Medical Clinic

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Executive Summary

Thompson Family Clinic is an outpatient family practice in Duluth, Minnesota offering primary care for adults and children, including preventive visits, chronic disease management, acute illness and minor procedures. It opens with one physician, nurse practitioners and support staff, and grows as the patient list builds. Year 1 revenue is projected at about $280,000, growing to about $1.1 million by Year 3. Startup costs are about $232,500.

Company Description

Thompson Family Clinic is an LLC owned by Eric Thompson, MD or DO, who has twelve years of primary care experience. A physician license is required to practice medicine, and the clinic cannot see patients until its physician holds an active Minnesota license, the clinic has its business registrations and it is enrolled with insurance plans. The clinic leases an 3,000-square-foot suite with six exam rooms, a lab area and a small procedure room. Services: preventive care and physicals, chronic disease management, sick visits, immunizations, basic lab tests and minor procedures.

How we make money. The plan has these income lines: office visits (net collections per visit) at about $118 each, about 1,949 in Year 1; labs, immunizations and procedures at about $65 each, about 769 in Year 1. Pricing is set so each line covers its direct cost and a share of overhead.

Unit economics. In Year 1 direct costs are about $27,127, a gross margin of about 90% of sales. Pay and overhead take most of what is left, so the plan first shows a profit in Year 2. Prices and volumes are set from the assumptions in the appendix and should be replaced with your own quotes.

Problem & Opportunity

Many patients wait weeks for a primary care appointment and use urgent care or the emergency room for problems a regular doctor could handle. Patients with chronic conditions need regular follow-up and clear plans. Families want one clinic that knows them and answers questions between visits.

Products & Services

A practice built for access and continuity. Patients can often be seen within two days, receive a written care plan and reach the care team through a patient portal and a nurse line. Visits are long enough to listen. Same-day slots are kept for sick visits.

Market Analysis

Duluth and nearby communities have a large health system, many older residents and families needing a primary care physician. Demand comes from patients leaving crowded practices, new residents and people with chronic conditions. Insurance and referrals drive volume.

Who we serve first. Families, adults with chronic conditions, new residents and patients who want a regular primary care doctor.

Competitive Landscape

Large health systems and several clinics serve the area, often with long waits for new patients. Thompson Family Clinic competes on access, continuity and clear communication. We do not promise cures, and we refer patients who need specialist or hospital care.

Our strengths and weak points. Strengths: Physician owner with twelve years of primary care experience; Access and continuity that crowded practices struggle to offer. Weak points we plan for: Credentialing and enrollment take months before income begins; A new clinic has no patient list at opening.

Marketing & Sales Strategy

Introduce the clinic to local employers, schools and community groups, offer a new-patient welcome visit and ask patients for reviews. We partner with specialists, labs and pharmacies who refer patients. The first goal is 800 active patients by month 12.

The first 90 days. Days 1 to 30: sign the lease, order equipment and file for registrations and insurance enrollment. Days 31 to 90: build out the clinic, hire the practice manager and medical assistants and start credentialing. Days 91 to 150: open, hold a community open house and begin the welcome visit offer.

Operations Plan

Each patient has an intake, a visit with a clinician and a written plan. The clinic uses an electronic health record with a patient portal, a billing service and a lab partner. Exam rooms are cleaned between patients, and sharps and waste are handled under safety rules. Records are protected under federal privacy law, and the clinic follows Minnesota practice and licensing rules.

Key resources and partners. Resources: A licensed physician, a leased clinic suite, medical equipment, an electronic health record and trained staff. Partners: A hospital system, specialists, a lab, pharmacies, insurance plans and a billing service.

What we measure. Active patients, new patients per week, visits per clinician per day, collection rate and cash in the bank.

Risks and how we plan for them:
- Insurance enrollment takes months and payments are slow. We enroll before opening and hold a cash cushion for the early months.
- Malpractice and patient safety. We carry malpractice insurance, follow written protocols and review any adverse event.
- Rules for billing and privacy are strict. We use a billing service, train staff and audit charts each quarter.
- A new clinic has no patient list. We use referrals, a welcome visit and community events to fill the schedule.
- Dependence on one physician. Nurse practitioners are hired as the list grows, and a coverage agreement is in place for time off.

Quality and safety. The clinic tracks follow-up on abnormal test results, has written protocols for emergencies and keeps staff trained on infection control and privacy. Billing. Claims are submitted only for documented services and audited each quarter. Referrals. The clinic keeps relationships with specialists and the hospital so patients get fast referrals when needed.

Quality. We track how quickly abnormal results are followed up, how many patients with long-term conditions have a visit every three months and how patients rate their last visit. Results are reviewed at a monthly staff meeting and shared with the whole team. Patients who miss a scheduled follow-up receive a call within two days, and anyone who needs care outside our scope leaves with a specific referral and a phone number. We also keep a short list of local pharmacies, labs and specialists so every referral is to a named person.

Management & Organization

Dr. Eric Thompson, MD or DO, Owner and Medical Director, leads clinical care. Two nurse practitioners join as patient volume grows. A practice manager handles front-office tasks, insurance and scheduling, with medical assistants supporting visits. An outside billing service and bookkeeper support the clinic.

Hiring plan. Dr. Thompson sees patients. A practice manager and two medical assistants start at opening, a nurse practitioner joins in Year 1 and more clinicians are added as the list grows.

Outside help. We rely on an outside bookkeeper for monthly reconciliation and tax filings, an attorney for contracts and licensing questions and an insurance agent who reviews our coverage every year. We meet with these advisors at least twice a year and keep notes of what they recommend.

Milestones Narrative

Year 1: sign the lease, build out and equip the clinic, enroll with insurance plans, open in month 5, reach 800 active patients by month 12, revenue about $280,000. Year 2: add a nurse practitioner and extended hours, revenue about $812,100. Year 3: add a second nurse practitioner and chronic care programs, revenue about $1,064,000.

What the plan's numbers say. Year 1: sales about $280,000, loss about $193,300; Year 2: sales about $812,100, profit about $88,600; Year 3: sales about $1.1 million, profit about $223,300; Year 4: sales about $1.2 million, profit about $224,800; Year 5: sales about $1.3 million, profit about $253,600. The lowest year-end cash is about $75,400.

How we will keep score. Every month we compare real sales to the plan, check the cash in the bank, review the direct cost of each job or product, and look at what customers say. If sales are behind plan for two months in a row, we slow spending and delay hiring until the numbers catch up.

Funding Request

How much we need and how we will use it. Total needed: $567,500. This number comes from the Funding Need Calculator in this plan. It adds up:
- Startup costs of $232,500, listed item by item in the Startup Costs section (the largest are Working capital reserve $60,000; Exam room furniture and medical equipment $45,000; Suite buildout and flooring $42,000).
- A cash cushion of about $335,000. That is the deepest cash dip in the early months plus about three months of bills, so slow weeks do not put the business at risk. Lenders call this "working capital."
- Together that comes to about $567,500 (rounded up to the nearest $500), which is the total we are planning for.
Where the money comes from:
- Owner money: $60,000.
- SBA 7(a) loan: $507,500.
Kind of funding we are looking for: SBA 7(a) loan: $507,500 at 12.75% interest over 10 years, about $7,503 a month. A loan is money we pay back with interest, and the monthly payments are already included in our cash flow.
How we will pay it back. We expect sales of about $280,000 in Year 1, growing to about $1.3 million by Year 5. We expect a loss of about $193,300 in Year 1, a profit of about $88,600 in Year 2, a profit of about $223,300 in Year 3, a profit of about $224,800 in Year 4 and a profit of about $253,600 in Year 5. Year 1 is lower than a full year because the clinic opens in month 5 and enrollment and the patient list take time. The lowest year-end cash balance is about $75,400 (Year 2), so with this funding the business has money in the bank every year of the plan.
What we are offering the lender: the equipment we buy as collateral and a personal guarantee from the owner.
A smaller first step, if needed. If we cannot raise the full amount right away, we can start with four exam rooms, buy used equipment where safe and add rooms as the patient list grows. Duplicate this plan and lower the equipment and buildout costs to match.
What if sales are slower? We also tested a cautious case where sales come in 20 percent lower every year. In that case the plan shows a loss of about $248,500 in Year 1, a profit of about $70,200 in Year 3 and the lowest year-end cash is below zero, by about $79,200. Cash would run short in that case, so we would cut costs early, delay hiring and talk to the lender before it happens.
All numbers in this plan are estimates. We will update them as real results come in.

Appendix Notes

Documents to attach before you send this plan:

- LLC operating agreement.
- Minnesota physician license and business registrations.
- Insurance certificates for malpractice and general liability.
- Insurance credentialing applications.
- Clinic lease.
- Equipment purchase agreements.
- Privacy policy and patient forms.
- Emergency protocols and billing compliance plan.
If you don't have any of this yet, no worries - let's continue.

The assumptions behind our numbers (change them in the Financials section to match your own):
- Office Visits (net collections per visit): about 1,949 units in Year 1 at about $118 each, costing about $8.00 each to deliver.
- Labs, Immunizations and Procedures: about 769 units in Year 1 at about $65 each, costing about $15.00 each to deliver.
- Pay: owner / physician $170,000 a year (the same number all five years); nurse practitioner $105,000 a year (people in Years 1 to 5: 0, 1, 1, 2, 2); medical assistant $40,000 a year (people in Years 1 to 5: 1, 2, 3, 3, 4); practice manager $60,000 a year (people in Years 1 to 5: 0.7, 1, 1, 1, 1).
- Other yearly costs in Year 1: clinic lease and utilities about $42,000, medical supplies and lab fees about $16,000, malpractice and general liability insurance about $18,000, billing service and electronic health record about $20,000, marketing about $8,000, accounting, licensing and admin about $10,000.
- Tax rate: 21%.
- Every dollar amount is an estimate. Replace them with your own quotes and research.

Plain words used in this plan:
- Primary care: a regular doctor who handles most health needs and refers to specialists.
- Credentialing: enrolling with insurance plans so the clinic can bill them.
- Continuity: seeing the same care team over time.
- Patient portal: a secure website where patients see results and message the clinic.
- Chronic condition: a long-term health problem such as diabetes or high blood pressure.

Startup Costs