Urgent Care Business Plan
I’ve thought about starting my urgent care on multiple occasions. The only downside is that it would be a long-term time commitment. Getting it off the ground and building it up would require a lot of direct supervision and starting it off I would be the sole provider there.
I wanted to lay out my urgent care business plan in digital ink and see how it tastes. If my partner and I settle down in a specific location long-term then I could see myself starting this. In Portland the St. Johns area is a particularly ripe location for this sort of business due to lack of medical access.
My practice style is fast with minimal use of resources. I’m not the provider who is gonna shoot the shit with you unless you are doing something super interesting. Today a patient of mine told me that she works with homeless youth living under the bridge, we chatted about that for quite a while.
I will take a quick look at the patient’s chart, look at the vitals and go in and ask an open-ended question and just let them tell me whatever they want. I’ll ask them a few more questions and then I’ll do my focused physical exam. I usually throw in plenty of humor and if I sense fear or discomfort then I try to address it before moving on.
If I can rule in a diagnosis and rule out the major serious stuff then I’ll put it down on paper and treat it and discharge the patient. This flow has worked well for me so far and my patients seem to enjoy it based on the feedback I have received.
Occasionally I will need to do further testing, place referrals or do a procedure. I’m very fast with procedures and I can type fast so placing referrals or detailed directions for patients isn’t a problem.
The reason I’m even thinking about my own urgent care business is because as far as speed, efficiency and efficacy I am in the top percentile among my peers and my medical group doesn’t pay more for any of those characteristics.
How Would My Urgent Care Stand Out
It would be in a part of town where people generally don’t have much disposable income and even less free time to get to the doctor’s office. I would do some preventative primary care (mostly teaching) and speed would be my focus.
I would become a face in the community by putting on free lectures. Inviting families to my urgent care on weekends for free health seminars. The local library is a great place to give free lecture in as well. Having a booth at the farmer’s market is another neat idea, sometimes all I would do there is answer health related questions. It’s something I would enjoy.
I think quality in medicine is quite subjective. Currently it’s all about controlling LDL’s and A1C’s and treating as many patients as possible to prevent that one inevitable poor outcome. That’s not my definition, so, I will provide quality care based on what I think is quality. It will be different but different can be good when competition is high.
What’s The Reason I Would Start An Urgent Care
I don’t fully agree with how medicine is practiced in larger organizations. There are a few physicians out there, specifically in solo practice, who are practicing medicine ethically, empowering patients and not relying on medications alone to build health.
I would want to establish something in a community that could help people achieve their definition of health. I would like my urgent care to be more than just a place to go for antibiotics. I would like it to be a community anchor. Watch the kids grow up in that community, treat their broken bones and repair their lacerations and guide people through their unfortunate health events.
I would want to make enough money to provide for me and my partner’s living expenses but also enough to invest back into that community.
Trying to make a lot of money isn’t at all on the list of reasons simply because the model that would make a lot of money is already out there and if I had the need for that kind of income then I would simply pursue that position.
What Would Be My Overhead
Depending on the location, the state or the country that I will end up in rent will likely be the biggest overhead. $3k/mo is a fair estimate in my neighborhood. I churn rooms over fairly quickly so I wouldn’t need a whole lot of space.
Utilities can run up to $500/mo for internet, electricity, water, phone access and miscellaneous.
A basic EMR would cost me around $200/mo until I decide on one that I like enough to purchase.
My malpractice would be in the $10k/yr range though I have toyed with the idea of not carrying any malpractice, it involves trusts etc and I’ll discuss that at some point in the future.
In the beginning I wouldn’t need a medical assistant, but I expect that within a few months I would hire someone at around $18/hr to handle the front office, do vitals, EKGs and perform injections. 8 hours a day, 5 days a week would come out to $3k/mo with workman’s comp etc.
Initially I wouldn’t have a xray but I would need some basic point of care tests such as strep, influenza, urine dip and urine HCG. These will cost based on how much I use them, let’s say $250/mo.
Let’s say around $8,000/mo in total to start +/-$2k.
How Much Could I Clear At The End Of The Month
My fees will take some trial & error and will depend on what the community is willing to pay. I won’t take any insurance at all, credit cards or cash. I can price it as low as $30/visit and as high as $50/visit. Any higher and I would have to get into insurance stuff which I have no desire for.
With 10 patients a day I would make $8,400/mo on the low end and $14,000/mo if I charged the higher fee.
10 patients a day is very conservative, I expect that if I’m charging $30/visit I would get somewhere around 25 patients a day and probably 16/day at $50/visit. The more realistic numbers would be $21,000/mo and $22,400/mo, respectively.
Again, with an overhead of $10k/mo I would probably be in the red for a short period of time. Then make around $2k/mo for a few months and end up in the $5-10k/mo of profit within 12-24 months.
What Problems Do I Foresee
Finding an MA who is fast and will stick around will be the hardest thing. However, I have no problem doing the work myself. Thankfully I work at a medical group where the staff’s competence is commonly below that of a Chihuahua’s.
Online reviews can harm any business but a good business will get repeat customers regardless of what’s published online. I would have to make sure that I really take the time with each patient to make them feel cared for.
The time commitment can be exhausting. For an urgent care to be effective it needs to be open during the hours when people are off of work. And for it to have that ‘anchor’ feel in the community I would want to be available even off-hours – I haven’t figured out how that would work yet.
I would need to charge a small fee for x-rays and point of care testing. I would need to stock some medication and dispense some medications out of the urgent care. With visit fees of $30-50 I have some wiggle room but it can get expensive quickly.
If I don’t have a medical assistant and have a female patient who needs a pelvic I’m shit out of luck because ain’t no way I’m doing any breast or pelvic exam on a woman without a chaperone.
I Could I Leverage The Income To Create Further Business Growth
Though I may not be able to do this right away, my goal would be to find a medical office building which I could purchase. The income from the urgent care would pay for the mortgage on the property and I may be able to even rent out extra office spaces. This has the added benefit of increasing the resale value of the business in the future.