10 Things Doctors Wish They Knew Before Starting a Private Medical Practice

Thinking About Setting Up a Private Practice? Here’s What You Need to Know.

Becoming your own boss in private medical practice is an exciting step, but it comes with challenges that most doctors don’t see coming. Beyond patient care, you’re suddenly managing finances, compliance, staffing, and marketing—all without the structure of the NHS.

Many doctors assume they’ll "figure it out" as they go, but the truth is a lack of preparation can cost you time, money, and even your reputation.

At DocSupport, we help clinicians set up successful private practices. We know what works, what doesn’t, and the common mistakes that can hold you back. In this guide, we’re breaking down the 10 things every doctor should know before making the leap.

If you're thinking about how to set up a private medical practice in the UK, this is your roadmap. Let’s get started.

1. You’re Not Just a Doctor—You’re a Business Owner

Most doctors go into private practice thinking their clinical skills will be enough. The reality? You’re not just treating patients—you’re running a business. That means dealing with financial planning, hiring staff, managing patient records, marketing your services, and keeping up to date with regulations.

Many doctors assume that if they provide great care, patients will come. But in private practice, patients won’t just appear at your door. You need a structured business plan, a clear pricing model, and a strategy for growth.

What You Need to Do from Day One:

•  Plan Your Finances – Understand your costs, from CQC registration to insurance and software. Know your break-even point before you open.

• Decide on Your Practice Structure – Will you be a sole trader, limited company, or part of a limited liability partnership.  Each has different tax and liability implications.

• Get Professional Help at the right time – A medical accountant and legal advisor can prevent costly mistakes. A practice manager can be useful to aid growth by handling admin so you can focus on patients.

• Set Up the Right Systems – From patient booking to electronic health records (EHR), having the right tools in place will save you from being buried in paperwork.

  
  

2. There Are More Costs Involved Than You Might Think

Starting a private medical practice is an exciting step, but it’s important to be aware of all the financial considerations from the outset. While rent and equipment are obvious expenses, there are other costs that doctors often overlook, and planning for them can make the transition much smoother.

What You’ll Need to Budget For:

• CQC (England/Wales) or HIS (Scotland) Registration Fees – If you’re offering treatment, this is a key requirement and can take time to process.

• Clinic Rent & Utilities – Location plays a huge role in both cost and patient flow, so choosing the right space is crucial.

• Indemnity Insurance – Private practice requires separate insurance, and costs vary depending on your specialty, services offered and level of cover required.

• Medical Equipment & Software – From electronic health records (EHR) to booking systems and telehealth platforms, investing in the right tools will help your practice run smoothly.

• Staffing Costs – Depending on your setup, you may need a receptionist, a practice manager, or additional clinical staff.

• Marketing & Website Development – Patients need to be able to find you, so setting up a professional online presence is an important early investment.

  
  

3. Marketing is Essential—Patients Won’t Just Find You

One of the biggest differences between NHS work and private practice is that patients don’t automatically come to you. In private practice, you need to make sure people know you exist, trust your expertise, and feel confident booking an appointment.

At a minimum, every private practice should have:

• A professional website: This should clearly explain your services, include patient testimonials, and make booking an appointment easy.

• Google My Business (GMB) listing: This is how you show up in local searches. A well-optimized GMB profile helps people in your area find your practice.

• Search Engine Optimization (SEO): Patients often search for symptoms or treatment options before they look for a doctor. Good SEO ensures your website appears when they do.

  
  

4. The Legal & Regulatory Maze Can Slow You Down

Setting up a private medical practice comes with a range of legal and regulatory requirements, and the process can take longer than expected. Being prepared for these steps from the start will help avoid delays and ensure you’re operating within the law.

These are the requirements you should keep factor in:

• CQC/HIS Approval Takes Time: If you’re offering treatments, diagnostics, or surgery, you’ll need CQC registration before you can open. The process involves accurate paperwork, compliance checks, and an inspection, which can take several months. 

• Getting Approved by Private Insurers: If you want to accept Bupa, AXA, or Aviva patients, you’ll need to register with insurers, which can be a slow and bureaucratic process. Expect to provide proof of qualifications, CQC compliance (if required), and negotiate reimbursement rates.

• Hiring Staff? Get Contracts Right: Employment contracts must be airtight to avoid issues down the line. A bad hire can cause major problems for a small practice, so investing in legal advice early can save you stress later.

  
  

5. Don’t Underestimate the Admin Load

Running a private medical practice means handling far more than patient care. Without the right systems in place, admin can quickly take over your time and slow down your practice.

Keep these things in mind:

• EHR Software is Essential: Managing patient records manually isn’t sustainable. Electronic Health Record (EHR) software streamlines documentation, appointment scheduling, and patient communication, reducing admin time and improving efficiency.

• Outsource Medical Billing if Working with Insurers: If you’re accepting private insurance, billing can get complicated. Different insurers have different processes, and chasing payments can be time-consuming. Many doctors choose to outsource medical billing to avoid errors and ensure smooth cash flow.

• Support Staff Make a Huge Difference: Even a part-time receptionist or virtual assistant can help with patient inquiries, bookings, and follow-ups, freeing you to focus on clinical work. Investing in support early can improve the patient experience and keep your practice running efficiently.

  
  

6. Insurance Reimbursement & Private Billing Are a Headache

Getting paid in private practice isn’t always as simple as it seems. While direct patient payments are straightforward, dealing with insurance claims can be complex and frustrating if you’re not prepared.

Here are some things to note:

• Not All Insurers Pay the Same: Each private insurer has its own pricing structures and reimbursement rates. What you charge and what you actually get paid can differ significantly, so review insurer fee schedules carefully before signing up.

• Billing Mistakes Can Delay Payments: Insurers have strict rules on invoicing, coding, and documentation. Even small errors can result in delayed or rejected claims. If you’re accepting insurance, consider using medical billing software or outsourcing the process to avoid admin headaches.

• Set Clear Payment Terms from Day One: For self-pay patients, clearly outline your fees, payment deadlines, and cancellation policies to avoid late or unpaid invoices. Many practices take payment upfront or before follow-up appointments to reduce risk.

  
  

7. Hiring the Right People Will Make or Break Your Practice

Your team plays a huge role in how smoothly your private practice runs. The right hires will make your life easier. The wrong ones will cost you time, money, and patient trust.

• A strong practice manager = peace of mind: They handle admin, compliance, and finances, so you don’t have to. Private healthcare experience is a must.

• Your receptionist is your front line: They need to be professional, organised, and welcoming—first impressions matter.

• Balance in-person and remote support: A receptionist is key for patient interactions, but virtual assistants can handle scheduling and admin to reduce costs.

  
  

8. Work-Life Balance is a Myth (Unless You Plan for It)

Most new private doctors work far more hours than expected, especially in the first two years. Without boundaries, work can take over your life.

Our top tips are to:

• Set patient limits early. Overbooking leads to burnout—define your working hours and stick to them.

• Decide on out-of-hours care. Will you be on call? If so, set clear policies and charge appropriately.

• Factor in admin time. Seeing patients is just part of the job—billing, compliance, and marketing also need time in your schedule.

  
  

9. What is Your Private Practice Pricing Model? 

Setting fees is about more than just covering costs—it’s about positioning your practice correctly while ensuring long-term profitability.

Keep these things in mind:

• Know your costs. Your fees need to cover rent, staff, insurance, and software—not just your consultation time.

• Find the sweet spot. Charge too little, and you undervalue your services. Charge too much, and you risk losing patients.

• Be transparent. Clearly define what’s included in consultations, follow-ups, and any additional services to avoid confusion.

  
  

10. Always Have a Long-Term Plan (Exit Strategy Matters)

Many doctors focus on getting their practice up and running but don’t think about what comes next. Having a long-term plan will shape how you grow and eventually transition out when the time comes.

Questions to ask yourself are:

• Will you expand? Consider whether you’ll add new services, open more locations, or bring in additional specialists.

• Think beyond yourself. A practice built around one doctor has limits—bringing in other  clincians or partners can help it grow.

• Plan your exit. Whether you want to sell the practice or step back while keeping an ownership role, having a strategy early makes it easier to transition when the time comes.

  
  

Final Thoughts

Most doctors underestimate the business side of private medical practice. It’s rewarding, but it’s not just about treating patients—it’s about running a sustainable business. Plan properly, invest in the right tools and people, and be realistic about the first few years.

At DocSupport, our Clinic Set Up Pro service provides expert guidance on everything from regulatory approval to pricing, marketing, and practice management. We help doctors navigate the complexities of private practice so you can build a business that thrives—without the guesswork.

Book a call today to find out how we can help you set up a private medical practice uk.

FAQ

What is private practice?

Private practice is when a doctor or healthcare professional operates independently outside the NHS or public healthcare system, providing services directly to patients or through private insurers. It allows greater flexibility in treatment options, appointment times, and pricing but also requires handling business operations, compliance, and patient acquisition.

What is private practice management?

Private practice management involves overseeing the daily operations of a medical practice, including finance, staffing, compliance, and patient experience. Effective management ensures the practice runs smoothly, remains profitable, and meets regulatory requirements. Many doctors choose to hire a practice manager or use external support to handle these responsibilities.

What is a private practice register?

A private practice register typically refers to a database or accreditation list where private healthcare providers are listed, often required for working with insurers like Bupa or AXA. In the UK, doctors must also be registered with the GMC and regulated by the CQC/HIS to operate legally.