Taking Over a Medical Practice: What to Ask Before You Say Yes

Have you landed what many consider the “gold mine”? Taking over a medical practice from a retiring physician or someone relocating can feel like the dream scenario.

You inherit a patient roster, office space, maybe even a seasoned team. It’s the ultimate “hit the ground running” moment.

And sometimes, it truly is.

But before you assume it’s plug-and-play, let’s talk about what taking over a medical practice actually means, because that phrase can cover a wide spectrum.

What Does “Taking Over” Really Look Like?

Not all transitions are created equal.

On one end, the outgoing physician has intentionally wound things down. No pending consults. No consented OR cases. No lingering long-term follow-up patients. In this case, you’re inheriting resources – but building your own patient list.

On the other end? They work at full speed until their final clinical day…and you step into a schedule full of pending consults, consented operative patients and long-term follow-ups.

That’s a very different experience.

Especially as a specialist, you may spend your early months managing patients mid-course in their care. And let’s be honest, every one of us has nuance in how we practice. You’ll be navigating their style and your own.

This is why clarity upfront matters.

(If you’re early in your journey, revisit What You Need to Know Before Starting a Practice for foundational considerations.)

Is There a Transition Period?

When taking over a medical practice, ask: is there an actual transition plan?

Are you sharing space while they wind down and you ramp up? Is there an educational overlap? If so, for how long – and what does that look like?

In some settings, this is formalized in your contract (a good time to review your agreement carefully).

Transitions can be incredibly valuable. They can also be awkward. Especially when you’re the new attending trying to ask uncomfortable questions.

Ask them anyway.

Clarify timelines. Clarify how resources are divided. Clarify what happens with patients.

If you’re fee-for-service or in independent practice, this isn’t just about patients, it’s also about your income. (Check out What Is Your Hour Worth? for a helpful mindset shift.)

And whenever possible? Get it in writing.

What About Pending Consults and Long-Term Follow-Up?

This is a big one.

Are there pending consults? Are you expected to take them over? Do they align with the type of practice you’re trying to build?

What about long-term surveillance patients: oncology follow-ups, chronic medication monitoring, procedural surveillance? What are happening with these?

If your specialty involves longitudinal care, you need to know whether you’re assuming that responsibility immediately, or whether your predecessor will continue managing those patients.

When you’re taking over a medical practice, vague assumptions are not your friend.

What’s Included Beyond the Clinical Work?

As they say: the devil is in the details.

Are you inheriting staff? An office lease? Equipment? Vendor contracts? Supplier relationships?

If there’s an admin in place, who pays their salary? How is overhead split? Who runs the accounts?

Even in a collegial group of great humans, ask about the numbers.

What’s the lease situation? Are contracts up for renewal soon? What are the real monthly overhead costs?

If you don’t ask, you won’t know – sometimes until something unexpected happens. And unfortunately, things can happen.

Final Thoughts

Taking over a medical practice can absolutely be a fantastic way to start strong.

But strong starts come from clear expectations. Ask the questions. Even the awkward ones. Especially the financial ones.

You’re not being overbearing, you’re being responsible.

For those already in practice: what would you add to this list?