Why Nobody Builds for Small Practices

The EHR market is worth $34 billion. Hospitals take 53% of that revenue. The logic is simple: one contract with a health system can be worth $50–80 million. One contract with a solo practice is worth $300 a month.

If you're a health IT company, where do you point your sales team?

The enterprise trap

Enterprise healthcare software is a great business. Long contracts, high switching costs, dedicated IT departments who manage the implementation for you. Epic's hospital deployments take 12–24 months and cost tens of millions. Once you're in, you're in for a decade.

So every ambitious health IT company builds for that buyer. The features, the workflows, the pricing, the onboarding — all designed for organizations with procurement teams and seven-figure budgets.

Small practices get a stripped-down version of the same software, at per-seat prices designed for scale, with an implementation process built for a 500-person rollout crammed into a practice of three.

213,000 practices, ignored

Here's the thing: small practices make up 73% of all physician offices in the United States. That's over 213,000 practices. Nearly half of all physicians work in groups of 10 or fewer. These aren't edge cases. They're the majority of where medicine actually happens.

And they're underserved not because the technology doesn't exist, but because the business model doesn't incentivize building for them. There's no VP of Procurement to wine and dine. No 18-month sales cycle with a six-figure close. Just a doctor who needs software that works and doesn't cost a fortune.

The opportunity everyone misses

Small practices are where patients know their doctor's name. Where the visit lasts more than 12 minutes. Where someone actually reads the chart before walking in. Study after study shows independent practices deliver more personal, often higher-quality care.

They deserve tools built for how they actually work — not a hospital system's software with the features removed. Not a product that assumes you have an IT department. Not a price that assumes you're splitting it across 200 providers.

The market says small practices aren't worth building for. The market is wrong.