The Practice Start-Up Checklist for Surgeons

by Ashley Gay — Creator of the brand and patient-acquisition system for several medical practices, including her husband's surgical practice, Texas Eye Aesthetics.

My husband opened his own surgical practice after years of delayed partnership. He handled the medicine, compliance, and operations. I handled the branding, the website, and getting patients in the door. We got plenty right, 261 referring physicians within the first year, but we figured a lot of it out as we went.

Most start-up guides are written by banks, accountants, and EHR companies. They're good on financing and entity structure, and they stop right around the point where patients start looking for you. This is the part they skip.

Here is the timeline that we followed. Complete with the branding baked-in. This tees you up for successful advertising and marketing after you've opened.

The 12-Month Timeline

Timeframe
Legal & Financial
Branding & Space
Ops & Marketing
Month 1–2
Hire healthcare attorney. Begin pro forma.
Decide on practice name. Claim domain and social handles.
Research EHR platforms. Explore lending options.
Month 3–4
Form LLC. Open business bank account. Finalize funding.
Begin branding: logo, colors, patient experience vision. Start commercial space search.
Identify a credentialing specialist.
Month 5–6
Sign lease. Hire licensed, insured medical-buildout contractor.
Website: sitemap → wireframe → design → development. Begin waiting room design.
Set up HIPAA-compliant tech stack. Select and onboard EHR.
Month 7–8
Begin credentialing and insurance board submissions.
Website launches with landing page. Index site online.
Verify Google Business Profile. Start networking with referring physicians.
Month 9–10
Monitor credentialing timelines. Build buffer for delays.
Final buildout and space setup. Staff onboarding.
Attend local medical society events. Join Chamber of Commerce.
Month 11–12
Confirm all insurance credentialing is active before open date.
Final brand touchpoints: signage, patient materials, waiting room.
Soft open or official launch. Start local SEO work.
Day 1+
Track revenue vs. pro forma monthly.
Continue building local SEO presence. Post to GBP consistently.
Ask for referrals. Show up. The first 90 days of relationships pay off for years.

Month 1-2

Legal & Financial: Hire healthcare attorney. Begin pro forma.
Branding & Space: Decide on practice name. Claim domain and social handles.
Ops & Marketing: Research EHR platforms. Explore lending options.

Month 3–4

Legal & Financial: Form LLC. Open business bank account. Finalize funding.
Branding & Space: Begin branding — logo, colors, patient experience vision. Start commercial space search
Ops & Marketing: Identify a credentialing specialist.

Month 5–6

Legal & Financial: Sign lease. Hire licensed, insured medical-buildout contractor.
Branding & Space: Website: sitemap → wireframe → design → development. Begin waiting room design.
Ops & Marketing: Set up HIPAA-compliant tech stack. Select and onboard EHR.

Month 7–8

Legal & Financial: Begin credentialing and insurance board submissions.
Branding & Space: Website launches with landing page. Index site online.
Ops & Marketing: Verify Google Business Profile. Start networking with referring physicians.

Month 9–10

Legal & Financial: Monitor credentialing timelines. Build buffer for delays.
Branding & Space: Final buildout and space setup. Staff onboarding.
Ops & Marketing: Attend local medical society events. Join Chamber of Commerce.

Month 11–12

Legal & Financial: Confirm all insurance credentialing is active before open date.
Branding & Space: Final brand touchpoints — signage, patient materials, waiting room.
Ops & Marketing: Soft open or official launch. Start local SEO work.

Day 1+

Legal & Financial: Track revenue vs. pro forma monthly.
Branding & Space: Continue building local SEO presence. Post to GBP consistently.
Ops & Marketing: Ask for referrals. Show up. The first 90 days of relationships pay off for years.

Credentialing timelines vary widely by state and insurance board. Some plans take 60 days. Others take 6 months. Build your open date around the slowest one, not the fastest.

Credentialing timelines vary widely by state and insurance board. Some plans take 60 days. Others take 6 months. Build your open date around the slowest one, not the fastest.

Phase-by-Phase Checklist

Phase 1 — Decision & Foundation (6–12 months before opening)

  • Pick a practice name that doesn't box you in geographically if you plan to scale
  • Claim your URL and social handles as soon as you have a name
  • Form your LLC (or file a DBA)
  • Draft a pro forma; build in 20% over projected costs
  • Shop physician lending products at both large institutions and local credit unions

Phase 2 — Build (3–6 months before opening)

  • Search for commercial space with your patient in mind — parking, signage, non-compete boundary
  • Begin credentialing and insurance board submissions early; it takes longer than almost anyone expects
  • Complete your visual brand before decorating your space
  • Non-negotiables on your website: About page, services pages, pricing/insurance info, online scheduling
  • Put your name everywhere on your site — patients search for you, not just your practice name

Phase 3 — Launch & Grow (Day 1 and beyond)

  • Verify and post consistently to your Google Business Profile — this is what gets you found on Maps
  • Visit potential referring physicians without violating any non-compete
  • Set up a process to request patient reviews
  • Local SEO and GBP management get you found for "near me" searches
  • Paid ads work best after the office is running smoothly, not before

Have a non-compete?

Your notice period, your non-compete's boundary, and how credentialing notifications interact with your current employer all change your timeline, sometimes by a full quarter if you get the sequencing wrong.

Get the full checklist, including the employment-contract appendix by filling out the form
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The practice start-up checklist for surgeons written my Ashley Gay, owner of Digital Ash Agency

FAQ Section

How long does it take to open a private surgical practice?

Most physicians need six months to a year from decision to opening day, depending on your specialty, state, and how fast your insurance credentialing clears.

When should I start marketing my practice, before or after I open?

Before. Your website should be live with a landing page by month 7–8, well before your doors open — patients start searching the moment there's anything to find.

Do I need a website before I have a physical location?

Yes. The branding and website process starts in month 3–6, in parallel with the space search, not after the lease is signed.

Can I start planning while I'm still under an employment contract?

Yes — most of Phase 1 (naming, LLC formation, funding, early branding) doesn't touch your current employer at all. The parts that do (credentialing submissions, notice timing) need to be sequenced carefully with a healthcare attorney.

What's the biggest mistake new practices make with visibility?

Waiting until the doors are open to start on Google Business Profile and local SEO. That work needs to start before month 12, not after.

Ready to talk through your specific situation?

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