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Private Practice À La Carte

Independent Resource Committee is a group of 10 local experts from different industries who have banded together to help fill in the gaps.

The North Dakota Independent Resource Committee members

Photos by J. Alan Paul Photography

A Mini Roundtable with the ND Independent Resource Committee

Meet a local group pooling its expertise to help area medical providers take the plunge into entrepreneurship.

Feature photo from left to right:

David Markel, Prairie Practice Management Professionals. Specialty: Revenue-cycle management, practice management; Darcy Pope-Fuchs, Payroll Express. Specialty: Administrative services, HR; Sue Mullins, Heartland Healthcare Network. Specialty: Private-practice services; Kevin Fitz, Town & Country Credit Union. Specialty: Commercial lending; Corey Elmer, Vogel Law Firm. Specialty: Legal; John Lillestol, Dakota Commercial. Specialty: Commercial real estate; Tracy Kuznia, Nordic Medical Consulting. Specialty: Practice management, financial management; Joe Kramer, Remark Technology Consulting. Specialty: IT services; Delrae Amann, Professional Resources, Ltd. Specialty: Practice startup and development; Amanda McKinnon, MSPIRE. Specialty: Branding, marketing.

What Is the Independent Resource Committee?

While most independent medical providers in the area belong to a network called the Heartland Healthcare Network, Heartland is unable to provide all startup services to a new practice.

Enter the Independent Resource Committee, a group of 10 local experts from different industries who have banded together to help fill in the gaps. What makes the IRC unique is its à la carte delivery model, which allows an entrepreneurial-minded provider to purchase services from any of the 10 members to help them get their small business off the ground.

Why an Independent Provider?

While most people default to using a larger healthcare system, that might change if more employers communicated to their employees that independent providers are an option, too, says McKinnon.

“The personal care is like no other,” she says. “I’ve been seeing independent providers since I was 5 years old, and there is no comparison, quite honestly. People just need to understand that they have a choice.”

Lillestol, whose family founded Lillestol Research, says that even if providers at larger healthcare systems wanted to spend more time with patients, organizational realities often prevent them from doing so.

“It’s important to establish relationships with healthcare providers who become familiar with your personal medical history,” he explains. “This is difficult if visits are scheduled with different providers each time. At an independent practice, every effort is made for consistency in care. That’s the biggest difference.”

What jumpstarted this idea?

Amanda McKinnonAmanda McKinnon

We were all finding that there are plenty of providers who want to have their own independent practice but don’t know where to start. They can get quickly deterred, so we wanted to bring a group together to be a resource for all of their needs, whether they’re buying an existing practice or starting one up.

John LillestolJohn Lillestol

A physician has a very busy schedule to begin with, so not having to worry about (the business) is big for them. And trying to coordinate all the people they need to even get their practice started is incredibly difficult.


Corey ElmerCorey Elmer

The goal is to provide a one-stop shop for independent medical professionals to start, build and operate a practice.



How did you recruit the various people for this committee?

John Lillestol

John Lillestol

We talked to people who we knew had worked with independent providers. It’s important to have worked with them because they’re a different breed of business from anybody else. We sat down, figured out exactly what we needed — as far as different fields — and then decided on people we knew and trusted.

Amanda McKinnon

Amanda McKinnon

One of the things I quickly realized in working with independent providers is that they don’t have a background in business, which makes sense. They were trained to care for patients, so they might not understand finances, branding and marketing, or HR, which is a beast on its own.

The mindset is often that they need to take on everything on their own until they start generating revenue, but the reality is: That takes away from productivity for them. We want to help change that by taking care of the various business needs to drive more revenue and make them more efficient as providers.

Corey Elmer

Corey Elmer

It’s a challenge to start any business, and when you layer on top of that the medical regulations, rules, and requirements, it’s a pretty daunting task. Our goal is to make that task more understandable and get them through it from start to finish.

You’ve set this up as an à la carte delivery model so that providers can pick which of your services to use. Why that route?

Amanda McKinnon

Amanda McKinnon

To use an example, a provider may already have an IT contact. If that’s the case, they’re still a great candidate for our group, even though they have that part of their practice taken care of. There could also be a case where a provider might not be a fit for me, and that’s okay. I have other resources and contacts I can direct them to.

What if one person’s services are being utilized less than others?

Amanda McKinnon

Amanda McKinnon

Well, like with John and real estate, for example, that’s a relationship that can take a long time to build. There are different areas of a business that are a little faster-paced, where decisions can be made quicker.


Corey Elmer

Corey Elmer

The group represents a variety of perspectives and disciplines useful in creating a practice. Some will be needed now and some later on. In the case of legal work, if somebody goes on to form a practice, they’ll need to incorporate. Which structure do you use? Is it a professional limited liability company or is it a corporation? How do we structure it if there are other partners with shareholder agreements?

As they go on, they may need IT work, or they may need marketing work; they may even plan on building at some point. And it may take time, but from our standpoint, the whole plate of services is there to start with.

And you all set your own rates?

Amanda McKinnon

Amanda McKinnon

We charge for our services how we would with any of our other clients, in any industry.



John Lillestol

John Lillestol

Our initial meetings are at no cost, but after that, it’s up to each individual and the committee members they plan to work with to agree on pricing. We’ve already had many say, “I wish this would have been here when I started my practice.” Because they didn’t know where to start or who to trust.

Have you taken on your first client yet?

John Lillestol

John Lillestol

Not from start to finish, but we’ve all started to work with people who have heard about the committee. That’s the reason the à la carte model is interesting is because they only utilize a few people at a time, but down the road, they’ll utilize other people, too.


Amanda McKinnon

Amanda McKinnon

We launched it to all the independent providers who are currently part of the Heartland Healthcare Network, and we are continuing to be out in front of them and letting them know we’re a resource.

You’re starting in healthcare, but you think this model could translate to other industries, correct?

Corey ElmerCorey Elmer

I think it makes sense in almost any business formation. When you start a business from scratch, how do you do it? You need to get it set up legally; you need to get a bank involved for financing; you need a space to operate out of. At some point, you’ll need to market yourself, and as you grow, you may have HR and payroll needs. So I think with almost any business, there’s a need for this kind of model.

Amanda McKinnon

Amanda McKinnon

And it’s that one point of contact. You don’t have a project management team handling it like you would in a larger organization. John’s the point of contact; Corey’s the point of contact; I’m the point of contact. I know that for myself, that’s been a big selling point.

To learn more about the ND Independent Resource Committee, visit

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Written by Nate Mickelberg

Nate Mickelberg is the former editor of Fargo INC! He holds his master's in journalism from the Medill School of Journalism at Northwestern University.

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