Skip to content

Small Business Fundamentals

Medical school taught you medicine. It didn't teach you business. This section fills the gap — the bookkeeping, cash flow, tax, and financial literacy basics every DPC owner needs to run a healthy practice.

Why This Section Exists

Most physicians open a DPC practice with excellent clinical skills and almost zero business training. That's not a criticism — it's the system. Medical education has no room for a P&L statement, a chart of accounts, or a quarterly tax deposit.

But a DPC practice is a small business. And small businesses fail not because the product is bad, but because the owner runs out of cash, misreads their numbers, or gets blindsided by taxes.

This section is your crash course in running the business side of the practice. It's not legal or tax advice — it's the working vocabulary you need to make good decisions and have intelligent conversations with your accountant, banker, and bookkeeper.

What This Section Is (and Isn't)

It is:

  • Plain-English fundamentals of small business finance
  • Enough knowledge to avoid the worst mistakes
  • A framework for talking to professionals
  • Practice-agnostic — these principles apply to any small business

It isn't:

The Five Things That Will Get You in Trouble

If you remember nothing else from this section, remember these:

  1. Commingling money. Never run personal expenses through the business account, or vice versa. It's the fastest way to lose liability protection and confuse your books.
  2. Ignoring cash flow. You can be "profitable" on paper and still bounce checks. Cash in the bank is what pays the rent.
  3. Forgetting quarterly taxes. As a self-employed physician, no one is withholding taxes for you. The IRS still wants quarterly payments. Skipping them means penalties and a catastrophic April surprise.
  4. Not reading your own statements. If you don't look at your P&L and bank balance monthly, you don't know if your practice is healthy. Your bookkeeper can keep the books — only you can run the business.
  5. Confusing revenue with profit. $20,000/month in membership dues is not $20,000/month in take-home pay. Understand the difference before you spend it.

How to Use This Section

If you're brand new to small business

Read the guides in this order:

  1. Accounting Basics for Physicians — the vocabulary
  2. Business Banking — separating personal and business money
  3. Bookkeeping Setup — how to actually record transactions
  4. Reading Financial Statements — what the numbers mean
  5. Cash Flow Management — keeping the lights on
  6. Understanding Business Taxes — what you'll owe and when
  7. Working with Accountants & Bookkeepers — who to hire and when
  8. Key Business Metrics for a DPC Practice — what to track

If you already have a practice running

Skim the basics and focus on:

Guides in This Section

Guide Topic
Accounting Basics for Physicians Cash vs. accrual, the accounting equation, chart of accounts
Business Banking Account setup, separating personal and business, bank relationships
Bookkeeping Setup Software options, workflows, monthly close
Reading Financial Statements P&L, balance sheet, and cash flow statement in plain English
Cash Flow Management Forecasting, runway, managing feast-or-famine cycles
Understanding Business Taxes Self-employment tax, quarterly estimates, deductions, entity taxation
Working with Accountants & Bookkeepers When to hire, what to expect, how to evaluate them
Key Business Metrics for a DPC Practice MRR, churn, panel economics, break-even math

Educational Content Only

This section is general small business education. It is not tax, legal, or financial advice. Tax law, accounting standards, and regulations change. Always consult a qualified CPA, bookkeeper, or financial advisor for decisions specific to your practice.

You don't need an MBA to run a healthy practice. You do need to understand your own numbers.