There are a myriad of processes the new practice must set up across a broad range of disciplines, including medical, legal, technologic, insurance, business and management. While many physicians have tried to save money by doing all of this themselves, it may not be the best way to proceed, as failure to correctly establish these systems may be a very expensive proposition for the practice in the long run. Practices need to weigh the skill set of the physician(s) in the new practice and consider whether they have the necessary training and experience on these complex topics.  

Choosing the proper help is vital to a new practice. Such help can include a practice management consultant, health care accountant (not only bookkeeper), and a health care lawyer (not a general practitioner). All  can entail significant expense in the short run. However, when used properly, they will pay for themselves many times over.​ 

Practice Management Consultant 

If you are planning to open a new practice immediately following residency training, it is important to begin working with a consultant during your third year of residency. Consultants can provide the overview you need to coordinate and get the most out of other consultants. They can review practice processes from a functional end-user point of view and can assist in assessing whether the business plan will work in a real-world setting. Consultants are also available to assist with coding and physician profit distribution, staffing, salaries, and marketing. Often, they can assist with drafting documents for later legal review. Consultants are available to help compare electronic health record (EHR) products and practice management software (PMS), negotiate with payers, and construct an office policy manual. Finally, practice management consultants can even help run a new practice until a practice management team is established.  

Health Care Accountant  

​This accountant will help with budgeting, facilitate contacts at local financial institutions, supply advice in financing business practices, and provide frequent reports benchmarking the practice’s performance against other practices in the field using national norms and local experience.  This consultant will also keep you abreast to any federal or state specific tax law changes that may affect your practice. They provide guidance on retirement strategy, structure and documentation. The accounting firm can also manage and produce your practice's payroll and file all necessary payroll reports to state and federal government. 

Legal Counsel 

Some practices choose to have everything set up by their legal advisor. While this may be possible with an experienced health care attorney, their time is the most expensive of all consultants. They may be good at what is legal but may not appreciate the day-to-day dynamics of medical practice management and administration. A good legal mind to advise on partnership agreements, corporate structure, leases, contract negotiations, and contracts is absolutely vital. Yet many of these tasks can be started with lower cost consultants, with a final legal review at the end. They can also assist with HIPAA compliance.  Please realize that none of this advice comes cheap, but it is a worthy long-term investment to make sure the new practice is primed for success.​ 


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American Academy of Pediatrics