MEDICAL PRACTICE START-UP BUSINESS PLAN

Creating your own medical practice is one of the most important professional decisions you can make. Building a private practice has rewards, but there is a lot at stake. Therefore, planning is vital to ensuring that you build a solid business foundation that will lead to a successful start that will help you to begin treating patients and getting paid more quickly. Take the time to plan and do it right from the start and it will ensure your success. When creating a business plan, make sure you provide enough information for your potential investor to get a full snapshot of your projected plans. The exercise of creating a business plan offers you several benefits that more than outweigh the investment of time:

The process of thinking and writing the plan provides clarity to your business

If capital is needed from beyond your savings, investors want to see a plan that demonstrates a solid understanding and vision for your business

The plan will help you to prioritise the tasks that are most important

With growth, the plan offers a common understanding of the vision to new leaders

It is something you should continually review and update over time

A simple business plan for a product or service company that is just forming, can be completed rather quickly. Write it simply keeping in mind who the audience might be. It needs to be understandable, readable and realistic.

This template is organised into seven sub-plans or sections to be completed.

Executive Summary

Company Overview

Business Description

Market Analysis

Operating Plan

Marketing and Sales Plan

Financial Plan

It is recommended to complete the Executive Summary last, once the other sections have been completed. As you move from the Company Overview to the Financial Plan, the writing should tell the story of your motivation, your vision, why you will be successful, how you will achieve success and how you will measure it.

It will be important to keep your plan up to date so you can see your progress, celebrate success and adjust where you missed the mark. This is best done on a quarterly, if not monthly basis.

EXECUTIVE SUMMARY

The Executive Summary should be written last after you have finished the rest of the plan. It is an overview (no more than one page long) of your business including the problem you think you aim to solve, why your solution is different, your ideal customer and the expected results. You should provide a high-level and optimistic description of your company. If you are seeking investment, include how much you want, where you will put it to use and how it will make the business more profitable.

Think of this as the first thing a potential investor reads so it must capture their interest in the first five minutes.

You may choose to organise it using some of the headings below.

Opportunity: What problem are you going to solve?

Mission: Identify what the company aims to do for customers, employees and owners.

Your solution: How will your product or service uniquely solve the problem identified?

Market focus: What market and ideal customers will you target?

Expected returns: What are the key milestones for revenue, profits and customers? How quickly will the investment be returned?

COMPANY OVERVIEW

Provide a brief summary of your intended business including what it uniquely delivers, your mission, how you got started, market positioning, operational structure and financial goals. After reviewing this section, the reader should have a broad understanding of what your business is setting out to do and how it is organised. This section is not meant to be lengthy. Keep it short and succinct. This is the snapshot of your business.

Depending on the type of business you are operating, you may or may not need the following sections. Only include what you need and remove everything else.

Company summary: This is the introductory section to the company. Think of it as the elevator pitch of what your company stands for and is setting out to do. Include the company’s goals and some of the near-term objectives.

Mission statement: A concise statement on the guiding principles of your company and what the company aims to do for customers, employees and owners.

Company history: Provide the back story, especially the personal story of why the business was founded. Bring the reader up to date on where the company is now in terms of sales, profits, key products and customers.

Location: As a medical practice, location directly speaks to the type of market you will be servicing. How does this location appeal and service your market? Why is this a good location?

Markets, Products and Services: Outline the market and the needs that your company will address. Include brief descriptions of products and services you will offer and what markets and customer types you will address. You will provide more details on this in a later section of this plan.

Operational Structure: Describe the operational details of your business. List your management team and any employees that you may need on the payroll to make your business run.

Financial Goals: Describe the start-up capital needed, projected revenue and profits, forecast, timeline and budget.

BUSINESS DESCRIPTION

This section will first frame the business opportunity. It should answer the question: what problem are you trying to solve? Potentially use a case example to describe the customers’ pain point and how they solve it today. If your product or service addresses something the market hasn’t identified as a problem (e.g. a dental surgery that is open in the evenings for working families), then also describe how your solution reduces stress, saves money or brings joy to the customer.

After framing the opportunity, describe in detail your solution (product or service) and how it solves that problem, and benefits your customers. This portion should also describe in more detail the product or service, how it will be supplied, pricing and if there is an upgrade or extension for it in the future. If there are other important participants in the market, such as suppliers or distributors or others, describe them in this section.

Opportunity: Describe how you see the market for your product or solution. At a high level, what is the market and who are its participants; is it business customers or consumers; a specific geography etc.? (For example, there is a lack of paediatric dental services in the suburban market.) Describe the current state of products or services available and how your product or service will improve patient care.

Product overview: Describe in as much detail as needed your product or service offerings. Are you utilising technology that is improving the current medical process? Or delivering your services in a way that is standout?

Key Participants and Management Team: In some businesses, products are custom-made and any break in their supply will affect the business. There may be key contributors to a service you offer, so it’s important to identify them. Identify any strategic partners in your business, such as critical suppliers, distributors, referral partners or any others.

Clinical/Regulatory: Outline your strategy for gaining marketing approval from the MHRA or other relevant body. Are you in compliance with all of the required preclinical studies to use your products and technology?

Pricing: Provide your product or service’s pricing, gross margin projections and any upgrade paths.

MARKET ANALYSIS

The Market Analysis provides the reader an understanding of how well you know your market and if it’s big enough to support your business objectives. The section provides an overview of the industry that your business will participate in. As you narrow this sector down to the ideal customer based on your business strategy, you will define your target market. A detailed description and sizing of the target market will help the reader understand the market value you are pursuing (the number of potential customers multiplied by the average revenue for your product or service).

In defining the target market, you will identify key elements such as geographic location, demographics, buyer characteristics, your target market’s needs and how these needs are being met currently. If there are any direct competitors, these should be compared to how your offering will solve it in the future.

This section may also include a SWOT (Strengths, Weaknesses, Opportunities and Threats) Analysis as necessary, to better assess your business’ position against the competition.

Depending on the type of business you are operating, you may or may not need the following sections. Only include what you need and remove everything else.

Industry type: Begin with the broader descriptions of your market opportunity. For instance, you are looking to open a dental surgery either in a suburban location or the city centre. Each location would cater to an entirely different market. For example, the city centre location would probably attract more of the busy office workers within a short commute compared to a more family-based market in the suburban location. Identify the number of families or customers in your local geography that might fit into your demographic target group.

Market Segmentation: As one example, if your industry is dental medicine, the TAM would be everyone that is in the market for health and hygiene. As a dental surgery located in the suburbs of Birmingham, your SAM might be anyone in a 15-mile radius in need of dental hygiene and attention. Finally, as you develop your unique offers, you might define your focus or target market (segment) as a practice focusing on paediatric and family dental health. You can also segment the market by criteria such as quality, price, range of products, operating hours, demographics, geography and others. A few other elements to consider would be to answer questions such as: Is your segment growing or shrinking, or will it plateau over the next few years? What percentage of the market do you think you will be able to reach? What share of the market do you anticipate having within the next 2-3 years? Graphics are best used in a section like this to either show growth (line graph) or percentages of markets or groups (pie chart).

Competition: Businesses all compete in one way or another. It may be with specific, direct competitors or it may be with the way customers have been doing things for a long time. They solve their problem in a different way. When identifying the competition, you should identify who else is providing products or services to solve the same problem you are addressing? What are your business’s advantages over these competitors? How will your voice be heard over the noise of competitors? Sometimes a business plan includes a matrix of features and compares how each business offers or doesn’t offer those features. This section should reflect how your solution is different and better suited for the target market you have identified than the competition.

SWOT Analysis: You can include a SWOT analysis by completing the boxes below to assess your business in the current environment in terms of strengths and weaknesses (internal) and opportunities and threats (external). This is a good exercise to go through on an annual basis. After completing your analysis, provide your thoughts on: how your strengths can help you to maximise opportunities and minimise threats; how your weaknesses can slow your ability to capitalise on the opportunities; and how your weaknesses could expose you to threats.

STRENGTHS Advantage Capabilities Assets, people Experience Financial reserves Value proposition Price, value, quality	SWOT	WEAKNESSES Disadvantages Gap in capabilities Cash flow Suppliers Experience Areas to improve Causes of lost sales
OPPORTUNITIES Areas to improve New segments Industry trends New products New innovations Key partnership	THREATS Economy movement Obstacles faced Competitor actions Political impacts Environmental effects Loss of key staff Market demand

OPERATING PLAN

Furthermore, you need to outline how you currently and will continue to develop and maintain a loyal customer base. This will include management responsibilities with dates and budgets, and to make sure that results can be tracked. What are the envisioned phases for future growth and the capabilities that need to be in place to realise growth?

The operating plan describes how your business works. Depending on the type of business you have, important elements of this plan should include how you bring products or services to market and how you support customers. It’s the logistics, technology and basic blocking and tackling of your business. Depending on the type of business you are starting, you may or may not need the following sections. Only include what you need and remove everything else. Remember: Try to keep your business plan as short as possible, so too much detail here could easily make your plan much too long.

Sourcing and order fulfilment: Based on the type of business you operate, describe if you are buying finished products or components from vendors and include details on how these are delivered and the contracts in place to acquire them. Also, describe your company’s procedures for delivering products or services to your customers. If inventory of goods is an important part to your company’s success, make sure that you include a review of how you store, manage and track key items.

Payment: Describe your standard payment terms and the payment methods you accept. Describe the pricing plans (one-off fixed, recurring, mixture or other) and any impact on cash flow.

Technology: If technology is critical to your business, whether it is part of the product offering or is fundamental to delivering a product or service, describe the key technologies use that are proprietary. If your business data (company or customer) might be at risk, describe the data security plan in place, as well as any backup or recovery in the case of a disaster or outage.

Key customers: Identify any customers that are important to the success of your business, whether because of a partnership, volume or pathway to a new market. It might also be important to identify any customers with more than 10% of revenues for your company.

Key employees and organisation: Describe any unique skills or experiences that are required of your current team. If important, describe any proprietary recruiting or training processes in place. List any key employees for success. Include any organisation chart that would support this section.

Facilities: Depending on the type of business, you may have leased, owned or shared business premises. Provide a listing of them, their purpose and future plans for facilities.

MARKETING AND SALES PLAN

Promoting your business, whether generating leads or traffic to a website or store, is one of the most important functions of any business. In this section of the plan, provide the details of how your market your business. Describe the key messages and channels you use for generating leads and promoting the business. This section should also describe your sales strategy. Depending on the type of business you have, you may or may not need the following sections. Only include what you need and remove everything else.

Key messages: Describe the key messages that will elevate your products or service in your target customers’ eyes. If you have sample collateral or graphical images of some messages, include them.

Marketing activities: Which of the following promotion options provide your company the best chance of product recognition, qualified leads generated, store traffic or appointments?

Media advertising (newspaper, magazine, television, radio)

Direct post

Telephone solicitation

Seminars or business conferences

Joint advertising with other companies

Word of mouth or fixed signage

Digital marketing such as social media, email marketing or SEO

Free initial consultation or cleaning for new clients

Health group seminars and meetings

Sales strategy: If needed, what will your sales approach be? Will there be full-time commissioned sales people, contract sales or another approach?

FINANCIAL PLAN

Creating a financial plan is where all of the business planning comes together. Up to this point, you have identified the target market and target customers, along with pricing. These items, along with your assumptions, will help you estimate your sales forecast. The other side of the business will be what expenses you expect to incur. This is important on an ongoing basis to see when you are profitable. It is also important as you start your business, to know what expenses you will need to fund before customer sales or the cash they generate is received.

At a minimum, this section should include your estimated startup costs and projected profit and loss, along with a summary of the assumptions you are making with these projections. Assumptions should include initial and ongoing sales, along with the timing of these in flows.

Here is how you set up your financial plan:

Projected start-up costs: What do you need to spend to get started? The table below shows a sample of ongoing and one-off cost items that you might need to open your business. Many businesses are paid on credit over time and don’t have cash coming in immediately. It is important to estimate when cash will begin to flow into the company by making assumptions about how many months of recurring items, in addition to one-time expense, you will have to fund out of savings or an initial investment. There is a blank table in the Appendix for you to complete your own start-up cost projections.

Actual budget: What are you able to spend? If you have a little extra in your budget, this plan can include equipment or staffing that you would like to have.

Projected profit/loss: This helps you determine where you can be more lean and where you can allot your profits for upgrades once your business becomes profitable.

Choose your experts, financial and administrative setup, and credentialing: There are three people who will be invaluable in guiding you through your practice setup: your tax accountant/advisor, a legal advisor and a practice start-up consultant. These experts will help you:

Get your payer credentialing done properly

Set up, plan and help you execute your marketing

Serve as a single point of contact for you, vendors and project managers

Negotiate with vendors

Hire and train staff

START-UP COSTS – MEDICAL PRACTICE
COST ITEMS	DATE DUE	BUDGET	ACTUAL	UNDER/UNDER
ADMINISTRATIVE/GENERAL
Licences/Registration	£750
Permits	£1,500
Insurance	£3,400
Legal	£300
Business Consultant	£2,500
Training	£2,000
Software (General)	£500
Miscellaneous
LOCATION/OFFICE
Space Rental/Lease	£50,000
Utility Costs	£2,500
Telephone Setup & Annual Cost	£410
Furniture	£15,000
Medical Equipment	£150,000
Hardware	£10,000
Software (CRM, imaging etc.)	£7,000
Installation Fees	£5,000
Start-up Inventory (pharmaceuticals)	£100,000
Nurse Supplies (gloves etc.)	£5,000
Miscellaneous	£10,000
MARKETING
Logo, branding, website	£1,200
Advertising/listing fees	£10,300
Printed Marketing materials	£500
Internet/Web marketing	£100
Trade Shows	£500
Networking events	£200
Miscellaneous
LABOUR EXPENSES
Payroll	£200,000
Training	£5,000
Miscellaneous
OTHER
Miscellaneous (Contingency reserve/launch party/etc.)	£500
ESTIMATED START-UP BUDGET	£584,660

Projected profit and loss model: The model below shows a sample of the projections a small business is forecasting for their first 12 months of operations. The top portion of the table shows projected sales and gross profit. This is a good place to begin creating your sales forecast. The next section itemises the recurring expenses you are projecting for the same months. These should be consistent with the estimated start-up costs you completed in the prior section. At the bottom of this model, you will begin to see when you are becoming profitable and what expense items are the most impactful to your profitability. There is a blank table in the Appendix for you to complete your own start-up cost projections.

MEDICAL PRACTICE
INCOME	JAN	FEB	MAR	APR	MAY	JUN	JUL	AUG	SEP	OCT	NOV	DEC	YTD
Estimated Sales	£80,000	£80,000	£80,000	£80,000	£80,000	£80,000	£80,000	£80,000	£80,000	£80,000	£80,000	£80,000	£960,000
Less (discounts, billing errors, declined insurance etc.)	(£5,000)	(£5,000)	(£5,000)	(£5,000)	(£5,000)	(£5,000)	(£5,000)	(£5,000)	(£5,000)	(£5,000)	(£5,000)	(£5,000)	(£60,000)
Service revenue	£0	£0	£0	£0	£0	£0	£0	£0	£0	£0	£0	£0	£0
Other revenue	£0	£0	£0	£0	£0	£0	£0	£0	£0	£0	£0	£0	£0
Net sales	£75,000	£75,000	£75,000	£75,000	£75,000	£75,000	£75,000	£75,000	£75,000	£75,000	£75,000	£75,000	£900,000
Cost of goods sold	£1,000	£1,000	£1,000	£1,000	£1,000	£1,000	£1,000	£1,000	£1,000	£1,000	£1,000	£1,000	£12,000
Gross profit	£74,000	£74,000	£74,000	£74,000	£74,000	£74,000	£74,000	£74,000	£74,000	£74,000	£74,000	£74,000	£888,000
EXPENSES	JAN	FEB	MAR	APR	MAY	JUN	JUL	AUG	SEP	OCT	NOV	DEC	YTD
Administrative General	£913	£913	£913	£913	£913	£913	£913	£913	£913	£913	£913	£913	£10,950
Location/Office	£29,575	£29,575	£29,575	£29,575	£29,575	£29,575	£29,575	£29,575	£29,575	£29,575	£29,575	£29,575	£354,900
Marketing	£1,108	£1,108	£1,108	£1,108	£1,108	£1,108	£1,108	£1,108	£1,108	£1,108	£1,108	£1,108	£13,296
Labour	£17,083	£17,083	£17,083	£17,083	£17,083	£17,083	£17,083	£17,083	£17,083	£17,083	£17,083	£17,083	£205,000
Other	£500	£500	£500	£500	£500	£500	£500	£500	£500	£500	£500	£500	£6,000
Total expenses	£49,179	£49,179	£49,179	£49,179	£49,179	£49,179	£49,179	£49,179	£49,179	£49,179	£49,179	£49,179	£590,146
Income before taxes	£24,821	£24,821	£24,821	£24,821	£24,821	£24,821	£24,821	£24,821	£24,821	£24,821	£24,821	£24,821	£297,854
Income tax expense	£3,723	£3,723	£3,723	£3,723	£3,723	£3,723	£3,723	£3,723	£3,723	£3,723	£3,723	£3,723	£44,678
NET INCOME	£21,098	£21,098	£21,098	£21,098	£21,098	£21,098	£21,098	£21,098	£21,098	£21,098	£21,098	£21,098	£253,176

APPENDIX

START-UP COSTS – MEDICAL PRACTICE
COST ITEMS	DATE DUE	BUDGET	ACTUAL	UNDER/UNDER
ADMINISTRATIVE/GENERAL
Licences/Registration
Permits
Insurance
Legal
Business Consultant
Training
Software (General)
Miscellaneous
LOCATION/OFFICE
Space Rental/Lease
Utility Costs
Telephone Setup & Annual Cost
Furniture
Medical Equipment
Hardware
Software (CRM, imaging etc.)
Installation Fees
Start-up Inventory (pharmaceuticals)
Nurse Supplies (gloves etc.)
Miscellaneous
MARKETING
Logo, branding, website
Advertising/listing fees
Printed Marketing materials
Internet/Web marketing
Trade Shows
Networking events
Miscellaneous
LABOUR EXPENSES
Payroll
Training
Miscellaneous
OTHER
Miscellaneous (Contingency reserve/launch party/etc.)
ESTIMATED START-UP BUDGET

INSTRUCTIONS FOR GETTING STARTED WITH ESTIMATED START-UP COSTS

Determining a business’ start-up costs is critical to ensure that enough cash is available to begin business operations within the budgeted time frame as well as within the cost budget. Start-up costs typically fall within two categories, monthly costs and one-off costs. Monthly costs cover costs that occur each month during the start-up period and one-off costs are costs that will incur once during the start-up period.

Steps for preparation:

Step 1: Enter your Company name and the Date you are preparing this estimate.

Step 2: Enter the number of months and the monthly cost for each cost item that is recurring. For one-off costs only, skip the monthly costs. If there are cost items that have both recurring and one-off amounts, you can enter those as well. The total cost will be calculated automatically in the far-right column.

Step 3: Once you have completed entering all of the costs, review the individual items and total amount to see where you might fine-tune it or move something out into the future when you have more revenue coming in.

PROFIT AND LOSS SHEET TEMPLATE
MEDICAL PRACTICE	6 November 2018
INCOME	JAN	FEB	MAR	APR	MAY	JUN	JUL	AUG	SEP	OCT	NOV	DEC	YTD
Estimated Sales	£0
Less (discounts, billing errors, declined insurance etc.)	£0
Service revenue	£0
Other revenue	£0
Net sales	£0
Cost of goods sold	£0
Gross profit	£0	£0	£0	£0	£0	£0	£0	£0	£0	£0	£0	£0	£0
EXPENSES	JAN	FEB	MAR	APR	MAY	JUN	JUL	AUG	SEP	OCT	NOV	DEC	YTD
Administrative General	£0
Location/Office	£0
Marketing	£0
Labour	£0
Other	£0
Total expenses	£0
Income before taxes	£0
Income tax expense	£0
NET INCOME	£0

INSTRUCTIONS FOR GETTING STARTED ON PROFIT & LOSS PROJECTIONS

Completing projections for Profit and Loss of a new company is a good exercise to understand and communicate when the company will begin to break-even and see how sales and profits will grow. The top portion of the model to the left, Revenue, is a good way to forecast sales, month by month for the first year. The lower portion then applies estimated expenses for the same period of time to derive the business’ profitability.

Steps for preparation:

Step 1: Enter your Company name and the Date you are preparing this projection.

Step 2: Enter for each month, beginning in January or whenever your estimate starts, what you expected sales to be. This could be for products or services or multiple products. You can add lines to this model for additional offerings. From this, you should subtract any product returns or discounts that you want to track (these should be shown as negative numbers, for instance -10). Below Net sales, you would enter the Cost of goods sold. These are the direct costs in selling a particular product, for instance, the materials costs, assembly labour or if you purchased the product and resold it, it would be the wholesale cost.

Step 3: Enter for each month, the estimated salaries, marketing, utilities and other items you are projecting.

Step 4: Once you have completed entering all of the costs, review the individual items and total amount to see where you might fine-tune it or move something out into the future when you have more revenue coming in. The objective is to get to profitability and positive cash flow as quickly as possible.