Running Your Medical Practice in Ontario – Growth, Profitability, and Long-Term Success
When It’s Time to Thrive
Getting licensed and starting work in Ontario a process in and of itself... a sprint to the start line. As an American physicians considering or starting practice in Ontario, you want to think through the credentialing and set yourself up for long term success. Ultimately, the goal is to have a practice and business (medical professional corporation, partnership or running a clinic) that’s profitable, sustainable, and personally fulfilling. Here are some of the key insights you need to actively manage your growth and adaptability in an always changing world.
This guide covers the mindsets, tactics, and systems that will help you level up your professional service business smartly.
Step 1: Remember Your Revenue Drivers
Topline revenue and overhead percentage mean nothing without gross profit. Focus on:
Maximizing revenue per patient visit - smart and careful planning of your lists and ensuring all patient information is properly charted will help make this easier.
Streamlining practice overhead - remember that it’s not about getting the best possible rate, it’s about finding the win-win where it’s in the practices interests to invest more in your income. If you make more $ at the end of the billing period, it may well be worth a higher % on your contracts.
Finding billing codes and services with the best returns on time - Within the bounds of what’s legal and appropriate, you must always consider not just which codes work, but though OHIP, you should always consider the nuances that matter, including but not limited to code prefix, suffix and modification codes.
Quick Wins:
Master OHIP bundled codes for common consults
Add complementary services (e.g., ECGs, minor procedures, etc. when appropriate as in Ontario, there are few premiums paid for extra visits in clinics.)
Monitor cost per dollar earned weekly, or income per day or month in different practices to help you made good decisions on your effort : income ratio.
Step 2: Build Operational Efficiency
Busy is not the goal. Profitable is. Probably the most important advice and concept we share with professionals. Professionals tend to believe their time and effort is worth more than they are paid, because their effort and time invested to become a professional is substantial. They however don’t always value other people’s value as they project years in school or other experience as the benchmark of value. In business, that isn’t the determining factor. In business, the goal is to SAVE time, build trust and improve financial return. If you pay a person $5 an hour above market rate, that turns into $10,000 a year. If that investment gets you a person who helps you recover or generate that much a much in increased efficiency, the investment is worthwhile.
Systems you need:
Admin support: Hire smart, not cheap!
Billing audit: Review claims regularly for errors, leaks and missed opportunities
EMR optimization: Fast, well-prepared templated charting = better throughput and higher billing ROI
Patient flow improvements: Reduce wait times = more visits/day
Step 3: Protect Against Burnout
Burnout is the silent killer of physician careers, and while unlimited volumes of patients and a seemly easier insurance payer system sounds frictionless, you must remember you’re your #1 investment - and you deserve to be put first!
Keys to protect yourself:
Habit stack daily admin tasks to avoid backlog
Invest in scheduling systems that balance volume + downtime
Outsource everything that takes time away from your highest and best use, and everything that drains you (e.g., bookkeeping, HR, billing)
Step 4: Track Metrics That Matter
Forget vanity metrics like gross billings alone. Focus on:
Gross profit margin
Net collections rate
Revenue per clinical hour / day / period net of all fees
Overhead as a % of revenue and if a % change will increase or reduce your income
We use our Clarity solution dashboard (but even simple Excel sheets can do the trick) to track and adjust every quarter.
Step 5: Strategic Growth Doesn’t Always Mean Change
When you’re settled into practice and ready to grow:
How should you grow? More physicians, allied health services that are complementary, integrating pharmacy… there are many options. Think about what adds the most value to your patients, what you would be most excited by in your practice vision, and then find your path…
Consider different hours or locations of practice to find higher returns for your energy, time and interests
Offer new services aligned to your specialty (e.g., group visits, research, etc. )
Stay focused: Grow capacity only when your margins justify it.
Helpful Resources
Questions + Answers
1. How can I grow my medical practice in Ontario?
By focusing on patient flow, efficient billing, lowering overhead, and tracking key financial metrics.
2. What are the best billing codes to maximize OHIP revenue?
Codes that bundle services (e.g., consult plus ECG) or offer premiums for complex cases maximize your billing efficiency.
3. How can I improve clinic profitability in Ontario?
Increase visit efficiency, optimize billing, control overhead, and add profitable ancillary services.
4. What is gross profit margin in a medical practice?
It’s revenue minus direct costs. High gross profit means you keep more of what you earn after paying clinic expenses.
5. How can I track my practice’s financial health?
Use simple dashboards to monitor gross profit, overhead ratio, and net collection rate monthly.
6. Should I hire admin staff for my practice?
Yes. Proper administrative support increases billing accuracy, patient satisfaction, and your personal efficiency.
7. What causes physician burnout in Ontario?
Overwork, poor admin support, inefficient billing systems, and lack of personal time are top contributors.
8. How do I prevent burnout as a doctor?
Automate tasks, delegate low-value work, maintain work-life balance, and protect your mental health proactively.
9. When should I consider hiring another doctor?
When patient demand exceeds your available hours and when profit margins justify expansion.
10. Can offering private services boost income?
Yes. Non-insured services like cosmetic treatments, travel medicine, or wellness consults can enhance profitability.
11. How do I set overhead targets for my clinic?
Aim for 20–30% overhead as a percentage of gross billings, depending on the services and support provided.
12. How often should I audit my billing claims?
At least monthly. Early error detection prevents major revenue losses over time.
13. Can I use an EMR to increase efficiency?
Absolutely. EMRs with billing integration and templated notes speed up workflow significantly.
14. How can a new specialist attract more patients?
Network with referring physicians, optimize your online presence, and provide exceptional service to build word-of-mouth.
15. What’s the best way to increase practice revenue?
Focus on seeing more patients per day while maintaining care quality, and add complementary services.
16. Can I build a group practice in Ontario?
Yes. Once established, you can add associates, allied health professionals, or even specialists under one roof.
17. Should I consider remote care options?
Yes. Virtual care is growing and can be a revenue booster while improving patient access.
18. Is specializing in a niche valuable in Ontario?
Yes. Niche specialists often command better referrals and have less competition.
19. How do I find good staff for my practice?
Leverage healthcare staffing agencies, referral networks, and PFF’s vetted support partnerships.
20. Who can help me scale my practice?
PFF offers growth consulting, staffing solutions, and profitability coaching specifically for physicians in Ontario.
