Are You Missing A Piece Of The Practice Startup Puzzle?

Starting a practice can feel like a big jigsaw puzzle, but it’s one you must solve without first seeing the picture on the box!

If you’ve worked with jigsaw puzzles before, you know they come in all sizes and shapes. While the average puzzle contains 500 to 800 pieces, complex ones may come with 1000s of pieces.

How do you solve a jigsaw puzzle, even if you don’t have the picture?

With strategy!

Here are the steps:

  1. Choose a flat surface.
  2. Layout your pieces.
  3. Separate the border pieces from the inner pieces.
  4. Assemble the border pieces first.
  5. Now fill in the center by trial and error, matching the shapes.

Are you’re wondering how this is going to help you start your practice?

Apply The Same Strategy

Use the same strategy, and you’ll be able to solve the practice startup puzzle too! Just follow the proven steps!

While choosing a flat surface is optional, you also want to start by laying out all your pieces.

For you, this means pulling together everything you’ve learned while exploring practice ideas and everything you’ve gathered during the research phase! Arrange in a way, so you have a comprehensive overview of all the moving parts that make up your new practice.

Next, separate your border pieces from your inner pieces.

What are your border pieces?

They are the guiding light, the structure, the backbone for your new practice. They include your vision, your mission, your practice model, your revenue model, and your projections.

To separate the border pieces from your inner pieces requires clarity on your part. You must know what it is you’re trying to create and what you want to accomplish.

Once you’ve identified and separated your border pieces, start arranging them to form a border. These pieces will become the defining structure for everything else in your practice.

And now, you’re ready to fill in the rest. Everything else, all the other details fill the center. They include the things that are dependent on your border pieces, for example leasing a three or four exam room office, hiring part-time vs. full-time employees, etc.

And just like different jigsaw puzzles will have fewer or more pieces, some practices will have fewer or more moving parts. Depending on the complexity, some will be far easier to put together than others. The principles, however, will remain the same!

Practice Startup Checklist


Feeling Stuck?

If at any time you feel stuck when starting your practice, or if you feel like you’re missing a piece of the puzzle, do this…

Think about what you want to create and work backward from there. Stephen R. Covey called it “Begin with the end in Mind!” In other words, begin with a clear vision of what you want to accomplish and then keep moving toward your goal, one step at a time!

While your border or your foundational pieces are unlikely to change, be prepared to adjust and rearrange your centerpieces.

Perhaps you had envisioned a particular space for your practice, but now it may not be feasible or even financially irresponsible. That’s why it’s good to maintain some flexibility when filling in your centerpieces, setting up your practice.

In Summary,

Starting your practice is a bit like solving a puzzle! While there are a finite number of pieces, they will fit together only in a certain way, no matter how hard you try.

Start your practice with the end in mind. You’ll see it’s both the foundation and the structure for your new practice!

For the last three weeks, we’ve talked about practice startup… because it’s one of the most frequent questions we get.  We’ve talked about the ABCs of starting a practice and which mistakes to avoid. I hope the articles have helped get you started in your practice!


Join the conversation! Share your experiences with your peers by leaving your comment below!


By Johanna Hofmann, MBA, LAc; regular contributor to the NPBusiness blog and author of “Smart Business Planning for Clinicians.”


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  1. Thank you so much for the information. It is really helpful. I wish to start my private practice however my challenge is on the capital to start. Most of those who loan business loans need an established business with weekly or monthly projections of their income. I just pray that God will make a way for me.

  2. Hello Tabu, Every startup should have a business plan with financial projections – even if you are not trying to obtain a business loan.

    When starting up a business, NPs find they will start small and build up from there. So take a look at your plans and see if you can adjust so you can move forward sooner.

    Good luck and thanks for commenting.

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