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Growing your practice: what you need to know

Associate Professor David Williams, MBBS, PhD, FRACP, GAICD, General Manager, Avant Practice Solutions

Monday, 20 May 2024


Like many doctors, when I started my own practice, I had only a rough idea of what I wanted it to be like.

Now, 15 years later, and after some hard-learned lessons, my vision of my dream practice is much clearer. This has helped it expand across five sites, supporting service delivery of over 40 neurologists who see over 45,000 patients a year.

Through building my practice and helping others build theirs, I’ve worked out some of the most important factors to consider if your ambition is to grow your own practice.

Have a clear vision

Firstly, form a clear vision of what you want to grow, so you can prioritise and plan for success. Consider your ambition: do you want to be the principal doctor within a practice, or aspire to owning a group of several practices? Will it be a practice of doctors, or a doctors’ practice? Will the practice focus on a specialist area, or offer a wider range of healthcare services? What are the points of difference you are delivering so that referrers and patients will want to use your services?

Whatever you decide needs to align with what patients need and want, and the area they are willing to find that service. You could plan to grow referrals yourself and leverage your success and profile to attract new doctors or patients. It’s also possible to grow the business by bringing in other doctors to offer a breadth of skills in one place. In which case, would these doctors buy into the practice (as shareholders), or buy time (as service recipients) or rent space (as a sub‑lease holder) in your practice?

Identify existing strengths and where you need support

Set out to deliberately lead the culture you want for the practice. Consider the patient experience and support you will provide to impress referring doctors – since this is central to any growing medical practice. Help lock this culture in place by documenting a business plan that includes a vision statement and an organisational structure. Draft some non-negotiables in terms of service levels and care standards that employees and other doctors can clearly understand. Prepare policies and procedures that include how decisions will be made and what expectations you have. This provides a foundational document for guidance of team members and new doctors you are expecting to execute your growth plan – it simply makes it easier to ensure everyone is on the same page.

Think about position descriptions for your staff and the capabilities you need to build your practice vision. Consider your own strengths and weaknesses as well as those of your practice staff, and set out clear roles and responsibilities.

Bring on experts to help build your vision. A larger practice will require more management and more robust systems. Unless you prefer to do business management rather than being a doctor, prioritise the right advice by using specialised practice management consultants, accountants and financial advisers who can all offer important insights on how to grow in a safe, scalable and profitable way. This advice shortens the learning curve and can assist in minimising expensive novice mistakes.

Scalable IT infrastructure

Your infrastructure needs to be able to scale up to support a bigger business, potentially across several sites. A basic booking system might work well for you and a receptionist, but how would it cope with more users and a greater volume of patients? Practice management systems that link to other services, such as transcription and accounting platforms, can deliver efficiencies that are necessary for sustainable scalability.

Security and continuity of service are other key considerations when thinking about the practice systems you’re providing for other practitioners. Cloud-based systems offer great flexibility and security but remember, the cheapest isn’t necessarily the best, so assess your options from the perspective of efficiency, security and accessibility as well as user experience.

Sound financial management is critical

Building a successful business is all about knowing how you generate, track and reconcile the money. It’s important to have clear compliance and governance for all financial matters, particularly if your administration team is taking responsibility for doing this for other practitioners. Invoicing, cash handling, banking, remitting and reporting all need to be transparent. Your practice manager should take full responsibility for this, and the policies and procedures documented so that financial handling is scripted and easy to teach.

Payroll expertise is essential to remain compliant with legislation and avoid fraud. Unless you have the requisite skills, outsource this to experts.

Reassuringly, there is plenty of support to help. Successfully dealing with these considerations, and the many other complex aspects you’ll need to address when building up your practice, makes fulfilling your dream even more satisfying.

This article was originally published in Connect magazine issue 22.


This publication is not comprehensive and does not constitute legal or medical advice. You should seek legal or other professional advice before relying on any content, and practise proper clinical decision making with regard to the individual circumstances. Persons implementing any recommendations contained in this publication must exercise their own independent skill or judgement or seek appropriate professional advice relevant to their own particular practice. Compliance with any recommendations will not in any way guarantee discharge of the duty of care owed to patients and others coming into contact with the health professional or practice. Avant is not responsible to you or anyone else for any loss suffered in connection with the use of this information. Information is only current at the date initially published.

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