9 questions to ask before turning your clinical expertise into a virtual practice
A few years ago, I wrote an article titled “So, Doctor, You Want to Launch a Startup?”. It was aimed at clinicians eager to build something from scratch — often involving cutting-edge technology, clever innovation, and the pursuit of funding.
These days, though, I’m hearing from a different kind of physician. Not someone chasing Series A funding. But someone craving autonomy, freedom, or simply having something on the side.
Someone ready to care for patients on their own terms — virtually.
They’re not looking to build the next big platform. They’re looking to launch a clinic. Online. Built around their own clinical expertise and, sometimes, non-clinical passion.
If that sounds like you, you’re in good company.
The Rise of the Digital Micro-Practice
Whether motivated by burnout, boredom, or bold ambition, ever since the advent of telemedicine, clinicians have been exploring how to deliver care independently — outside the constraints of a health system, reed from RVUs, unburdened by traditional bureaucracy and red tape.
Telehealth has made this more feasible than ever. But feasibility doesn’t mean simplicity.
Before you start shopping for EHRs or securing a Zoom license, I’d encourage you to pause — and reflect.
Because launching a telehealth clinic isn’t just a technical or legal process.
It’s also a deeply personal one.
Nine Questions to Ask Yourself First
Below are nine questions we discuss with clinicians considering this path. They’re not a checklist; together, the answers give you a roadmap and a compass. Use them to assess your readiness, clarify your goals, and anticipate what’s ahead.
1. Why do you want to start a telehealth clinic?
Is this about escaping burnout? Building a more flexible lifestyle? Reaching underserved patients? Or turning a passion into a platform?
Your motivation matters. It will guide your decisions—and sustain you when things get hard (and they will).
Running a telehealth clinic is not like picking up a night shift at your 24×7 gas station. It’s not even as easy as picking up a few shifts as a telemedicine clinician for larger telemedicine services who would love to use your expertise.
2. How much experience have you had running your own business?
Practicing medicine and running a clinic are two different skills.
If you haven’t managed finances, operations, or (especially) marketing before, be honest about what you’ll need to learn — or delegate to others (in exchange for money, of course).
This isn’t a dealbreaker. But awareness here can save you from expensive detours.
While most clinicians I’ve met are exceptionally smart, hubris makes success much harder than it needs to be. Humility and knowing your limits are the much better traits.
3. Who exactly do you want to serve?
Clarity beats breadth.
Will you focus on women’s health? Pediatric behavioral health? Preventive care for men over 40?
Do you want to help them just clinically or also more comprehensively, more holistically?
Knowing your target population helps you tailor your services, messaging, pricing — and ultimately, your success.
4. Where will your patients be located?
“Online” might seem like the obvious answer. But, as you may know by now (after Covid), practicing medicine online (at least in the US) requires licensure in the state where the patient is (not, as one would assume, where the clinician is).
Therefore, you need to consider that licensure and scope-of-practice laws vary by state.
Will you serve just one state? Several? Are you part of the IMLC (a licensure compact)? Will you need to expand your licenses? What about international?
This question influences marketing, legal planning, and also how fast you can grow.
5. How will you find patients — or how will they find you?
“If you build it, they will come” rarely applies anywhere and surely does not apply in healthcare.
Will you rely on word-of-mouth? Your existing patients? Online ads? Online interest groups? Or a niche referral network? Thought leadership?
Having a great clinical offering means little if no one knows you exist.
Not surprisingly, this is one of the hardest parts to figure out, and oftentimes the most costly (those Alphabets and Metas want to make their shareholders happy with advertising dollars).
Launching a Telehealth Clinic is Like Starting on a Green Field
6. Who will care for your patients?
This question is usually straightforward, but nonetheless bears asking.
Will you be the sole provider? Will you bring on other clinicians? Or contract out to nurse practitioners or therapists?
Think beyond care delivery: Who handles triage, follow-ups, and questions? Patients expect responsiveness — how will you staff for that?
7. How critical is income for you in the first 12-18 months?
This question helps you set expectations — and financial strategy.
Are you bootstrapping slowly while maintaining another job? Do you need to replace your income by month six?
Your urgency determines your pricing model, marketing pace, and personal runway.
It often reveals how serious you are — and that directly impacts your chances of success.
8. What role do you want to play in this clinic?
Are you the full-time clinician? The visionary leader? The behind-the-scenes founder?
Many entrepreneurially-minded clinicians consider themselves Jacks (or Jills) of all Trades. But very few of them are masters of them all. Play to your objectively assessed strengths — not just your interests or aspirations.
To be successful, decide early on: Are you building a practice for you — or a business beyond you?
9. What does success look like?
“If you don’t know where you are going, any road will get you there” is the paraphrased advice by the Cheshire Cat from Alice in Wonderland.
Are you just running from something versus running toward something?
What is the goal here —Is it income? Impact? Freedom? Growth?
Define success on your own terms. If you don’t, someone else will and you might end up building something you never really wanted.
From Reflection to Execution
If these questions leave you energized—or a bit overwhelmed—that’s good. It means you’re thinking like a founder.
If they leave you exhausted and puzzled, it’s a reason for further introspection.
In an upcoming article I’ll share the high-level step-by-step breakdown of what’s involved in actually launching a telehealth practice: from licensure and legal setup to tech stack, marketing, patient communication, and the revenue cycle.
But this article is all about mindset.
Because starting a clinic is about more than legal questions, infrastructure, or marketing tactics. It’s about intention.
And that starts with asking the right questions.
You can reflect on these questions alone — or we can guide you through them. If you’d like to explore what your telehealth future could look like, text me at 657-464-3648.
To receive articles like these in your Inbox every week, you can subscribe to Christian’s Telehealth Tuesday Newsletter.
Christian Milaster and his team optimize Telehealth Services for health systems and physician practices. Christian is the Founder and President of Ingenium Digital Health Advisors where he and his expert consortium partner with healthcare leaders to enable the delivery of extraordinary care.
Contact Christian by phone or text at 657-464-3648, via email, or video chat.
