5 Low Overhead Practice Ideas

Starting a medical practice does not have to be a high cost ticket item.

Nurse practitioners and other advanced practice clinicians who want to start a practice often have questions about startup cost, loans, employees, size of clinics, and more.  For many of us, the models of care we see take place in small, medium, large and mega sized clinics.

However, it’s wrong to assume that is the only way to deliver care to your patients.

There are many ways to start a practice on a shoestring budget or smaller. You don’t necessarily need a lot of space, and for that matter, you may not need any kind of an exam room.  In fact, it’s possible to start a small practice with little if any equipment, staff, or even loans.

Here are 5 practice ideas that require little overhead (read: money) to start and operate a practice.

  1. House calls. Mobile practices where you visit your patient at home or work is a popular type of practice to start. You need very little equipment that you don’t already own; you don’t have the overhead of the office and exam rooms, and can basically get started quickly.
  1. Assisted Living.  Very similar to house calls, you visit patients in their “homes” within an assisted living community. The advantage here is that you don’t have to travel far between patients – you can walk down the hall rather than drive across town.  The facility may even be able to offer you space and equipment in return for coming to their facility.It’s a benefit to their patients, and to the facility themselves.  Another option to consider would be “boarding homes”. The patients and the home operator will both appreciate your visit.
  1. Long Term Care.Visiting patients in a long-term care facility is both challenging and rewarding at the same time. In addition to the complex needs of these patients, there are complex rules and regulations the facility has to meet. Your participation will not only help the patients, but the staff and facility as well. Most facilities are very pleased to have you and may be willing to provide you with room and supplies to assist you in doing your work.
  1. Telemedicine or virtual practices. I think we will be seeing more of these. In these practices, you offer your expertise to patients virtually through a secure telemedicine platform. Perhaps you consult on diabetes or you are a psych-mental health provider – this platform is perfect for those practices.  While I see this as more of an add on service for primary care practice, we are seeing more “stand alone” tele-health practices.
  2. Rent-a-room.  One way that is often overlooked in starting practice, is what is considered an “Ideal Medical Practice” model.   One way to set this up is to rent a room in an existing practice (or church or community center). Your overhead is basically the room that you rent and any additional services such as EMR cost, billing services and the like.

As you can see, it does not have to take a lot of money to get started on your practice. It makes sense to start slow and low and allow your practice to grow to the size, shape, and capacity that you desire.

Your Turn

What type of practice have you started, or are considering starting? Let us know below.



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  1. Yes, a bare bones practice is realistic! My RN practice start up 19 years ago was a $20 start up to open a checking and out of my house. 12 years ago when I started my NP practice I was still out of my house, but seeing patients in their environment. 8 years ago I “rented” one room without a lease knowing I would not be staying there long and it was a launch location. I have always been very mobile and my exam table and basic equipment fit in the back of my van. I have moved to a third location via the van and always had one room, basic equipment, quiet and private environment. My only mobile phone is the office phone, use a free EMR – Practice Fusion now for progress notes and eprescribing, faxes are received via Maxemail to my email so I can pick up on my mobile, iPad or computer. I have my laptop as my “office” and it travels with me. By basic monthly overhead including rent, mobile phone, and a few other expenses are about $500. I do not have any employees. It is basic, simple, fun and it works. Check out http://www.naturalhealthycare.com and the SageClinicans Podcast http://sageclinician.com/debbie_karas/ for more information. You can do it to! Low budget is very real! Good luck to all of you!

  2. I’d love to speak with Dr. Debbie Karas regarding her business. My business is very similar to hers. Way to go!

  3. Hello Tawanda! Please email me and lets connect. Yep…. I chuckle everything I think about a time I “consulted” with an attorney and he told me I had to have about $250,000 to start my practice. Yea… right…. I smiled and ended our consult. Start small and stay out of DEBT. I won’t get rich off of this but I enjoy what I do, cost are low. A good biller is also key.

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