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Time for a Change? 9 Considerations When Starting a Medical Practice in Texas

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When you've been with a medical practice for a while, it can be hard to imagine leaving. After all, you've built up a good rapport with your patients.  You know the ins and outs of the office, too. 

But sometimes, circumstances change and you find yourself thinking about moving on to greener pastures. 

For some, those greener pastures mean striking out on your own. 

Starting a medical practice in Texas doesn’t happen simply by selecting a suitable location and taking appointments. As with opening a medical practice anywhere, there are special considerations to weigh before doing anything. 

[Checklist] 9 Considerations for Starting a Medical Practice In Texas

There are many aspects of managing a medical practice, all of which fall on you when you decide to go solo. 

When evaluating how to start a medical practice in Texas, your to-do checklist should absolutely include: 

  1. Financing the Project
  2. Office space
  3. Equipment and Vendors
  4. Technology
  5. Billing
  6. Coding
  7. Staffing
  8. Consider Legalities
  9. Business Development

1. Financing the Project

Starting your own practice requires a financial commitment, which typically requires assistance. The first step is to establish a business plan, clearly outlining the needs of the business and goals moving forward. From that plan, a line of credit will need to be secured with the bank. Accounts for the practice will also need to be set up, initiating a relationship with your financial institution of choice. 

2. Office Space

Once the financial details are in place, you need to consider a location for your practice. You need to think about the demographics of the office location, whether it is close to the metro area and accessible to those who require public transportation. You'll also want to consider the length of your lease, to make sure the office is located somewhere that fits your needs and will be available to you for as long as you require the space. 

Make sure your new office will have enough space to accommodate you, your staff, and your patients. The last thing you need is a space that’s crowded and cramped.

3. Equipment and Vendors

Will you need filing cabinets? Exam room equipment? Computers and printers for administrative tasks? Specialty-specific medical equipment? 

Make a list of everything you'll need to ensure your new office can function properly. 

All of this necessary equipment must fit into your office comfortably, ensuring privacy for staff handling PHI,  while leaving sufficient room to move and providing a comfortable setting for your patients. 

In addition, what happens with your vendor contracts? What kind of medical waste management contract will your new office need? What about janitorial services? And don't forget about IT, phones, medical supplies, and an EHR vendor. You’ll need those as well. 

4. Technology

Your new office will need Wi-Fi capabilities and a reliable phone system. Consider using an answering service as well. Be sure the computer system in your new office is up-to-date and able to handle all of your needs, including billing and coding requirements. 

how to start a medical practice in Texas

5. Billing

Speaking of billing-- how will overhead expenses be paid? What kind of banking relationship will you have? What software will you use for billing purposes? The answers to these questions will affect your bottom line and the success of your medical practice.

6. Coding

An important aspect of any medical practice is coding. There are forms and tickets that need to be filled out correctly in order for records to be accurately coded. This is important not only for reimbursement purposes but also for compliance. Make sure you understand how coding works in your new practice, and that staff is adequately trained, so there are no surprises down the road. 

7. StaffingiStock-1352489891

When thinking about leaving your current medical practice, consider staffing. How easy will it be to find qualified staff members? Was there a provision in your previous contract regarding the solicitation of employees? How much training will they need? And will you use in-house staff or an agency for task management? 

8. Legalities

There are some legal issues that you need to take into account when thinking about starting your own medical practice. HIPAA laws are always changing, so it's important to make sure that your new office is up-to-date on all the latest regulations. OSHA compliance is also something that needs to be considered to protect employees from bloodborne pathogens, biological hazards, and other serious safety concerns. These are just a few of the things that you need to keep in mind from a legal standpoint. 

9. Business Development 

Name and brand development are important to the future of your business. It’s important to spend time to find the right combination of business name and brand identity. These decisions will play a prominent role in your marketing strategy as you establish your practice and build name recognition. 

Once you have selected your medical practice’s name,  publicize it and your office location to potential patients in online directories, on social media, and through membership in the local chamber of commerce. Actively seek opportunities to engage with your community and raise brand awareness through sponsorships, health fairs, and open house events.

When it comes to tackling the items listed above, it’s important to have a plan and stay on track. Here’s a resource to get you started:


Streamlining Setting up Shop With a Physician Practice Management Agency Partnership

Starting a medical practice anywhere is a big job. 

Physician Practice Management Agency or Management Services Agency (MSO) can lighten your load as you establish a new medical practice.  


They can help with things like developing a business plan, finding space, setting up the office, etc. While this may sound ideal, there are also some things to consider before making this type of decision.

The Pros of Hiring a PPMA

There are advantages that come with hiring a PPMA. They can help take care of the business side of things, such as bookkeeping, handling insurance claims, and marketing, so that you can focus on patient care. 

Also, a PPMA can help delegate work to capable, trained staff. This frees up your time to see more patients or take on additional responsibilities. Finally, a PPMA can make a plan to address any gaps in staffing or administrative needs during those critical first few months of operation. This ensures your patients are taken care of in a timely and efficient manner, setting you up for positive patient reviews and recommendations.

The Cons of Hiring a PPMA

Of course, there are also some disadvantages that come with hiring a PPMA. First, you'll be less involved with the day-to-day operations of your medical practice, which can be a challenge for some physicians. 

Also, not all PPMAs are created equal. Some focus on certain aspects of the practice and others balance a commitment to the overall administrative operation tasks. Be sure to do your research before selecting one to work with. Otherwise, you may find yourself frustrated with their level of service or lack thereof.

Leaving a Practice: Tasks to Complete

When it comes to leaving your current medical practice, there are multiple steps to finalizing your departure:

    1. Notify patients you’re leaving. Provide them with all options for their care, including the other physicians they can see at the current location. 
    2. Sign all necessary documents and make sure to read carefully through any provisions related to advance notice or non-compete scenarios. 
    3. Review policies regarding employment and leaving your employer, as well as tail coverage (also known as a supplemental endorsement policy) to prevent malpractice insurers from refusing to cover claims because of your departure. Keep in mind that you may be financially responsible for the cost of tail coverage if you are terminating your relationship with the medical practice without cause. 
    4. Consider a plan for patient records. Remember, the records are the property of the medical practice. However, patients can request their records be transferred to a departing physician. In the case of a transition, it will be helpful to be prepared to receive those records. Likewise, if the patient chooses to terminate the relationship, make sure they are provided sufficient support and treatment options until they can begin seeing a new physician. 

Starting a Medical Practice in Texas: Should You Work with an MSO?

Starting your own practice in Texas, or anywhere else for that matter, is an involved process. Choosing whether or not to work with a PPMA is an important decision to weigh. Ultimately, the choice comes down to what's best for you and your medical practice.

Discuss Your Needs for Starting a Medical Practice in Texas

Reach out to 99MGMT today to discuss your proposed timeline and the plans you have established. You may be able to streamline the process or reduce costs you hadn’t considered by beginning a partnership with a team of medical practice management professionals. 

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(Editor's Note: This blog was originally published in November 2022 and was updated in December 2023 to reflect the most current information.)

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