Leaving Employment? A Step-by-Step Guide for Physicians Starting a Private Practice in 2026

The dream of starting a private practice is often clearer than the path to building one. Private practices must be flexible to accommodate regulatory changes, rising patient demands, tightening financial constraints, and many other factors. For experienced practitioners, adapting to this shifting landscape can be challenging. For physicians considering running their own practice for the first time, it can seem downright daunting. 

According to an analysis by the American Medical Association (AMA), the share of physicians who worked in private practices dropped by 18 percent from 60.1% in 2012 to 42.2% in 2024. While physician-owned practices remain very popular options for orthopedic surgery and specific surgical subspecialties, the broader medical community is steadily moving toward hospital and private equity employment.

Entering private practice requires a defined plan

Despite the specter of inadequate reimbursement rates and other ongoing challenges, private practice remains a viable and rewarding option for physicians seeking autonomy, more personalized patient care, and relief from burnout often associated with corporate or hospital models.

This guide outlines a practical roadmap for launching a private practice. The following sections highlight key strategies to manage risk and prepare for a successful opening. Topics covered include the following:

• How to pick a location and ensure enough patient demand
• Determining if your licensing and credentials are good to practice in your selected area
• What are the different payor models, and how to negotiate payor contracting
• Evaluating various technology and practice management tools to support your practice
• Considerations for hiring  staff to support your physicians and patients 

No two private practices open the same way, but the road to launch typically includes several essential steps. Let’s explore each step recommended by the AMA to get a better understanding of what it takes to start a private practice in 2026. 

Step 1: Selecting a location

While telemedicine has grown since COVID, your physical location still plays a critical role in visibility and accessibility, especially at launch. You will also need a business address for paperwork, credentialing, and billing. 

Careful market research and a clear vision for your setting will help you choose the right space for your practice. In your search with real estate professionals and other advisors, consider the following questions to ensure alignment:

• Does the local population match your specialty’s needs?
• Are you entering a saturated market or an underserved one?
• Is the space suitable for efficient patient flow and future scalability?

Step 2: Credentialing and certification

Before you can see your first patient, you must ensure that you and any other physicians in your prospective practice are licensed and credentialed in the state. This can be a time-consuming process, so you should get started as soon as possible. Steps within this process will include:

• Verifying that all medical licenses are active and unrestricted.
• Updating your National Provider Identifier and DEA registrations to your new practice address.
• Ensuring that all specialty-specific certifications are current to meet hospital and payor requirements.

Step 3: Choosing a revenue model

One of the most critical decisions in launching a private practice is how you get paid. Your revenue model dictates everything from patient volume and cash flow to clinical autonomy. While independent models offer the greatest flexibility and control, it is important to understand the private equity model as well to make a fully informed decision for your practice’s future.

Traditional insurance (fee-for-service)

Practices contract with payors and bill per visit or procedure. This offers access to a broad patient base with various insurances and offers a familiar model for patients. It can also offer a steady revenue volume once the practice has been established. The most important benefit of this model is that it maintains physician ownership and control.

Concierge model

Patients pay a monthly or annual retainer, sometimes combined with insurance billing, which can provide practices with predictable recurring revenue, too. It also enables smaller panel sizes and more one-on-one patient time. However, a limited patient pool, regulatory hurdles, and potentially slow growth are all limiting factors for this model. 

Private party partnership

Private equity offers immediate capital in exchange for an ownership stake. However, the trade-off is often your autonomy because the physicians will be ceding control over clinical and business decisions. It may also feel similar to an employee-style role and recreate the same issues you sought to escape by going private.

Step 4. Payor contracting 

Unless you adopt a fully direct-pay model without insurers, payors will significantly shape your practice’s revenue cycle. Negotiating contracts with insurance carriers is critical, as reimbursement rates ultimately determine the financial viability of your business model. As this process can get extremely complex, work with an experienced healthcare attorney to advise on the following: 

• Payer Manual Integration
• Prompt Payment Protections
• Rate and Coding Integrity
• Regulatory Compliance

Step 5: Getting your practice insured

Physicians in a private practice may want to consider getting other forms of insurance to guard against the unique liabilities of medical practice and general business ownership. Working with your advisors, you can determine the best insurance options to ensure your practice and partners are covered for a range of scenarios, including the following:

• Business interruption
• Commercial liability
• Cybersecurity
• Directors and officers
• Life
• Medical liability
• Property
• Workers’ compensation

Step 6: Procuring supplies and technology

A modern practice relies on a blend of high-tech infrastructure and essential medical supplies. Your goal here is to equip your office without overextending your initial capital. Your procurement checklist will definitely require at least the following to get started providing stellar patient care:

• Clinical Equipment: Make sure to prioritize essential diagnostic and treatment tools.
• IT Infrastructure: Secure EMR systems, HIPAA-compliant email, and robust cybersecurity are must-haves in today’s clinical environment.
• Inventory Management: Establishing relationships with vendors for recurring medical and office supplies can help ensure you have everything you need at competitive rates.

Step 7: Building your team

Your staff will be your greatest asset and your largest expense. The number of administrators and technicians you need will depend on the number of full-time physicians employed, as well as the support needs of the practice. To ensure you are not over-staffed during the lean early months, nor under-staffed to the point of burnout, consider the following recommendations:

• Use benchmarks to determine the right ratio of clinical to administrative staff.
• Prioritize staff who understand the boutique nature of private practice and have experience with your specialty.
• Standardize your billing and scheduling protocols from the beginning to establish SOPs.
• Cross-train team members early to increase flexibility during growth phases.

Having the right advisors to help you get started

Success in private practice is rarely a solo endeavor. As we’ve highlighted throughout this guide, having a team of advisors to define your processes and protect your interests is essential.

At Cor Value, we offer comprehensive practice management and revenue cycle services to support private practices at every stage and take the administrative weight off your shoulders. We provide the operational strategy, staffing solutions, and patient-centered processes that help build a practice that lasts. Explore our services and approach to get your practice on the road to success.