Why Most Healthcare Founders Underestimate Their Clinic Launch Timeline
Most healthcare founders think opening a clinic is a 6–9 month project. In reality, the journey from picking a market to treating your first patient often takes 15–24 months. The reason for the gap? The most common mistake founders make is consistently underestimating the timeline.
Healthcare real estate is unlike broader office space. Vacancy is tighter, competition for quality sites is higher, and the number of specialized tasks required between “lease signed” and “first patient” is far greater than most anticipate.
This guide breaks down the true timeline from selecting the right market to opening day and highlights the most common ways founders underestimate along the way.
Phase 1: Market & Site Selection (6–9+ Months)
Where founders underestimate:
Most assume they’ll find a site in 1–2 months. In reality, healthcare vacancy is extremely tight compared to general office, and the good spaces go fast. Layer on the unique requirements for clinical use — parking ratios, floor load, zoning compliance, accessibility — and the search can stretch into half a year or more.
Market Analysis (1–2 months): Identify submarkets that align with your care model, patient access requirements, and payor mix.
Site Identification & Tours (1–3 months): Vet a large pool of properties, knowing that only a handful will truly fit.
LOI & Lease Negotiation (3–6 months): The LOI and lease are often far slower than expected. Business terms (e.g., rent, operating expenses, renewal options, HVAC hours, medical waste, expansion options) take time to negotiate.
👉 Reality check: Rushing site selection is the fastest way to end up with a space that’s misaligned with your model — and an expensive set of change orders later.
💡 Pro Tip for De-Risking Timeline: Even at this stage, it’s wise to bring on a contractor under a Preconstruction Services Agreement. They’ll help evaluate sites, assess build-out feasibility, and flag hidden costs early.
Phase 2: Design & Permitting (20–30+ Weeks)
Where founders underestimate:
They think design is a quick set of drawings. In truth, it’s months of iteration — and permitting can take even longer.
Design Development (9–15 weeks): Architect-led schematic design (SD), design development (DD), and construction documents (CDs). This is the last chance to make significant changes without triggering massive costs.
Permitting & Plan Check (8–20+ weeks): Jurisdictional reviews often take longer than the construction itself. A plan examiner can send back multiple rounds of comments that stall your timeline.
Procurement (Ongoing): Founders often overlook that long-lead items — switchgears, HVAC units, custom millwork, medical equipment — must be ordered during design, not after. Missing this window can freeze construction for months.
👉 Reality check: The design phase isn’t where you speed up. It’s where careful planning prevents change orders ($$$) and catastrophic slowdowns later.
💡 Pro Tip for De-Risking Timeline: Start procurement during design, not after. Long-lead items for infrastructure, equipment, and furniture often have 16–20+ week lead times. Identify and order these items during the design phase to avoid months of delay.
Phase 3: Construction & Inspections (20–30 Weeks)
Where founders underestimate:
They assume once walls go up, the hard part is over. But inspections and vendor coordination are where projects most often stall.
Construction (20+ weeks): Includes demolition, framing, MEP (mechanical, electrical, plumbing), IT, and security rough-ins.
Inspector Management (Ongoing): Inspectors may interpret code differently than what’s in your approved plans. Managing this dynamic is an art — push back too hard and you invite delays; concede too easily and you rack up costs.
Vendor Coordination (Final Weeks of Build): Furniture, fixtures, equipment (FF&E), and IT infrastructure all need access to the site. Without a tightly managed sequence, the final weeks turn into chaos.
👉 Reality check: The build phase will slow down. Without a proactive GC and project manager anticipating inspector requirements and vendor timing, your launch date slips.
💡 Pro Tip for De-Risking Timeline: Build a team that can manage inspectors. A proactive GC and project manager will anticipate requirements and build relationships to mitigate delays. This is an art—not just a task.
Phase 4: The Final Push (4–6 Weeks)
Where founders underestimate:
They assume this is just “move-in.” In reality, this stage is a domino effect where one missed step can derail the entire sequence.
Vendor Domino Effect: IT infrastructure must precede security systems and A/V. Some municipalities require furniture in place before issuing a Certificate of Occupancy (CofO), while others won’t allow it until after. Mis-sequence this, and you’re stuck in limbo.
Final Inspections & CofO (1–5 weeks): The jurisdiction’s approval is the final milestone. Delays here can push your go-live by weeks.
Setup & Punch Work (2–4 weeks): Furniture installation, medical supply stocking, IT setup, deep cleaning, and final punch list corrections.
👉 Reality check: This phase feels like the finish line, but it’s where morale is tested. Without precise sequencing, you risk a “death by a thousand cuts” that delays patient care.
💡 Pro Tip for De-Risking Timeline: Create a detailed vendor choreography for the final push and track it weekly. The handover from construction to operations is a delicate sequence where one missed step (e.g., internet installation) can cause a domino effect. Have a plan for every vendor’s access and sequence.
Key Takeaways for Founders
Model a Conservative Go-Live Date: Build your proforma assuming delays, but set more aggressive targets for your contractors. It gives you buffer.
Procurement is a Phase, Not a Task: Order critical items during design, not after.
Build Your Team for Execution, Not Just Bids: The GC, architect, and PM who can navigate inspectors and vendor chaos are worth far more than the lowest bid.
Plan for Your Backup Plan: Have contingencies on contingencies. Something will slip — it’s how you adapt that matters.
The biggest risk to your clinic launch isn’t the construction itself. It’s underestimating how long each step really takes.
By anticipating where founders typically misjudge timelines — site competition, lease negotiation, permitting, procurement, inspections, and the final vendor choreography — you can avoid the chaos, protect your capital plan, and get to what really matters: delivering exceptional care to patients.
The path from market selection to first patient is complex, but it doesn’t have to be chaotic. By anticipating where founders typically misjudge timelines—and having the right strategic partner in place—you can avoid the chaos, protect your capital plan, and get to what really matters: delivering exceptional care.
Ready to build a predictable roadmap for your clinic launch? Let's connect to discuss how we can de-risk your timeline and get your vision open on schedule.