Build a Practice From Scratch

If you’re building a practice from scratch, use the checklist below to guide your transition and develop a plan of action. Be sure to click on each action item for a list of supporting tasks and resources.

Please note: This checklist is for your informational use and not intended to replace the advice of professional advisors and specialists, including, but not limited to, attorneys and certified public accountants.

Establish relationships with industry-specific advisors and specialists
  • An orthodontic/dental consultant to represent your interests, manage vendors, and guide the implementation of your practice start-up
  • An attorney to review contracts, create a proper entity for your practice, and ensure legal compliance
  • An accountant to assist with financial planning and tax compliance
  • A lender to finance the purchase
  • A realtor and/or demographer to select a practice location
  • A contractor to build the practice
  • An equipment specialist to purchase equipment
  • An insurance agent to determine insurance needs and coverage limits

Helpful Resources:

Analyze costs associated with starting a practice and prepare a budget
  • Consider personal living expenses such as rent or mortgage, car loans, student loans, insurance, household expenses, income and property taxes, and other discretionary spending
  • Consider practice expenses such as staff costs, facilities, equipment and supplies, insurance, professional services, advertising, and owner compensation

Helpful Resources:

Develop a strategic plan and business plan
  • Develop your mission, vision, and core values
  • Identify goals and specific actions to achieve your mission and vision
  • Write your business plan and include an executive summary, company description, market analysis, design and development plan, operations and management plan, marketing plan, financial projections, and request for funding

Helpful Resources:

Research and identify a location for your practice
  • Evaluate demographic information such as age, race, ethnicity, gender, language, employment, education, income, religion, household size, competition, population growth rate, economic conditions, nearby businesses, schools, colleges, and healthcare facilities
  • Evaluate psychographic information such as values, opinions, lifestyles, behaviors, leisure activities, entertainment preferences, cultural interests, and social activities
  • Review region-specific business expenses, state and local taxes, and government incentives

Helpful Resources:

Work with an attorney to determine the legal structure of your practice (e.g., sole proprietorship, limited liability company, partnership, etc.) and draft necessary documentation
  • Consider how each structure will affect day-to-day operations, taxes, and personal assets

Helpful Resources:

Understand federal and state laws, regulations, and requirements affecting your practice and obtain necessary business licenses and permits
  • Obtain your state dental license and DEA license (if needed)
  • Choose your business name and register with the state government
  • Apply for an Employer Identification Number (EIN) with the Internal Revenue Service (IRS)
  • Apply for National Provider Identification (NPI)
  • Register for local occupancy, zoning, and building permits
  • Check with local government offices for inspection requirements
  • Understand HIPAA, OSHA, infection control, and waste management regulations
  • Apply for life, health, disability, malpractice, general liability, property, and workers’ compensation insurance
  • Understand anti-kickback statutes and self-referral (“Stark”) laws that may apply to you

Helpful Resources:

Open a business checking account
Helpful Resources:

Work with a lender to secure financing
  • You may need to provide your CV/résumé, a net-worth statement, income tax returns for the previous two years, consent to conduct a credit check, and licenses such as dental, driver’s, and controlled substance license

Helpful Resources:

Work with a realtor to purchase or lease an orthodontic office space
  • Consult the advice of an attorney before signing a legal contract

Helpful Resources:

Work with a contractor and/or equipment specialist to design your office
  • Decide how will you use the space and run the office
  • Consider patient volume and experience, staff effectiveness, aesthetic quality, as well as equipment, storage and technology needs
  • Understand legal regulatory standards such as the Americans with Disabilities Act (ADA), OSHA, and local zoning and building codes
  • Schedule building inspections during and after construction by necessary city or county officials

Helpful Resources:

Work with an equipment specialist to purchase supplies and equipment
  • Explore options for x-ray equipment, clinical instruments, sterilization supplies, tray systems, computer equipment, clinical/practice management software, telephone and answering systems, furniture, and other office supplies
  • Determine whether to purchase, finance, or lease new and/or used equipment
  • Evaluate tax implications, maintenance/support costs, and contracts for all purchases

Helpful Resources:

Staff your office
  • Understand federal and state employment laws and payroll taxes
  • Develop compensation structures including pay philosophy, job descriptions, salary, and benefits
    • Research wages, hours, requirements, qualifications, and working conditions for specific positions
  • Develop a plan for recruiting, interviewing, hiring, training and evaluating employees
  • Establish an employee handbook with information such as non-disclosure agreements, conflict of interest statements, anti-discrimination policies, compensation, benefits, work schedules, leave policies, standards of conduct, training, performance evaluation, general employment information, policies for safety and security, computers, technology, and media relations, etc.

Helpful Resources:

Develop practice management structures and systems
  • Set hours of operation and schedule for doctor/staff availability
  • Establish a fee schedule and patient financial policy
  • Determine which payment methods and insurance plans to accept (e.g., HMO, PPO, HSA, etc.)
  • Create your practice website and overall strategy for marketing, communication, and customer service
  • Establish policies and procedures for patient communication, education, appointments, records, treatment planning, and continued care
  • Establish policies and procedures to comply with HIPAA, OSHA, infection control, and waste management regulations
  • Develop standard operating procedures (SOPs) for staff performance, business administration, front and back office procedures, technology, recordkeeping and data management
  • Establish key performance indicators (KPIs) to track the overall health of the practice

Helpful Resources:

Set opening date
  • Announce opening online and through various communication channels within the surrounding community

Access Additional Checklists

Purchase an Existing Practice

Become an Educator

Become a Partner
Become a Partner

Practice in the Military

Expand an Existing Practice

Explore Your Options

Become an Associate or Independent Contractor

Search for Existing Opportunities

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