a sonographer's guide to entrepreneurship

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Episode 31: 5 Steps to Starting Your Ultrasound Business

In this episode, we’re diving into the 5 steps you’ll want to take when starting your ultrasound business. 



Hey. Hey there. Welcome, welcome. Today we are talking about five tips for planning out your new ultrasound business, and this episode is brought to you by our brand new deep-dive workshop that I’ll be hosting on January 25th. Head over to our website at aic-ultrasound.com/workshops to learn more. It’s going to be epic. I’m so excited about it. I can’t wait to work with you on diving deep into your business planning. I’d love for you guys to make it live so we can workshop your business together, but of course, you’ll be able to easily rewatch later as long as you register. So head over to the website and do that. 

Now, this episode that we’re doing on the podcast today is going to give you a taste of what we’ll be talking about inside that workshop. So let’s start on the five tips for planning your new ultrasound business.

Number one, we have to pick our business model. I talk about the eight kinds of main business models that we have access to in the ultrasound industry over in our Business Blueprint course. And I want to lay out the super specifics there, but let’s break them down in general here for you. 

We are looking first at mobile ultrasound fee for service. So in this setup, you are providing services out to physician practices and the like. They are billing insurance directly. Your client is billing insurance directly, and you are charging a fee for providing those services in the office. 

The next option for a business model is a mobile ultrasound IDTF or independent diagnostic testing facility. In that scenario, you are credentialed with insurance, so you’re receiving your revenue directly from the insurance companies. That means it’s free for your physician practice to have you come in to provide the services because your revenue is coming directly from insurance, and there is a way to pay them fair market value rent for the space that you’re utilizing. There’s a specific Medicare calculation that you can use there. 

There’s also, as another business model idea, 3D ultrasounds. I’ve got many clients that are either starting as 3D and adding in diagnostics later, or starting as diagnostics and adding in 3D or straight up starting 3D, which is their main source of revenue. You can do this as a facility model, where you have patients coming to a location of yours, or you can also do it as a mobile model, where you’re out to patient homes and the like. You could also set this up easily as a hybrid as well, so where you’re doing both a facility and a mobile option. 

The next business model I’d love to talk about really quickly is staffing services. Gosh, we all know, especially right now, healthcare staffing has gone awry, and so I’ve got tons of clients right now adding in staffing as an additional revenue stream for their services.

But there’s also the opportunity just to do that in that scenario where you really just need yourself and a contract to be able to provide those services inside physician practices. You know, imaging centers, hospitals, those types of places to provide staffing where they have a need for the staff. They’ve got the equipment there already. 

The other option is providing a facility location, so providing services in an existing facility where patients are coming to you. You can set this up as an IDTF. Just like we talked about for mobile, a facility IDTF is one that is credentialed with insurance to be able to bill patients’ insurance directly. Or you can also set it up as a self-pay facility location, catering to those with no insurance, high insurance deductibles, HSA plans, and those types of things. That’s an easy hybrid to put together as well, where you’re doing both insurance services and self-pay.

The next business model is providing services to nursing facilities. Looking at the opportunity of working with skilled nursing facilities where you’re providing mobile services out to their location. A lot of nursing facilities, the way they are set up, and this would, of course be something you would find out during your sales process going out and talking with these facilities, but a lot of times, they are set up where they receive a lump sum from insurance for the patient that they are housing inside their skilled nursing facility out of that lump sum. They are then required to pay out of pocket, so to speak, for any of the services that that patient needs. So if the patient needs an ultrasound, the nursing facility would pay directly for transport to the hospital, the ultrasound service at the hospital, and they would pay for the interpretation service from the hospital.

That can run them a couple thousand dollars by the time, all of that is added up. Whereas if you came in to provide a service and charged them directly for the services, you could charge a few hundred dollars for the service, huge cost savings. So huge benefit to nursing facilities that are set up to receive payment in that way. You could also set it up even if they are set up to receive payments directly from each of the services they do. A physician practice is easily charged an hourly rate, just like you would in the mobile ultrasound fee-for-service business model. 

The last one that I wanted to talk about, and of course, there are offshoots of different types of business models, but these are the eight main ones, is screening services.

So this can be set up in a multitude of different ways. I’ve got clients that actually set this up where that is their main mode of revenue. I’ve got some really cool clients doing some cool things. So partnering with corporations to provide screening services directly to the corporation’s employees because when corporations provide preventive services, a lot of times, they can save money on the healthcare costs that they’re paying out to their insurance providers to provide health insurance to their employees. Such a cool business model option. There are also, of course, just general screening services that you can provide inside physician practices. Usually, that would be more of a hybrid with other diagnostic services in that specific scenario. My suggestion is to start with one or a hybrid of a couple that makes sense to put together, like I was talking about 3D doing a facility and mobile or a facility doing IDTF and self-pay together.

You can easily make this more of your focus when you start with one or a hybrid of a few. That would be easy to put together initially when you’re starting up. You can always add on other services later, and I highly suggest this; you guys, if you’ve listened to me for any amount of time, know that revenue diversification, I talk about this as the best way to keep your business diversified so that if one stream of revenue takes a dip. There are always ebbs and flows in business; you still have other areas of revenue bringing money into your business, it keeps your business diversified in that way, and it keeps your revenue growing. There are multiple streams of revenue, and multiple available revenue streams coming into your business. Some of the things I see sometimes, I’ve got some clients that get tunnel vision.

They want to start their business this way and only this way, this one specific way. And that is a huge detriment when things inevitably come up where they need to pivot a little bit. A little bit or a lot. I mean, let’s be real, when we’re business owners, sometimes pivoting is the name of the game. So when we get tunnel vision, and we say, okay, I want to start mobile ultrasound fee for service, here’s exactly how want to provide those services, here’s exactly what I want to do. I’m not going to deviate from that, and if I have to deviate from that, it’s going to crush my world. We have got to take the blinders off as business owners and understand that we need to have an idea of how we want to start. Still, we need to be open to growth and pivoting as problems, issues, and roadblocks come into our way as they inevitably will in business and life.

I have other clients though, that get so excited about the thought of diversifying their business and all the opportunities that they have access to that they inadvertently sidetrack their progress because they’re trying to do too many things at once. They’re trying to start mobile ultrasound fee for service and also be a mobile IDTF, and what if I also added in 3D because I know there’s not really a place local to me that has that opportunity, and I could also get a facility location, and then they start working on all those things at the same time, and it takes them 10 times as long to just get started with the one thing. So my pro tip here is to find that kind of happy middle, and understand all that we have at our fingertips in the ultrasound industry.

With so many ways of making revenue that diversifying your business is key, but start with a niche. Start with that one thing, get that up and going, get that streamlined and seamless, and then work your way out from there. 

Tip number two in our five tips here today, is research the heck out of the industry. When we’re thinking about starting a new business or anything new, we want to binge everything we can to fill that knowledge gap whenever we start anything new at all. Whether it’s, you know, I’m going to get into fitness now, or I really want to shore up my diet. Whenever we start something new, there’s a knowledge gap that we have to fill. We need to learn more about the industry, the topic as a whole to feel more confident in what our next steps should be.

And so, I want to know if any of you listening here have ever tried to Google how to start an ultrasound business? It’s a rabbit hole, right? Can’t find hardly anything. And what you do find just confuses you because it’s a little bit here and a little bit there. So I always joke that I want to be your Google for the ultrasound industry for ultrasound business. So use this podcast. I’ve got free guides on our website, and we’ve done multiple trainings over in our Facebook group. I’ve got some on Instagram.

Use all of those things to get an idea of what the industry looks like. Gather information, start getting an idea of what you think your business will look like once you have some basics, some on the industry as a whole. So use the information I have out there, for that specific purpose.

That’s literally why I started this podcast, was because it was so difficult to find any of that information anywhere. I wanted to be the place that sonographers could go to find out more about the ultrasound industry and the potential that they have in starting their own business within it. So research the heck out of the industry.

Number three, once you kind of have an idea of, okay, here’s kind of what the industry looks like. Here’s the idea that I have for my potential business. Now I need to set my business foundations. So number three is setting your business foundations, and what does that look like? So if we think about building a house, we want to have a firm foundation in that house. We want everything, all that’s being built, to be built on that firm foundation.

If we’re building our house on a  lump of sand when anything comes our way, any kind of flood, any kind of inclement weather, the house is not going to stand sturdy like it should. And so I’m using that analogy to explain that when we start a business, we’ve go to set those firm foundations. We want a very firm foundation for that business to be laid upon. 

So what does that look like? What does a firm business foundation look like? And what do I need to do? Firstly, we need to do market research. We need to understand what our market looks like in our area to see if your business idea is viable. We need to look more at what does our target market look like? What does the market in general, look like? How many physicians are there?

I mean, this is going to alter based on your business model. It’s something that we’ll dive deep into in the workshop that I’m talking about. And also figure out what our target market looks like and start kind of putting together an overview of what our sales and marketing process is going to be for that target market. And it’ll be different based on your business model. If I’m starting a 3D business, my target market is completely different than if I’m starting a mobile ultrasound fee-for-service diagnostic business. In one, my target market is pregnant women, and the other, my target market is physicians. So your target market will be completely different based upon your actual business model. Now, next, you’re going to want to figure out what our startup costs are going to be. How much is it going to cost for me for the startup phase of my business?

You’ll also want to look at your ongoing business expenses as well. So when we start a business, we have those startup expenses, and then we also have expenses that it costs us to continue to run our business. It of course, varies again, based on business model. But rent payment for our ultrasound machine supplies, staff once we have them, those types of things, our ongoing, monthly business expenses. We want to know what that looks like so that we can forecast what we need to be bringing in. This brings me to my next point because it’s just as important and more exciting than the expenses part; figuring out what your revenue potential is going to be. How much revenue can I bring in from my business? Now you guys know I talk about this all the time, we’ve got to figure out our revenue potential.

As an example, we’d figure out that in the mobile ultrasound fee for service business model as an example, when we’re setting our pricing, we’re looking at industry average about 125 an hour. Okay? One of the things we would do is set our pricing in this revenue model. When you’re, when you’re looking at that 125 an hour for an eight-hour day is a thousand dollars in gross revenue a day for, for a mobile ultrasound fee for service business. Now there are usually 20 working days on average in a month. The revenue potential easy math here for this type of business model is $20,000 a month. But hear me. It’s $20,000 a month for one sonographer and one machine. When I’m the business owner, I have the capacity to add on as many revenue opportunities as I want. I just have to work toward them.

So the actual revenue potential of any business that we own is unlimited. I’m going to say that again. The actual revenue potential of any business that we own is unlimited. We are not bound by how much our employers willing to pay us. We are not bound, we’ve climbed the ladder at the hospital. We’re now director of radiology and where do we go from there? We are not bound by any of those things when we are the business owner. Now, on the flip side, that means we have a lot more responsibility, but I will take that responsibility all day long in my business over the last 20 years to have the revenue potential be absolutely unlimited to me. And we’ve seen that growth in our own business. You know, I’ve talked about this before. It’s, we started just like anybody else did.

And sometimes you can look at people and say, “oh gosh, they’ve got such an amazing business. How would I ever get there? Or gosh, they’ve been so lucky,” and we start that comparison game. But I’m here to tell you I started with an idea just like you have. I started with an idea 20 years ago, and today we consistently create a seven-figure business every single year, year upon year, upon year, upon year because we have the mindset that we work at until it works. We pay attention to our market; we add in different opportunities for revenue diversification over the years. And I’m telling you that if I can do it, you can do it too. So we have the ability to build our businesses as we see fit, and that is truly the true beauty of business ownership.

Tip number four. Now we have to plan for our startup. So we’ve set our business foundations. We know what that looks like. Now we’ve got a plan for our startup. So you’re ready to launch your business at this point. Time to put together a business plan. Time to start working towards getting all of our startup items in order. So this will be based on your business model and’ll be different for each one. But in the startup phase, this is where we are incorporating our business, getting our contracts as an example, searching for an office space if we need one for our type of business model—all of those startup things. Now, shameless plug, if I had to do all of this over again, I would hire a coach to help me with all of these things, and that’s why I live and breathe our coaching division.

When you start a business without a coach or without buying into a franchise, you are winging it no matter how you look at it, able to be done. Absolutely, of course, it is. Will it take more time and cost a lot more money? Absolutely. And I am living proof of that. Working with someone who has already been there, who knows the exact path you need to take that will be there to answer questions along the way is worth its weight in gold. That’s why I love working with our clients on starting, implementing, and growing their ultrasound businesses. Once we’ve got the startup plan in place and we’ve launched our business, we really need a plan for implementation and growth. 

So this is step number five. This is the part of the business I think so many people forget about, and it’s why I have an entire module on it.

In our ultrasound business academy, I always tell my clients this. The last module is operations and growth. And I have down literally to week by week what they need to be doing in their business to continue to grow, to continue to increase their revenue stream and understanding how to implement your services no matter what. Your business model is absolutely essential. So knowing what systems to have in place, how you’re going to roll out your services, what the day-to-day is going to look like. 

Do I need a pack system? Do I need a scheduling system? All of those things. Having all of that in some kind of SOP as we call them, our standard operating procedures ahead of time is going to be so, so helpful for you. I highly recommend ensuring that you understand how you’re going to implement your business, your services to your client, or your patient’s service.

What we’re actually providing to them. And then understanding how to create a strategic growth plan is very, very important. You will also want to plan for growth and understand how to set yourself up for success. By knowing how to plan for our year. Breaking that down by quarter, what do I want my revenue to be at the end of 2023? 

For example, if I know that and set that standard, I can break that down by quarter. What do I need to then have done financially every single quarter? Break that down by month. There are four quarters in a year, three months in each quarter. What do I need to do month by month to reach my quarterly goal? Then I can break that month down by week. And eventually, that gets you to know exactly what you need to do daily to continue moving your business forward.

And depending on your business model, when you know the revenue you need to make, you’ll understand, how many clients is that? Then if I’m doing mobile ultrasound fee for service and I know that I am making a thousand dollars a day gross revenue, how many service days do I need per month to reach my monthly goal that reaches my quarterly goal, that reaches my yearly goal? Same if you’re doing, um, let’s say, 3D facility model or mobile model. If I know, I’m making $XX per client patient that I’m going to see or that’s coming into my office, and I know I need to make $XX per month to meet my quarterly goals, to meet my yearly goals, how many patients do I need to have coming in every single month? So it’s easy to lay out the math when you do it that way.

Okay, guys, that was a lot of information. It gets me super excited for this workshop that I am hosting on January 25th because we are going to dive deep into the planning. We will have worksheets to go through. We’re going to have a q and a session. It’s going to be so much fun. I don’t want you to miss it. So head over and register over at www.aic-ultrasound.com/workshops. And notice I’ve made that plural because I am really hoping to do more of these throughout the year. I am so super proud of this community as a whole and of all of my clients over the course of this year. I can’t wait to see what’s in store for all of us in 2023. Until next time, as you know, I will be over here cheering you on. Bye-bye for now.


Ready to see what it takes to start your own mobile ultrasound business? Grab our free startup guide and learn how to make a thousand dollars a day with your own business. Head to our website www.aic-ultrasound.com to check it out.

your strategy-obsessed ultrasound business coach.

I'm Jennifer -

Welcome to the Talking Tech podcast, where we answer your questions about legal, marketing, admin, sales, and so much more. After nearly 20 years in the industry running our own mobile ultrasound business and helping techs across the country do the same, I'm so excited to bring you industry insight, mindset, productivity, business tips, and inspiration to help you design the business of your dreams.

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