How to start a clinic in Singapore
Starting your own clinic is an exciting and attractive venture that is a dream of many medical professionals. It gives you full control and autonomy over your practice and also provides more personalized and dedicated care to your patients, developing a closer and more loyal relationship.
In Singapore, starting your own clinic can be challenging and demanding. This guide will help you through the process of setting up a clinic in Singapore, including step-by-step processes such as registration, finance, hiring, and operations.
Starting a clinic in 2024? Here are the things to consider:
Why do you want to start your own clinic?
What are the types of clinics you can engage in?
Funding
How much money is needed to start a clinic
Prepare your Clinic’s Business plan
Name your clinic and create a logo
Pick a location for your clinic
Pick the right clinic business structure
Clinic Incorporation
Hiring
MOH Inspection
Partner up with Labs
Equipment checklist
Pick a CMS
Why do you want to start your own practice?
There are many reasons why practitioners choose to start their own clinics. Besides the obvious financial benefits, some doctors also prefer the freedom in running their own clinics and the personal relationships built with their patients.
It’s crucial for every doctor starting their own clinics to understand the rationale behind it, the driving force that’s motivating you in your practice, it will serve as your lighthouse and guide you through many hurdles ahead.
Some doctors enjoy the personal doctor-patient relationship. Some like the flexibility in time management. Others simply enjoy being their own boss.
You need to know what it means to you not only as a doctor but as an individual to start your own business.
What are the types of clinics you can set up?
There are 3 types of strategies you can engage in when starting out your own
Solo
Group
Takeover
Depending on your background and medical experience, you may prefer one over the other. Your career goals and financial situation will influence your choice as well.
Solo – Solo practice offers you full autonomy in every aspect of clinic operation, but you will have to bear the full initial startup cost yourself, which puts you in a more vulnerable position financially.
Pros: full autonomy, flexibility, 100% profit gain, no conflict, quick decision making
Cons: no financial support, sole responsibility and risks, restricted skillsets and knowledge, high start-up cost, and risk
Group – In a group or partnership clinic, your partner bears the financial risks with you. But it’s extremely difficult to find ideal partnerships that are long-lasting, sometimes even the most perfect partnership turns out to be, for a lack of a better word - disaster.
If you manage to find the right partner or partners, lucky you, you’ll get to enjoy a more pleasant and less abrasive partnership clinic. But if you’ve picked the wrong partner, you are in for a really bad time, especially in the event of a split, not much different from picking your spouse!
We recommend you go through a thorough and detailed selection process to pick the best partner option. Shortlist a list of suitable partners, work out pre-agreed terms with them, including profit shares and split terms, then select the best option. This is usually defined in the partnership agreement or articles of association documents.
Pros: financial support, shared responsibility and risks, a larger pool of skillsets and knowledge,
Cons: no autonomy, no flexibility, profit-share,
Takeover – Taking over an existing clinic can often be the fastest option as you get to avoid renovation from the ground up, skip part of the setup process, have the clinic’s existing customer base instantly, and maybe even remove the long-drawn hiring process if you decide to keep the existing staff. But clinic takeovers can be extremely expensive, takeover fees can easily be in the six figures, especially if the location is good.
We also recommend you do a series of due diligence checks on the clinic before taking over. One way you can do this is by going through the clinic’s reviews online, such as Google My Business listing reviews.
Pros: full autonomy, flexibility, 100 profit gain, no conflict, quick decision making, lower start-up cost and risks, instant patient traffic
Cons: no financial support, sole responsibility, and risks, restricted skillsets, and knowledge,
Since 2015, UNO Technologies have helped medical professionals set up their businesses. We know how difficult and challenging it is for doctors to start out on their own. We hope this guide can help in the process.
Planning to start a private practice in Singapore?
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Funding
Starting up your own clinic can cost you a lot. If you are starting your own clinic from the ground up, you need to pay for rent, renovation, equipment costs, license fees, salaries, utility bills, and various other costs.
At some point in your startup venture, you might need to take a loan or look for funding. Taking a bank loan is simple, but funding raising involves the sale of clinic ownership to investors. The funding from investors can either be in equity, debt, or hybrid forms - terms should be thoroughly discussed between you and your investors before starting a venture.
There are generally 2 sources of funding:
Bank loans
Investor
How much money is needed to start a clinic
Starting your own clinic can be quite expensive in the early months. The cost of starting a medical clinic can be somewhere from SGD $80,000 to $120,000 if you start from the ground up, this will include rent, inventory, payroll, insurance, renovation, furniture, equipment, clinic software, and various other miscellaneous bills.
If you are starting a solo practice it will be the most expensive option, the cost can easily go up to 6 figures. For group practices, your financial burden is lesser as your partners will share the cost with you. As for takeovers, it can vary depending on the clinic.
If you can takeover an existing clinic for a low cost, it will be your cheapest option as you can save a lot on the renovation, equipment, and hiring. You can also almost guarantee instant patient traffic from the clinic’s existing patients.
What’s your Business plan?
We recommend you prepare a comprehensive business plan. After all, your clinic is a business and you want to be profitable. So naturally, the business aspect of things can’t be neglected.
Your business plan should at least contain the following:
Company V.M.O
Service offered (GP, specialist, dental, physio, other)
How to market your service (follow PHMC)
Operational strategy
Manpower
Finance
Company Vision, Mission, Objective (V.M.O)
This is about your clinic’s long-term vision and short-term goals, the service you provide, and the niche market you operate in. Having a competitive edge will help you survive in the competitive market and the key to your business success.
Service offered (GP, specialist, dental, physio, other)
This part is subject to your personal experience. For doctors who’s been in the primary care for a long time, they will definitely opt for General Practice (GPs). The same applies to the rest.
How to market your service
If you intend to run any form of marketing or advertisements, be it online or offline, you must follow MOH’s Private Hospital and Medical Clinic Act (PHMC), failure to do so and you could be fined or suspended from practicing.
Healthcare agents can also bring in foreign patients to your clinic. Singapore is well-known for being a Healthcare Hub in the region, foreign patients seeking medical treatment in Singapore can be a great source of revenue for you. Do note that if you overcharge foreign patients you may face legal actions.
Since COVID-19 in 2020, the need for Telemedicine and Artificial intelligence software for doctor-patient communication has been increasing drastically. Private clinics could leverage this amid the poor economy caused by COVID-19.
Operational strategy
Your operation strategy will determine how competitive you are in the market. The efficiency in your daily operations can help cut costs, speed up workflow, and allow you to see more patients.
Private clinics should be going paperless by engaging in a cloud-based clinic software, this minimizes the need for manual filing. Administrative tasks such as inventory management, patient scheduling, queue management, invoices should all be automated. So that your staff and yourself can pay more attention to what really matters, your patients.
Prepare a list of software and equipment you require in your operations to help you manage your clinic more efficiently.
Manpower
A skilled and professional medical staff is rare and expensive in manpower-deprived Singapore. Getting the right employee and retaining them will be a tough task. Doctors need to know exactly what they want from their employees and how to keep them.
Finance
Maintaining a healthy cash flow is crucial for the sustainable growth of your clinic. It’s important to get your clinic’s financials in order to avoid unnecessary stress from financial woes.
Projecting your clinic’s cash flow for the next couple of years, estimated time for break-even. You should let a professional accountant handle this task.
So what’s the name of your clinic? What about your logo?
After you completed your business plan, it’s time to give your clinic a name and create a clinic logo.
Choose a name that’s easy to remember, it shouldn’t be anything offensive. You also can’t use the word ‘Singapore’ and ‘National’ in your name without approval from MOH. You may check with MOH guidelines for the exact details
Run a name check with Singapore Company Incorporation to make sure your name isn’t taken yet. Then you can proceed to register your business name with Singapore ACRA.
Create a memorable logo for your clinic. Again, it shouldn’t be anything offensive. It should be something well designed that’s going to feature in many of your marketing materials. Hence, we strongly recommend hiring a professional designer to do so, it’s worth the money.
Where will your clinic be?
You need to register your company’s address before incorporation. Competition for business locations can be stiff and costly.
The cost of rental in Singapore has gone up exponentially since the pandemic started. Commercial units at popular areas or shopping malls are going for $15 – $20 psf. Which means for a 500 square foot clinic, you will have to pay between $7,500 - $10,000 per month, plus a stagger amount of deposits. Even at such a high price, you will still face stiff competitions.
For family physicians, GPs, and dentists, areas with high population density and traffic will be a good choice, preferably residential areas that are convenient and accessible for patients.
Cost of rental for commercial units near residential areas can range from $5 - $12 psf, which is about $2,500 - $6,000 per month for a 500 square foot clinic.
For specialists and allied health practitioners, you may consider CBD regions, medical centers, or hospitals, the rent may be higher in those areas but medical centers and hospitals usually carry a good reputation in healthcare that can enhance your clinic’s name and brand.
We don’t recommend overspending on rent and end up having cash flow issues. Allocate a budget for rent and pick a location within the budget.
When picking a location, you must know the following regulations
Zoned for commercial use
Up-to-date with building codes and fire safety protocols
A Fire Safety Certifications (FSC), which you can get from Singapore Civil Defence Force (SCDF) through a registered architect or engineer before occupying the building
Approved for medical operations by Urban Redevelopment Authority (URA)
Approved for design and layout by the Central Licensing Branch (CLB) of MOH. An on-site inspection will follow as part of the licensing process.
Certified by the Building and Construction Authority (BCA) for any building works.
Advertisement Licence from BCA if your clinic has an outdoor advertising sign or signboard.
Picking the right clinic business structure for you
Selecting the right business structure is important as it affects your clinic’s business activities, growth, benefits, and liabilities. Two common business structures are sole proprietorship and private limited company (Pte Ltd.).
Sole Proprietorship
The owner and business are of the same entity
The owner will be liable for all business deals
The owner’s personal assets can be liabilities to the creditors.
Should the owner cease operations, retire, or in the event of death, the business will cease to operate as well.
Business funding comes from personal fund and loans
Taxed according to personal income tax of between (0 – 22%)
Clinic ownership transfer will be difficult
Setup, maintenance, and termination of the clinic will be easy
Private Limited Company
The business is an independent legal entity
Shareholders and investors are liable within their investments in the business
The owner’s personal assets are not liable to creditors
The business continues to operate in the event of any shareholder’s death or retirement
Business funding comes from partners, venture funding, and loans
Taxed at corporate tax rate of 17% with the potential benefit for tax exemption
The clinic’s ownership transfer is easy
Setup, maintenance, and termination of the clinic will be difficult
Even though a sole proprietorship might seem like the go-to choice for solely-owned businesses, the financial risk is high and does not work in favor of entrepreneurs. Pte. Ltd., on the other hand, is an attractive business structure as it protects the owner’s personal assets from business liabilities—unless there are proven fraudulent intentions—offers attractive corporate tax benefits, and provides flexibility for growth. Registering your business as a Pte. Ltd. Is common in Singapore and the recommended path to take.
Incorporating your clinic
After you have registered your practice name and chose your business structure, you can now prepare for incorporation.
There are some pre-registration requirements you have to fulfill:
Appointed at least one director who is locally resident in Singapore.
Anywhere between 1 and 50 shareholders.
A locally registered address for your company.
A corporate secretary who must be appointed within 6 months of incorporation.
An auditor who must be appointed within 3 months of incorporation.
Decide on your Financial Year End (FYE).
Minimum issued capital of S$1. Upon incorporation, issued capital must be paid up immediately and deposited into the company’s bank account for business use.
The company constitution ready
And a list of documents to prepare:
Registered and approved business name.
Brief description of the business’ activities.
Company's registered address in Singapore.
Particulars of the director(s), corporate secretary, and shareholder(s).
Locals must provide a copy of their Singapore identity card.
Foreigners must provide a copy of their passport and proof of overseas residential address.
When everything is done correctly, now you are ready for incorporation:
Log in and register on BizFile using your Singpass
Foreigners are to engage in a filing agent for the process
There are also loads of businesses that provide corp sec, auditor, and business registration services. Just do a quick google of “corporate services Singapore” and pick the right provider for you
Who to hire?
Now that you’ve registered your business and got a location, you are ready to recruit some staff.
Clinic manager
Your clinic manager will oversee your clinic’s day-to-day operations. He/she will:
Hire/train/manage clinic staff
Allocate a budget for clinic operations
Carry out administrative duties (e.g. ensure all licenses are up-to-date, oversee financial records and billings)
Work closely with various stakeholders
A good clinic manager should be:
A leader and team player
Well Organized
Has good problem-solving skills
Strong written and spoken communication skills
Strong ethics
Solid understandings of the laws and regulations governing clinics
Has a good understanding of how various third parties—corporations, labs, and hospitals—work with a clinic
Prior experience working in healthcare-related field
If you are a Doctor going into the private healthcare sector from the public healthcare sector (i.e Public Hospitals). An experienced clinic manager from the private sector will be extremely helpful in your setup process and day to day operations.
Clinic assistants
Clinic assistants will:
Handle clinic’s administrative tasks (e.g. insurance claims, billing/payments)
Manage and schedule appointments
Register patients
Prepare consultation rooms
Assist doctor in the consultation room
A good clinic assistant should be:
Strong written and spoken communication skills
Empathetic towards patients, warm and friendly
Responsible, well organized and detail-oriented
Able to handle pressure and difficult patients
Patience and manners
Integrity
Strong ethics
Bilingualism (if your clinic requires)
Nurses
Your clinic’s nurses will:
Cater to patients
Record patients’ vitals/medical details
Assist the doctor during medical examinations/clinical procedures
Answers questions about and explains medical treatments/procedures to patients
Provide comfort/counseling to patients and their families
Handle basic administrative tasks
Order and maintains medical supplies
Liaise with labs or other medical facilities for patients’ tests/follow-up consultations
A good nurse should be:
A registered nurse in Singapore
Has a valid practicing certificate from Singapore Nursing Board
Good knowledge and understanding of the legal obligations in nursing practice
Empathetic towards patients
Effective written and spoken communication skills
Strong ethics when executing quality nursing practices
Leader and team player
Good problem-solving skills
Strong management and leadership skills for registered nurses
The above 3 medical-related roles can be hired via online job portals, SMA, government programs, and other networks.
Secretary
The clinic secretary is in charge of fulfilling the company’s administrative duties and ensuring business compliance with statutory regulations. Failure to do so can result in fines, penalties, or both.
The company secretary must be a natural person and local resident in Singapore. The sole director of the company and the secretary can’t be the same individual. Hiring a secretary must be done within 6 months of company incorporation.
You will want to look for a secretary that’s
Proficient in corporate governance - strong knowledge of company activities to execute relevant filings to avoid fines.
Well organized – Able to meet deadlines and complete all administrative duties and tasks.
Excellent communication skills – Able to communicate in written and verbal format with internal and external parties.
Accountant
The accounting role in a clinic business is something that requires certifications, qualifications such as the Certified Public Accountant (CPA). Many clinics have tried doing their own bookkeeping to save money, which totally understandable as long as you understand the basics of taxation and your business doesn’t have too many shareholders involved.
However, it’s still recommended to delegate this role to the professionals to avoid making mistakes when doing your own bookkeeping, and it saves you plenty of time too.
A certified accountant can provide you with proper taxation and an overview of your clinic’s financial health. Since clinics are largely cash based-businesses, it’s always beneficial to know your business health and have the accounts ready. When your clinic’s revenue grows beyond S$1 million, you will need to register for GST and your business will need an audit, so a standardized accounting process along the way is good preparation for the audit.
If your business is just starting out, the best way is to simply outsource the accountant role to a CPA, since you don’t really need a full-time in-house role yet.
Also do take note of some points covering Employment law:
If you are hiring Singaporeans or Permanent Residents (PR), you will need to pay monthly CPF contributions. If you are hiring foreigners you will need to pay a foreign worker levy.
MOH inspection
You will need to pass the MOH inspection in order to open your new clinic and obtain your clinic license. The documents that you will need to apply for a clinic license are:
ACRA profile
Fire safety certificate
Clinic floor plan
NEA Licenses for radiation-emitting equipment (e.g. x-rays, lasers, ultrasound machines)
Read MOH’s guidelines for important information to know before applying for a clinic license and the detailed application process.
Complete your clinic renovation before MOH inspection. Any incomplete renovations could result in rejection. Schedule MOH inspection at least 2 months before your clinic’s commencement date.
Prepare your Clinic Management System (CMS) before the inspection. You will be asked about the CMS used during inspection, so make sure you have a CMS prepared.
During the inspection, your will need to have at least 1 clinic staff present who will explain your clinic’s operations to the inspectors. Be punctual for the inspection, do not be late.
The inspection result will be released to you within a week. If there are any areas of improvement, you must make the changes and update MOH in writing.
*Licenses are valid for two years and have to be renewed afterward. You will also be eligible for 5-year license if you show full compliance for 2 cycles.
Partner up with labs
A good and lasting partnership with laboratories can be very beneficial to both the clinic and your patients. You get the benefit of convenience in terms of sending test samples and receiving test results, as well as the option to customize subject to doctor’s needs.
A few big laboratories in Singapore are:
Innovative Diagnostics and Quest Laboratories
Parkway Laboratory Services
Reste Lab
Eurofins
The partnership with labs can be set up and integrated easily with the help of a CMS provider. They can link you with labs directly through their CMS.
NEHR & Healthier SG for new Clinics
If you are a practicing Doctor in Singapore, you would have definitely heard of the National Electronic Health Records (NEHR) and Healthier SG (HSG) initiative by MOH. Both NEHR and HSG will play a key role in GP clinic’s operations in 2023.
The HSG will be a major transformation of Singapore’s healthcare system towards population health, Every Singapore resident will be assigned a GP Doctor of their choice to manage their long-term health.
The GP Doctors assigned will have the duties to:
1. Manage and deliver preventive health to the residents
2. Develop health plans for lifestyle adjustment, health screening, and vaccinations
Healthier SG is expected to start by mid 2023. HSG enrolment for Singapore residents age 60 and above will start in second half of 2023. For age 40 – 59, enrolment will start in 2024.
How can new GP clinic startups prepare for HSG and NEHR?
To take part in HSG and contribute to NEHR, new GP clinics will need to be on a clinic management system meeting the following criteria:
· NEHR integrated and ready
· IHiS SmartCMS Gold Tier (tier 1)
· HSG requirements by IHiS
· HSG compatible with HSG modules
Equipment checklist
Your clinics should at least be equipped with the following equipment:
Temperature screening and SafeEntry/TraceTogether registration equipment
Autoclave (need to register with MOM)
Automated external defibrillator (AED)
Audiometer
Basic diagnostic equipment
Pantry appliances (e.g. coffee machine, microwave, refrigerator, cutlery, etc.)
Clocks
Colposcope
Computers, printers, payment terminals
Emergency equipment and supplies
ECG unit and accessories
Examination tables
Body or eye charts
Janitorial equipment (e.g. vacuum cleaner, mop, sanitizers, etc.)
Laboratory diagnostic equipment
Procedure tables
Protective equipment (e.g. gloves, aprons, eyewear, facemasks)
Specialized lighting
Stainless steel equipment
Step stools
Stethoscopes
Telephones
Televisions/Queue Screens
Water filtration system
Weight scales
Wheelchairs
Clinic Management System
Label Printers
Computers & Peripherals
Queue Management/Ticketing System
Personal protective equipment (PPEs)
Inventory/Medicine storage space (MOH compliant)
PICK A CMS for your clinic
A good clinic management system can save your clinic plenty of manpower and time. A flexible and scalable CMS can bring plenty of benefits to your clinic.
Reliable - A good CMS should at least be reliable; you shouldn’t encounter downtimes or errors when using the software. Neither should the software have frequent maintenance work that disrupts your clinic’s operations.
Streamline and automate workflow - Automates as many administrative tasks as possible to reduce the manual labor required. Your CMS should help you with patient registration, appointment, and queue management.
Improved efficiency – Doctors and skilled nurses should not be doing any tasks that don’t require a medical degree. Your clinic staff should not be overburdened by repetitive administrative work. A digital CMS that’s cloud-based can simplify the filling process.
Technical support and training – A good CMS vendor should provide you with adequate training to learn how to use the software. It should also provide timely technical support whenever there are software-related issues.
Accounting, billing, and audit - Make your account’s life easier by using a CMS to help them with accounting reports.
Scalable - Your CMS should not limit the growth of your clinic; it should grow with you. A fully scalable CMS should scale to your business growth.
Onboarding, off-boarding, and data migration – Your should own 100% of your data, your CMS absolutely should not hold your data back or give you unusable data when you change CMS.
NEHR integrated and HSG compatible – If you are planning to start a GP clinic in 2023, you must be on a CMS that is NEHR integrated and HSG compatible. So that you can make contribution to NEHR and take part in the HSG initiative.