General Medical Practice Finance
Canadian and US general medical practices look like fundamentally different businesses despite providing similar clinical services. Here's how the financial structure actually works in each system.
Independent general medical practice is one of the most challenging healthcare specialties to write about consistently across Canadian and US markets, because the two systems operate on fundamentally different financial foundations. A Canadian family physician operating fee-for-service through provincial billing and a US primary care physician navigating commercial insurance, Medicare, Medicaid, and patient self-pay simultaneously face genuinely different economic realities despite providing similar clinical care.
The foundational post below addresses Canadian and US dynamics separately rather than blending them into generic content. The supporting operational content covers concepts that apply across both systems — working capital, KPIs, ramp curves, financial metrics — from the broader content library.
Operators in either country can use the financial planning tools to model their specific situation with country-appropriate defaults.
Financial Structure at a Glance
- Startup capital range: $150K to $400K depending on country, scope, and clinical infrastructure
- Two fundamentally different systems: Canadian fee-for-service vs. US multi-payer billing
- Canadian visit fees: $35-$80 per visit, 25-40 patients/day, 25-35% overhead
- US insurance reimbursement: $80-$200+ per visit, 18-28 patients/day, 50-60% overhead
- Alternative payment models: Capitation, Family Health Network/Organization (Canada), value-based care (US)
- Concierge and direct primary care: Subscription models that bypass traditional insurance billing
- Practitioner shortage tailwind: Strong patient acquisition in shortage markets in both countries
- Administrative burden: Significant in US insurance billing; lower in Canadian fee-for-service
Start here
A foundational post that addresses Canadian and US general medical practice separately given how differently the two systems operate.
Model your practice
The financial planning tools support general medical practice among 13 specialties with calibrated defaults reflecting the genuine differences between Canadian and US systems.
Clinic Cost Estimator
Estimate total project cost for your medical practice startup, including build-out, clinical equipment, EHR setup, working capital, and credentialing costs (especially relevant in US).
Estimate project costCapital Structure Tool
Compare four capital scenarios for financing the practice: all cash, cash plus loan, cash plus loan plus lease, or cash plus lease only.
Compare capital structuresProfitability Calculator
Model monthly profitability across capacity scenarios with country-specific defaults reflecting genuinely different fee structures between Canadian fee-for-service and US insurance reimbursement.
Model profitabilityPerformance Benchmarks
Compare practice metrics — revenue per visit, EBITDA margin, rent percentage, labour cost — against published reference ranges for general medical practice specifically.
Compare benchmarksOperational content that applies to general medical practice
These posts from other clusters address operational and financial topics that apply broadly across healthcare practices, including general medical and family medicine.
- How to Think About Working Capital for a New Healthcare Practice
- The Three Capital Stack Structures Most Clinic Startups Use
- Financial KPIs Every Independent Clinic Operator Should Monitor
- Labour Cost as a Percentage of Revenue in Healthcare Practices
- Rolling 13-Week Cash Flow Management for Clinic Operators
- Ramp Curves in New Healthcare Practices: General Patterns
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