted to start my own practice. Occasionally I need that reminder…
Getting Started
The first and probably mostimportant task is deciding what type of practice you want to start: for profit,nonprofit, LLC, C corp, S corp, single provider, multi provider, primary care,specialty care, urgent care, etc. I sought advice from a tax attorney as wellas a corporate attorney before choosing the type of business structure we haveat ECFC.
Iwanted to protect my family’s assets without jeopardizing my ability to securefinancing. I needed to understand the structure of for profit vs nonprofit, aswell as the type of corporation that would work best for my idea. I chose to bea C corporation, primary care, multiprovider, for-profit business. Good? Bad?It seems to be working for me.
Next,solidify your goals, and develop your mission statement.
WhenI first thought about starting a clinic I had a myriad of ideas with vastlydifferent goals. I knew I could do pediatrics, but I really wanted to includean adult component for families who were as sick as their children but couldn’tget into their own provider. I wanted our clinic to serve our patients byproviding excellent patient-centered care and our community by offering“fireside chats,” health fairs and school educational sessions. And I wantedthe clinic to serve our profession by keeping the focus on NP care and allowingNP students the opportunity to develop their clinical skills at our facility.
Whatkind of care will you provide? Whom do you want to serve? What will bedifferent (and better) than others who provide the same type of services?Foremost, why do you want to do this?
The Business Plan
I am not independentlywealthy. I knew I was going to need financial assistance and had never writtena business plan. I went to the library and bookstore to find a reference thatwas written in language I could understand. Eventually I just borrowed acomputer program for writing business plans. I found that business plans arenot particularly hard to write but vitally important to the process of openinga business.
Thereare certain areas that are included in a typical business plan. State thebusiness and its purpose. Include long-range and short-range goals and yourmission statement. Identify your market and competition in the market, what youplan to do to advertise and recruit clients and how you plan to retain theseclients.
Tellwho you are, including your credentials and qualifications for businessownership. You will need to provide your curriculum vitae (and that of anyother owners). Describe your structure, corporate officers and who will be“managing” the practice and day to day operations. If you plan to use anyoutside professional services for marketing, billing, etc. include a briefdescription of the company.
Developa “pro forma,” which includes your projected growth and expenses over the first5 yeas. Any lending institution will ask for projected revenue and expenses,the pro forma satisfies this requirement. A pro forma is a “best guess” of yourrevenue and expenses with adjustments that reflect increases in production andexpenses as you grow. It is considered a living document and should be revisedperiodically to reflect actual costs as they occur. I have a business adviserwho put this part together for me. We use our pro forma to compare ourprojected budget with our actual budget, then make adjustments as needed.
Concludethe business plan with a recap (brief) of the included information. Yourbusiness plan is yours and is proprietary — share it only with those who needto see it. I recommend having a signature page that assures that whoever readsit must hold it confidential.
Yourbusiness plan is a road map for the rest of the process. Take your time, anddevelop a plan that makes sense and clearly states your intentions. Seek helpfrom friends and family, or whatever contacts you may have in your network. Berealistic with your pro forma, and keep the plan confidential.
—Gretchen