How to Open a Podiatry Practice After Residency
Many new DPMs finish residency wanting to open a podiatry practice of their own rather than spend years as an associate. Starting fresh offers control over location, culture, scope of services and how patients are treated, but it also means building a business from nothing while managing the realities of student debt and a new career.
This guide lays out the path from residency to opening day in order, with a focus on the decisions that affect financing. Licensing, ownership and entity rules vary by state, and nothing here is legal, tax, billing or compliance advice. Healthcare counsel and an accountant should be part of the process from the beginning.
Step 1: Decide Whether Start-Up Is the Right Path
Opening a new office is one of several routes to ownership. Some podiatrists join a group and later buy in, while others purchase an existing practice from a retiring doctor. Each path carries different risk.
A start-up may suit a podiatrist who has a clear vision, is comfortable with a slower initial ramp and wants to choose a specific market. An acquisition may suit someone who wants existing patients from day one. Our guide on buying a podiatry practice covers that alternative.
Step 2: Get Your Personal Finances in Order
Lenders look closely at the founder’s personal financial picture. Before applying for financing, review your credit, organize records of student loans and other debts and build personal savings where possible.
Student loans are a reality for most new podiatrists. They do not automatically disqualify a borrower, but repayment plans and monthly obligations affect how lenders view affordability. Our article on podiatrist student loans and practice ownership explains how lenders typically consider this debt.
Step 3: Choose Your Market and Location
Location shapes almost everything that follows. Consider:
- The local population, including older and diabetic patients who often need foot care
- Existing podiatry competition and unmet demand
- Proximity to primary care physicians, wound care centers and hospitals for referrals
- Hospital and surgery center privileges you may want to obtain
- Parking, accessibility and visibility for patients with limited mobility
Then decide whether to lease or own the space. Our article on podiatry office real estate walks through that decision.
Step 4: Set Up Your Entity and Advisors
Work with healthcare counsel to form the appropriate entity for your state, since rules about who may own a medical or podiatric practice vary. An accountant can help with tax elections, payroll setup and bookkeeping. Early advice can prevent costly restructuring later.
Step 5: Build a Business Plan and Budget
A written business plan is the foundation of a financing request. It should describe the services you will offer, your target market, how you will attract patients and referrals, staffing plans and a detailed budget.
The budget should include build-out, equipment, technology, staffing, marketing, professional fees and working capital to cover expenses while revenue builds. Our companion article on the cost to start a podiatry practice breaks those categories down.
Step 6: Secure Financing to Open a Podiatry Practice
Most founders finance a start-up rather than paying cash. Options may include SBA 7(a) loans, conventional practice loans and equipment financing, depending on the founder’s profile and the plan. Lenders generally review:
- Clinical training, board status and licensure
- Personal credit and existing debts
- The business plan, budget and projections
- The founder’s personal contribution and reserves
- The market analysis and referral strategy
Lenders will typically ask for personal tax returns, a personal financial statement and the business plan. Eligibility and terms depend on the business, the borrower, use of proceeds, program rules and lender review. Every loan is subject to approval, and nothing here is a commitment to lend.
Step 7: Begin Credentialing Early
Credentialing and enrollment with Medicare, Medicaid and commercial insurers can take time, and claims generally cannot be paid until it is complete. Many founders start this process well before opening. Qualified billing professionals can help with applications and with setting up billing systems correctly.
Hospital privileges and surgery center access are separate processes and should also be started early if surgery is part of your plan.
Step 8: Build Out and Equip the Office
Once financing and the lease or purchase are in place, build-out can begin. Coordinate with contractors on exam rooms, imaging space, sterilization and accessibility. Order equipment with enough lead time for delivery, installation and any required inspections or registrations.
Step 9: Hire and Train Your Team
Hire front desk staff and medical assistants before opening so they can be trained on scheduling, intake, billing workflows and patient communication. Employment agreements and worker classification should be reviewed by qualified professionals.
Step 10: Market the Practice and Open
Introduce yourself to referral sources in person. Build a website and local search presence, and plan an opening announcement. In the early period, track new patient volume, referral sources and collections closely, and keep working capital available for slower months.
Common Start-Up Mistakes
- Choosing a location before studying referral patterns
- Starting credentialing too late
- Overspending on build-out at the expense of reserves
- Underestimating how long it takes to build a full schedule
- Signing a lease without counsel reviewing it
Final Thoughts
Choosing to open a podiatry practice after residency is a major commitment, but a deliberate, step-by-step approach can reduce surprises. Preparing your personal finances, choosing the right market, starting credentialing early and building a complete budget can position a new practice for a stronger start.
US Medical Funding helps podiatrists finance new practices. Learn more about our podiatry practice start-up financing and our full range of podiatry practice financing options.
