I'm not clear why you're so intimidated about taking out loans. Nobody wants to pay interest, but "spend money to make money" is a basic principle of business that there is really no way around. Unless you have a LOT of family benefactors' support, you will probably need loans to get what you need.
Banks will borrow money to doctors. You will pay for it, but you can certainly make it happen if you have halfway decent credit. I was already been approved for an AmEx business card that would have a limit high enough, but the rates are too high for purchasing everything on that unless I could pay it off relatively fast. I began prelim loan talks at my bank - and others to compare rates - regarding six figure loans for future rent/staff/equipment. The banks gave me basic info on what they like to see in terms of business plans, equipment lists, staffing ideas, marketing ideas, etc, and you should have no problem if you scour PodiatryM.com, AAPPM, etc for that stuff. Doctors are a "good risk" for loans: very seldom not working... whether it's solo practice, for a hospital, for a group, etc, you are always seeing at least some patinets and having some cash flow. Besides, they always know where to find (and garnish) you if you don't pay up for whatever reasoning. If you can show them you are going to an area of need for foot specialists, all the more reason they have to assume you'll find success.
Between a good solid loan at a decent rate and then a business CC or two for short term extra loans, you'd be pretty set. Why not use your $15k as a downpayment on a big loan and start practicing how you want to practice right off the bat? As long as you are committed to the location and have done your homework, it's probably how you'll end up happiest.
As for wife as an employee/partner, I'd steer very clear of that. My wife (soon-to-be PhD who is "grossed out" by most medical stuff) suggested that she try that office manager role, and I laughed at her. Not sure how many private practices you've shadowed, but nearly every time I saw the husband/wife working close together in the same office 50+ hours per week (in other businesses besides pod as well), it was almost invariably NOT a good situation in terms of stress level or efficiency/morale. The exception might be if you're both docs or midlevels and you see pts on different locations/days? In the end, it depends on your relationship and wife, of course, but I'm just saying that I haven't see it work well very often. Besides, you could probably afford receptionist, biller, MA, etc with more experience and less salary requirement than your wife (based on her current work income and/or the $ you'd spend on daycare if you both worked the same 5+ days per week).
Another option is to approach some Family Practices to see if you can rent space in their office during the week. If there is a day or a half-day during which they have a vacant room, you may be able to pay them a set fee in exchange for using their room, equipment, and staff.
You would have to provide any podiatry-specific instruments and equipment that you need. You do not need a Midmark podiatry chair to treat your patient; the standard general medical chair that most FP's have will work (it's just not as nice). My group has a few satellite offices in rural areas spread out over eastern Oregon and we have this type of arrangement. Generally we pay a couple hundred bucks to the FP's per day.
If you want to open in a rural area, be prepared to have multiple offices and do a lot of driving. You might be able to set up half-day-per-week arrangement at a few different FP offices in outlying communities, then go to a different town each day.
Working out of a local FP office also serves as a built-in referral source. Your overhead expenses remain minimal this way.
This is great advice and all stuff I definitely plan to do.^
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Even in a location with few/no other dedicated and well trained F&A specialists, that brand new private office you spent loan $ to furnish with plush leather power chairs, digi XR and US, solid gold bandage scissors, great receptionist, etc will still be almost 100% empty for awhile. You need to gain reliable income and build your reputation/referral bases by seeing patients ASAP, and those multispec or primary care clinics are great and usually starved for anything past basic foot care.
I'm planning for my private practice 1-1.5d, surgery 0.5-1d, and multispec clinics + hospital consults 3-4d per week for awhile, and maybe transitioning to more and more private practive over the years (if I'm lucky enough to gain referrals and reputation). I think it'll take at least 3-5yrs of pounding the pavement to build a patient base big enough to even have two full days of ~50 clinic pts for the office(s) I'd like to start from scratch. Then maybe We'll see...
