How I Started And Grew A $1M Medical Clinic
Hello! Who are you and what business did you start?
My name is Umayr Azimi MD, a physician based out of Southeast Michigan. I grew up with a pretty typical midwest childhood upbringing: going to school, playing sports, etc. As I grew older, I became interested in science and in the human body. My general personality lent me towards wanting to study these fields.
As I entered college, I eventually realized I wanted to pursue medicine with the innate desire to help others. I have a strong sense of purpose and a deep commitment to both my family and the broader community, leading me on a journey from recognizing a passion for helping others to pursuing a career in medicine, particularly with a focus on internal and obesity medicine, showing a dedication to addressing significant health challenges.
I established a clinic near my hometown of Ann Arbor, Michigan, taking on multiple roles such as medical director, lead physician, and administration and marketing director. With combined professional expertise and a personal commitment to improving the well-being of those around me, I’ve managed to keep the clinic going and expand since our creation. Our clinic generates a monthly revenue of $85k, reflecting our success and growth.
Balancing clinical care with administrative and business development roles is no small feat. I’ve navigated a range of responsibilities with skill and adaptability, especially during the period of the COVID-19 pandemic. As we are all aware, the 2019 COVID-19 pandemic greatly affected all of us, particularly in the medical field. At the beginning of the pandemic, there were days when no patients came to our office.
Shortly after, more people became ill and sought medical needs, and urgent care became a first-line testing and treatment center. Due to this, we became one of the most sought-after centers, and our patient numbers quickly increased. We adapted swiftly to changes in providing clinical care and attending to our patients efficiently.
We went from a startup clinic to one of the most popular in the area, achieving the highest rank in urgent care as a general facility, both for small and large multinational corporations running the center. This was achieved through long nights of working 18+ hours a day and being nimble, allowing us to provide new strategies that offered excellent care for our patients while ensuring our clinic’s financial and operational success.
We were able to adapt patient care approaches while supporting our staff. As a result of our success, in 2024 we expanded to our second location and added multi-specialty services, including urgent care, primary care, and obesity care, to further provide needed services to the community and ensure additional operational success.
Through our expansion, we plan to continue our service trajectory with the expectation of opening more clinics in the coming years to provide more access to clinical care and ongoing operational financial success. We aim to become the center of excellence in all our specialties in every city.
What's your backstory and how did you come up with the idea?
I was born in the Ann Arbor, Michigan area, where I grew up. Living in this environment greatly influenced my upbringing and development of my general characteristics. Ann Arbor is a city that promotes higher education, personal improvement, and, more importantly, being a good human being.
It has always been our goal to ensure equal treatment for all, regardless of cultural or societal status, and to embrace the diverse populations throughout the community. As a result, I developed a keen understanding of how to navigate my upbringing in a unique community. I developed characteristics that promote empathy and putting others ahead of myself, as the golden rule says: treat others as you want to be treated.
From a very young age, through my family and personal involvement in my community, I was heavily involved in volunteering, with opportunities in both academics and social services, such as distributing food to those less well off, working in food kitchens, and developing educational programs to assist future generations such as tutoring and mentoring.
Through these experiences, I eventually decided to pursue medicine. Once I completed my training, I was unsure what setting I wanted to work in long term. I had all the tools to be a successful clinician, but I had no idea how to improve the lives around me beyond general medical care. I worked initially as a hospitalist physician, taking care of acutely ill patients, getting them better from that acute illness, then often not seeing them again.
During my time in the hospital, I noticed an ongoing shift in the medical system, and saw the “business“ of medicine rear it ugly head. As I saw its continued evolution through my years of training and initial few years of working as an attending, I observed how physicians were being devalued.
Through extensive investigation, I became acquainted with private practice owners and was able to see areas of effectiveness, but also where they were lacking in meeting the needs of the community. Given these opportunities and the tools available in the 21st century, such as the internet, advancing apps, I was able to utilize different technologies to enhance our service in providing care and meeting people’s specific needs.
Through my relationships with people from various fields, I was able to leverage their expertise to ensure my business models were financially viable and effective. Being a physician at my core, I also utilized the scientific method to analyze data and further calculate the unique business aspects of the medical field, including revenue value unit assessments and insurance payer models in the current medical climate.
I decided to pursue outpatient medicine so I could create meaningful change in the community, connect with people in a more continued manner and also utilize all the most cutting edge technology to promote improved wellbeing, throughput and provide more efficient clinical care.
Take us through the process of building the first version of your product.
During my residency training in a large system in Western Michigan, I trained in Internal Medicine, taking care of all adult aged patients in both inpatient and outpatient settings. During my first few years, I developed my skills as a clinician. In my third year, I worked in an administrative role within the department as a chief resident providing clinical and administrative expertise.
Through my unique experiences in both clinical and administrative areas, I was able to see both the triumphs and failures of the service aspects of the healthcare system. After completing my training, my experiences as a physician further allowed me to identify the unique needs of medical care in America. I went on to create relationships with business technology experts and was able to see how we could effectively integrate other industries into the medical field. Given the unique time and great technological advancements, especially in software and AI, we established a better service-based medical practice.
In the early days of developing a new clinic in established locations where large systems prevailed and controlled patient flows, it was evident that without patients, a medical business would not be successful. The only way to compete was through exceptional care and service.
We utilized online scheduling software before this was routine and used the available data to enhance both service delivery and marketing abilities, directly correlating with our reputation as a center of excellence and a leader in the community despite our competing with large corporate backed entities.
Incorporating diverse technologies significantly increased our visibility and allowed us to directly target individuals seeking specific services. Once patients stepped through our doors, they consistently returned and referred us to their families and friends, largely due to our unique patient engagement strategies utilizing a variety of technologies and softwares.
Our current patients value the personalized care we provide, which fosters loyalty and referrals. Additionally, our marketing efforts are robust, combining grassroots techniques of going to schools, billboards, community outreach with sophisticated digital marketing strategies as well.
We leverage advanced SEO practices and targeted paid advertising to reach new patients and enhance our online presence as well as use of social media, email marketing to further educate our community and provide them what they are seeking.
No knowledge is more helpful than experiential knowledge
Describe the process of launching the business.
Obtaining the necessary permits, licenses, and architectural design for our medical practice took about 12 months. This timeline varied depending on the city's planning and coding requirements, and we experienced significant delays due to these factors.
Overall, the development process, from concept to opening, including website design and finding a suitable development partner, took an additional 3 months.
In total, it took approximately 1 year to open our doors and begin seeing patients. Despite not seeing patients during that first year of development, we saw a few patient per day initially during our first 3 months. Then we were able to see a 50% increase in patient volume within the next 3 months of operation.
While competition was fierce with multiple organizations operating in the same space, the nature of the medical field—where people are always seeking the best care—played to our advantage. As a result of our focused efforts, we made a significant impact on the local community within the first 6 to 12 months.
It took about 3 years to establish ourselves as a major player in the field and 5 years to establish ourselves in our current state.
Additionally starting a medical practice involves substantial initial cost investment. Costs include day-to-day operational expenses, salaries for specialized staff, and the architectural design and construction of the facility.
Additionally, expenses associated with advanced medical equipment and technology, as well as the recruitment and training of skilled professionals, must be accounted for. These costs include obtaining permits and licensure. As an outpatient facility offering urgent care, primary care, and obesity care, we required appropriate imaging and designs, which added further costs.
In the mid-2010s, the total cost was around a million dollars, with real estate costs quickly bringing the startup total to between $1-2 million if purchasing real estate in most locations.
Since launch, what has worked to attract and retain customers?
First, through word-of-mouth from exceptional care: Our commitment to exceptional patient care has lead to strong word-of-mouth referrals from our current patients, which significantly contributes to our growth and reputation.
Second, we implemented a robust patient acquisition campaign utilizing a comprehensive strategy that includes paid advertising. Our approach also includes retargeting campaigns to engage users who have previously interacted with us.
We also implement strategic email campaigns to reach out to past patients and those who have shown interest but have not yet scheduled an appointment. Our emails provide valuable information and updates tailored to the needs and interests of our recipients.
The initial financing for our medical practice was primarily achieved through diligent savings and living below my means over several years. In addition, I received valuable assistance from friends and family, who provided no-interest loans during the startup phase.
The remaining funds were secured through traditional bank financing. We did not utilize any Kickstarter or crowdfunding platforms in this process.
When pursuing a business, having expertise and experience is crucial, but one of the most important factors is taking risks and being dedicated to your craft.
How are you doing today and what does the future look like?
Our primary location in Canton, Michigan has been successful, allowing us to grow and expand. We initially had 2 employees and currently have 9 full-time staff members, with additional part-time employees as well total 15 employees.
We have expanded to Ann Arbor, MI in 2024, and now each of our locations features two unique practices, providing comprehensive multispecialty care: Urgent Care & Occupational Medicine, Primary Care and Medical Weight Loss/Obesity Medicine.
Ongoing specialized recruitment and internal employee development are key to our growth. We are committed to continuing this trajectory and plan to expand to 1-2 additional locations within the next few years.
This expansion will be strategically planned to meet the needs of the local communities and ensure that we deploy services effectively and keep our current excellent standards as while business development is one of our goals, also provided excellent care and customer service are our other primary objectives.
Through starting the business, have you learned anything particularly helpful or advantageous?
No knowledge is more helpful than experiential knowledge. Unfortunately this can be difficult dealing with in real time. Lessons learned during the start up and scaling process include detailed planning and resultant flexibility and adaptability. It is crucial to have a meticulously crafted and viable business plan.
However, it's important to expect that things will not always go according to plan and to remain flexible. Ensure that you have a backup financial plan and backup options when things don't go your way. Maintaining sufficient financial reserves is vital, as initial finances may be slow despite your best projections, and you might not draw a salary for a substantial period of time.
The thought is to acknowledge that the startup phase is happening versus saving more with a salary. Navigating competition is the next aspect I have learned many hard lessons from: Competing as a smaller player in a large market is challenging.
Understanding this dynamic and being prepared for it can help in strategically positioning your business.
Understanding your value proposition to the public is key. While unique value is beneficial, simply doing things better than the competition without reinventing the wheel, is also of utmost importance and understanding.
What platform/tools do you use for your business?
By integrating diverse tools and services, we optimized our operations and enhanced our patient care and outreach efforts. We ensure that billing is handled appropriately by selecting high-quality, specialized billing services.
We use a range of Google utilities, including ads to manage our online presence and streamline operations along with proprietary partners for reputation management. Online scheduling platforms are also employed to facilitate patient appointments and text based communication to reach patients where they are rather than expecting people to adopt our processes only.
For niche projects and specialized tasks, we also engage freelancers through platforms like Fiverr and Upwork. We maintain strong relationships with reputable digital agencies to support our marketing efforts.
Internally, we utilize CRM tools to evaluate and manage data, ensuring that lead generation is optimized and followed up correctly to make the most sound financial and data driven decisions.
What have been the most influential books, podcasts, or other resources?
I highly recommend "Atomic Habits" by James Clear to both employees and patients. This book is instrumental in building and reinforcing the necessary habits for success. It emphasizes that success is not solely dictated by innate abilities but is largely a result of daily small habits, persistence, and dedication.
We often see that highly “intelligent” individuals may struggle with motivation and productivity and never achieve the success expected of them, while those with less traditional acceptable definitions of “intelligence” who work diligently and consistently achieve significant success. Success comes from a combination of hard work, dedication, and persistence with perseverance more than anything else.
For those who may not have time to read extensively, I recommend using the app Blinkist. This app condenses a wide variety of books into brief, high-value summaries (10-45 minutes), allowing users to quickly grasp essential and meaningful insights and incorporate them into their daily routines and habits. While detailed reading is beneficial, focusing on high-level principles and integrating them into your daily work ethic and routine can also be highly effective.
Advice for other entrepreneurs who want to get started or are just starting out?
When pursuing a business, having expertise and experience is crucial, but one of the most important factors is taking risks and being dedicated to your craft. Success does not come easily or quickly; it requires ongoing development and a willingness to try, fail, and try again.
It's essential to push beyond your comfort and continuously strive to improve. No matter what field you are in, you must be willing to embrace the possibility of failure as a stepping stone to success. The key is to work hard every day, learn from setbacks, and keep making progress despite challenges.
Don’t let failure deter you from your goals—use it as an opportunity for growth and perseverance.
Are you looking to hire for certain positions right now?
We are constantly hiring and always open to collaborating with experienced professionals and clinical providers who align with our goals. It’s important for us to work well with others, regardless of their capacity—whether they are PRN, part-time, or full-time staff.
Cultural fit is crucial to our team, and we value dedication, hard work, empathy, and being generally a good person more than anything else. These qualities are essential for fostering a positive work environment and achieving our collective goals.
Where can we go to learn more?
MI Express Urgent & Primary Care’s Online Presence:
- Website: Our official website for MI Express Urgent & Primary Care serves as the central hub for information about our services, locations, and patient resources. It offers easy navigation for booking appointments, accessing health information, patient portal and contacting our team. MI ExpressCare
- Facebook and Instagram: Our Facebook and Instagram pages are actively managed to engage with the local community, share updates, health tips, and promotions.
- MI ExpressCare Canton Urgent Care Facebook
- MI Express Primary Care Ann Arbor
- Bio
- Company Instagram
- MI Express Primary Care in Canton, MI
By maintaining an active and engaging online presence across these platforms, MI Express Urgent & Primary Care Michigan aims to effectively communicate with our community, provide valuable information, and promote our services.
Our Canton Practice Images:
Our Ann Arbor Practice Images:
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Download the report and join our email newsletter packed with business ideas and money-making opportunities, backed by real-life case studies.
Download the report and join our email newsletter packed with business ideas and money-making opportunities, backed by real-life case studies.
Download the report and join our email newsletter packed with business ideas and money-making opportunities, backed by real-life case studies.
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