Podiatry Business From Scratch

A Primer for Setting Up Your Business

When a podiatrist recently asked about what to focus on when transferring from the NHS to private practice, as in the independent sector, I decided to talk to Gaynor Woolridge about current practice. I am grateful for her input and expertise, which I have consolidated with my own experience from setting up, albeit many years before. I hope that this short article will act as a primer. The Institute of Podiatrists and the Royal College of Podiatry both produce excellent free guides for members.

Which business?

 Whether you are starting your business following graduation or transitioning within the podiatry sector, there are several red flags to watch for. We should refer to them as green flags to counter any notion that independent practice is something to be avoided.

This article looks at clinical practice from a base rather than a domiciliary practice, although there are principles that overlap. Naturally, in such a short space, it is not possible to cover all that there is, and it would be a good idea to consider one of the books as part of your bibliography. More about resources at the end.

Find an accountant and discuss which type of business fits your needs best.

 Business decisions come in two varieties: sole trader or limited company (Ltd.) Unless you are already making a decent income, limited registration is expensive and requires more bureaucracy. No matter which you might select, an accountant is one investment most men and women need. The change from PAYE as in the NHS or other employment will require you to pay His Majesties Revenue & Customs (HMRC) each year. If you are moving across from PAYE (pay as you earn) to self-assessment, then steering your way through the maze of liabilities is essential. Some methods legitimately save money, but being savvy is necessary. Your accountant will offer the correct techniques, from car purchase to use of home, mileage, purchase of equipment, and depreciation.

  • Where should you practice?
  • Home, rent or buy?
  • Rural, or urban or mixed?

Irrespective of these choices, you will need to check if you are allowed to run a business from that address. The advantages of using a home are plenty if you have space, adequate parking, and don’t mind the cross over with people knowing where you live or seeing your family. You will need to check with your mortgage lender if the use of the home contradicts their terms.

Renting is a good place to start, but of course, you have to cover your costs. No income means you are running on an empty tank. If you go in with another professional—osteopath, physiotherapist, dentist, and there is room, the passing clientele will see you whilst attending for another appointment. Visibility is more or less the key to growth.

Some private hospitals rent out rooms and support services, and it may be worth considering this option. Good visibility, support, and professionalism are essential. You pay for the rooms only as needed, but of course, there may be a minimum requirement.

Buying a location requires a lot of money, and if you don’t have the funds, this is not an option. Buying goodwill from another person is an option, but it has pros and cons.

For many, starting a business means working across several environments. Retaining an NHS part-time contract allows income flow while trying to establish a new business. Although stated at the top of this article, domiciliary, this outlet offers some start-up benefits. At the same time, you build your clientele, but if you want to practice the broadest scope, domiciliary is limited to essential foot care.

Hidden costs

Practice can be expensive, depending on your goals. Sharing mitigates some of that expense. If you lack start-up funds, you will need to lease, hire, or take a loan for autoclaves, sonic cleaners, couches, clinical units, lighting, instruments, and dressings.

Health & safety cannot be ignored, as there are fines for not taking care of waste. Suitable sinks and drainage are essential. Protective clothing and first aid are required, along with fire prevention and management. Taking this all into consideration, you will need insurance against accidents. This is where using professional indemnity may be best to use a policy offered for podiatrists or foot health practitioners. Do not confuse buildings and contents with other insurance. In addition, it is essential to have practice indemnity covering at least five million for regular podiatry practice, more for higher risk.

All graduates wishing to use their professional title of podiatrist have to pay a fee for registration to the Health & Care Professions Council (HCPC) of £116.36 a year, reduced in the first two years for new graduates.

Those registered under the HCPC can incur additional legal costs when defending a case brought to the HCPC. Barristers are required for many claims, and a case of proven negligence can end a career. Below is an essential list paid annually.

  • Buildings & contents.
  • Public Liability.
  • Malpractice & legal costs.
  • Motor insurance for businesses should be added to your regular car insurance.

Other hidden costs

  • Continuous education & professional meetings.
  • Online courses & building your library.
  • Holidays (essential for health).
  • Sickness provision. Once you are self-employed, this falls to you.

What style of podiatry?

Your role is to manage people and their foot health, so you should always practice to the best of your ability, no matter what sphere you intend to work in.

There is a balance between making a living and existing to cover your outgoings against a desire to practice in one field alone. Essential care, often called maintenance podiatry, will always pay the bills. Trying to set up as a specialist is rather tricky without a previous base and the right to specify that you are a specialist. It is essential to ensure training is continued, and this has to be funded.

The practice of high-risk care is less prevalent in the independent (private sector) sector, although there is nothing wrong with developing a practice prepared to provide such a service. However, the higher litigation risk of this type of care might limit what is offered. It is unlikely you can offer the complete care provided by the NHS depending upon the affordability of resources required by your patients.

Orthotic work is part of a podiatrist’s role. You can set up a room with a grinder for limited provision, but using external laboratories avoids some of the high set-up costs and health and safety concerns. Selling over-the-counter products can be valuable. Still, your competition is the Internet and high-street outlets such as sports shops and pharmacies.

People incorrectly consider nail surgery a specialty since all podiatrists are trained in these procedures. The problem lies in confidence and setting up the additional conditions needed to deliver this treatment. Where podiatrists do not provide nail surgery, this does offer the newer graduate an opportunity to close any gap.

Paediatric podiatry is limited as a service but essential and should be part of every practice. Traditionally, this came under a wart provision service, but MSK and advice should rank highly. More about advice and education in a moment.

Sports activities can attract patients to any practice, depending on your brand, reputation, and interest. Offering advice and attending local dance sessions and football games can enhance your name, but much of the start-up may have to be delivered gratis.

Your primary role will be dealing with the skin, and a good knowledge of dermatology and screening is essential. This brings us back to education and advice. Getting out and using aids and providing talks to outlets cannot be underestimated in the power of advertising your services. Quality foot health material can be purchased or made for this purpose as giveaways. A skeleton (plastic), foot model, and basic anatomy charts are all part of the educational scene.

Target Audience

Know the audience you want to reach, as well as the location and community demography. Poor areas with high unemployment will lead to slower growth than areas with good industry and more expensive housing. These are facts, and naturally, our services should reach all potential clients. As the NHS podiatry services continue to shrink, it is unlikely that you will not attract growth.

Visibility is important, and you will need local medical surgeries to be aware of you and what you can offer. GPs are under enormous strain due to delays. Fill this gap and use your medical skills to offer guidance after a quality consultation.

Your brand is you, but consider representing this with a logo and caption, be creative, and set up a website. While these are expensive if designed by others, you can develop your own with time and patience using outlets such as Wix.com. Advertising is not always cost-effective, but you can invest in small posters for locations willing to allow placement. Word of mouth, based on reliability, is important.

If you decide to work with an established practice as an associate or partner, then your growth may be faster than setting up from scratch. Social media has become the watchword, and if it is free and valuable, but it is time-consuming. The percentage of income from such an effort may be less than hoped as everyone is using the same platforms, but it gives you visibility.

Competition

There will always be competition, and your only asset is that you can offer a faster appointment, depending on your location. Rural competition is lower than urban because all practices thrive on demographic numbers. An older population in retirement offers a client-patient base for the standard ranges of podiatry and foot health care compared to younger populations. However, never underestimate those under retirement age, as there is little NHS provision outside their strict criteria. Fill in gaps with domiciliary work, especially in rural areas.

Set your fee structure sensibly. Simply cover your costs (see earlier) and ensure you have a profit margin. Be creative and offer services others do not. In a dense marketplace, offering some services at no cost can increase exposure and loyalty to existing client patients.

Availability

One of the biggest problems any practice has is access availability. Too many have full books. People want to speak to humans, and a telephone, now more a smartphone, is the only way to solve this problem, other than a physical receptionist. Once you employ someone, you have to consider all the paperwork, employment requirements, and costs. Having someone to capture your patient’s requests 5-6 days a week is important. Many use their websites for patient appointments. This allows little support requirement and is 24-hour friendly.

Those entering podiatry and inevitably qualifying will gain a thirst for one of the many opportunities. Older graduates with families have a different imperative than younger graduates who have no dependents. Careers are built on time, effort, motivation and patience. Going into self-employment alone is not for the faint-hearted because growth will take a number of years, hard work, and potentially long hours. Spreading your employment across different opportunities pays the bills, but at the end of the day, you have to enter what has always been known as a private practice with eyes wide open.

Resources

You should do as much research and reading as possible before embarking on independent practice. The leading professional bodies, such as the Institute of Podiatrists and the Royal College of Podiatry, produce and support independent practice. OSGO is slightly different. It is set up to offer comparative services stylised toward business.

Gurus—Everyone is an expert these days, and cynism is an in-built defence mechanism as many have set up a business to help podiatrists. While this article cannot judge their value or refute the value of such services, it is recommended that you attend conferences and local meetings and discuss the business of practice before spending money on a lengthy course with a sizable price tag.

Attending conferences is important for learning more about your business, which is what independent practice is—a business. The following books are available through Amazon. There is a surfeit of marketing books that offer helpful guidance. Look at the reviews and star ratings where available. Not all books are helpful.

‘If you learn anything from this book you are still at primary school and not, therefore, a podiatrist. This is simply a marketing tool for his marketing.’ (not listed above, and the book was now unavailable)

Learn About Your Profession ~ booklist.

  1. Voices From Podiatric Practice (2023) Tollafield, DR. Hardback £30.25, paperback £9.99 & digital £4.99 provide a rare insight into all the specialties and outlets with helpful stories in how each podiatrist set about their career. 388p. (UK)
  2. A Guide to Setting Up and Running a Successful Podiatry Practice. Flanagan, T. (2015) Paperback £49.99 Kindle £9.99. 366p. (UK)
  3. The Podiatry Practice Business Solution. Wishnie, P. (2019).  Hardcover £19.99. 174p. (US)
  4. Podiatry Business Secrets. Donaile, LO. (2020) Digital £8.47. 129p.(Eire)
  5. Podiatry Prosperity. How to Market, Manage and Love Your Practice. Jackson R. (2019). Paperback £13.59. 140p. (US)
  6. Podiatry Profits: Crafting a Seven-Figure Lifestyle Practice. Ahn, TJ. (2024). Paperback £15.00. Digital £7.99. 175p. (US)
  7. It’s No Secret…There’s Money in Podiatry. Franklin, T. (2014). Paperback £14.99. Kindle £10.99. 230p. (Au.)

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Posted on

January 4, 2025

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