As many of my regular readers know, I am opening my second men’s health practice within the next month. I will be writing a series of “diary” articles to enlighten everyone on my progress as I enter these unclear waters. This will benefit me as it will help track my progress, but my main hope is that it will motivate many of you to get off your ass and get started building a niche side practice. I will also include little “tips” that I have learned along the way as I chronicle my journey.

I originally had planned on opening my second men’s health practice back in April and then COVID happened, so unfortunately, I had to postpone my plans. Looking back, I wish I hadn’t, but it is what it is. You cannot change the past; you can only change the future. Regardless, I am back on track now!

I wanted to open my second location in the same state I am in, as this will allow me to see patients via telemedicine while I hire another nurse practitioner to see the patients. I do not want another job, I want this to be a partially passive income stream, but sometimes you have to put some work into business at the start… Hopefully I will find a good nurse practitioner to see the patients, but worse case scenario, I will see them as needed. I have a long term goal though of opening a dozen clinics all over the country in the next 2-3 years, so basically, this first secondary office is my “experiment.”

The first step in opening any type of practice is doing some market research. You need to determine if you have any competition. NEVER, and I mean NEVER, start a practice in a very saturated area. You will have an uphill battle from the start. I picked this location because there are no men’s health and testosterone clinics for about 50 miles. The population of the area is well over 100,000 people, so I know there is a market here. I chose this city about 6 months ago, so step one has been complete for some time. It was just time to take action.

So over this past weekend, I drove 280 miles north to scout out commercial real estate for this second location. The week before, I began looking at multiple locations over Craigslist and various commercial real estate websites. I picked about 10 locations that looked promising and called the associated brokers and scheduled viewings. I was able to knock this out over 4 hours on Saturday. It did not take long.

Tip #1: Do not get analysis paralysis. You would be amazed with what you can accomplish in just a short amount of time. Do not cloud your judgement thinking that various business tasks will take many hours, days, or even weeks. You can get most things done within a matter of a couple hours!

So, what were my criteria for a new location?

• It had to be at least 600sq ft. I have learned that with a small niche side practice, you only need a small lobby, reception area, a bathroom, and 2 rooms. One room for storage/labs and another as an exam/consultation room.
• It had to be conveniently located off a main road. I was not going to spend $2000+ a month for a location right on a main street. Yes, the visibility is awesome and has its advantages, but those commercial locations in strip mall type properties generally require a build out. I just wanted an office that was easy to find on Google Maps and is convenient for the patient.

Tip #2: ALWAYS GOOGLE MAP A NEW POTENTIAL OFFICE. If Google or any other type of GPS/direction app cannot find your office or give you clear directions on how to get there, then you will run into continuous problems. Patients will be blowing up your phone line constantly asking for directions because they will be lost.

• It had to be move in ready. Like I said above, I do not want to remodel or build out a location. I am okay with a coat of paint, but other than that, I do not want to put any work into the space. Why improve some stranger’s property? Screw that, I only remodel what I own. If you follow The Elite Nurse Practitioner Model, you should have MINIMAL expenses in your personal and business life. Try to get away with things as cheap as possible.
• The properties rent had to be under $1,200 a month. I am not going to spend more than that. This city is more affluent and property values are very high, so I know I will have to spend more than my first men’s health practice and medical cannabis clinic. This is fine though; I will be charging $20-$40 more across the board on everything at the new practice!
• The landlord/property management company had to be willing to sign a 1 year lease. I am NOT signing a 2-3 year lease. If things go south, and sometimes they do with a new business, you are on the hook for that entire lease term until they rent it out to someone else.

Tip #3: Never sign a lease that is longer than 1 year when you initially get started building a new practice or business. It is financial suicide, just like taking out large amounts of debt. THE BIGGEST RISK OF OPENING A BRICK AND MORTAR PRACTICE IS THE LEASE. Therefore, it is IMPERATIVE that you stay at 1 year. I have found a little trick on how to get around 2-3 year lease requirements. Offer to take the property AS IS, and also offer to pay for 6 months in advance. This has always worked for me.

• The office had to have ample parking. You do not want an office that only has 1-2 parking spaces or where parking is on the street. This is INCONVENIENT for the patient. Remember, everything you do needs to be convenient for the patient.

That was it!

So, after going to all 10 locations, I had to automatically throw 5 out the door because they did not meet one of the criteria above. Online listings are often inaccurate, so that is why it is important you physically check out the locations. The other 5 were promising, but 3 of the offices needed some remodel work, and I was not willing to invest in that or sign a longer lease obligation for the landlord to do so.

Tip #4: If a property needs work, the landlord will usually be willing to do a remodel of the property in exchange for a longer lease duration. This could be beneficial if you already have an established practice and know it will succeed. But be wary, if this is a new venture, signing onto long term leases can be dangerous.

I now had 2 offices to choose from:

• The first one was an outdated medical office that needed paint and new carpet. The property manager was willing to do a “facelift” on the property before moving in without any other contingencies. The issue though, was that the office was tucked back in a large office condominium type plaza. I automatically knew that patients were going to have a hard time finding the office. The plus though, was that the design was PERFECT for my men’s health practice. They were asking $1,200 a month.
• The second office was move in ready. Beautiful hard wood floors, neutral colors, windows with natural light, and it was in a convenient location. My trucks GPS and the directions through Google took me straight to the front door. The office complex has mostly medical offices and there are plenty of “alternative” practitioners here, so I could likely get some referrals from my neighbors also. Essentially, this place was PERFECT. The issue? The rent… They wanted $1,450 a month for it. The good news? The complex had about a dozen vacancies! They were desperate.

After discussing various options with my commercial realtor who was showing me the properties, we decided to send the property management company an offer on the second office. We asked the rent to be dropped to $1,175 a month, the right to put a banner along a guard rail that was facing the main street to advertise the practice, and a lease for 1 year in exchange for taking the property AS IS and I would pay them 8 months of rent in advance.

Tip #5: EVERYTHING IN BUSINESS IS NEGOTIABLE. You need to be negotiating everything you possibly can.

They came back accepting everything but wanted $1,250 a month and we countered at $1,200 a month. They accepted! Score! I am at the high end of my budget, but this place is perfect. I literally just need to move some furniture/equipment/supplies in and get a sign made. Talk about simple!

Now that I have my location secured, it is time to get to work! I need to hire a medical assistant, a nurse practitioner, get local business licenses, sign up for utilities, begin marketing, etc. Ugh, this sounds exhausting already… Stay tuned!