You’ve got the itch. You’re eager to dive into the challenges and rewards of owning your own private practice. Maybe you want to operate a family practice, or a nursing home, or a women’s health clinic. No matter which, once you feel ready to take on an exciting new challenge, it’s time to wrap your head around the realities and necessities of preparing to go private. We’ve outlined the broad strokes of some of the big ones below, so you can get started.
The first thing to embrace is that now you’re not just an NP, you’re an entrepreneur. Patients are increasingly aware that they can see a Nurse Practitioner instead of the doctor, either as their PCP or for their primary treatment in many facilities. From the receiving end, NP care may feel almost identical to that you would receive from a physician. As an NP you are rigorously trained and tested to perform the tasks and responsibilities associated with MD care. You can write prescriptions, you perform diagnoses and develop treatment plans. Now that you’re thinking of your own spin off, it’s time to self-educate (with some help) on how to perform like a business owner.
Need to Knows…
Familiarize Yourself with State-by-State Restrictions
While all Nurse Practitioners are certified nationally when they pass the National NP Certifcation Board Exam, each state has jurisdiction over whether NPs have the legal autonomy to open and operate a private practice. Make sure your state’s individual regulations aren’t prohibitive in any way. Check into any other restrictions that might apply to you, your staff, or your facility. Do this first, before committing to any location or property. This knowledge will help drive many of the decisions you’ll make.
File an LLC and a NPI
Time for the paperwork. The fun part of filing an LLC or as a Corporation is the satisfaction of seeing your name, or the chosen name of your practice, in ink. You’ll also need to file a National Provider Identifier (NPI). Without both of these things you will be unable to accept insurance. There are tax and liability considerations as well. Getting your LLC and NPI approved and active can take some time, so plan ahead and start early.
If you plan to prescribe and/or dispense medications, you’ll also need to be registered with your state’s DEA. If you don’t already have DEA registration as an NP, make sure you do this as well.
Analyze Costs to Open and Maintain a Practice
Owning and operating a private practice is expensive. As you might expect, this will vary by each state’s individual economy and infrastructure, and vary further according to whether you’re practicing in an urban or rural area, for example. Expect overhead and plan to manage your budget with a fine-toothed comb. Startup costs can include:
Office Space: You’ll need to secure a location, make sure it is zoned and permitted accordingly, and furnish it appropriately. While you may be able to find a turnkey location, you’ll still need a stable reservoir of funds for rent while you ramp up your practice.
Personnel: Depending on how many primary caregivers are in your practice, you’ll need support staff and external resources as well. Make sure you budget for reception, billing, transcription, and any technicians or additional nurses. Plan also for an office manager and offsite resources like payroll and tax services. Make sure you bake employee benefits into your personnel costs.
Supplies and Equipment: Depending on your type of service this will vary widely. You might be able to invest in some used equipment. Determine how you’re going to continue to source materials for replenishment. Don’t get caught with empty cabinets.
These costs add up, and many are ongoing. Underfunding is a major contributor for early failure of a new business of any type. You’ll almost definitely need a lender to get up and running, and stay solvent in the early stages.
Insurance Considerations
Insurance is notoriously Byzantine, and the reputation is well earned. You’ll need to decide which insurance providers you’re willing to work with and accept. You can create a profile through CAQH so you don’t have to duplicate your efforts as much. Once you’re set up to accept insurance, it’s an ongoing and high-maintenance part of your business. As a private care Nurse Practitioner, you may not have the expertise–and you definitely won’t have the time–to manage this on your own. You’ll need to either hire a rockstar insurance team or outsource this to an existing service.
What about your own insurance? You’ll be required to have professional liability insurance (malpractice insurance) to operate. You may also need additional coverage like disability and renter’s insurance. Get professional advice on how to best protect yourself and your practice.
Marketing and Online Presence
Word of mouth is always the best source of business, but in the beginning you’ll probably need to get your name out there. Set up your social media and website, and consider whether to build out a marketing budget for mailers, online ads, etc. Start with a small spend and see what works.
Overall, it’s a lot! And there’s a lot more. But if you’re already an NP, you know how to do your diligence and don’t shy away from challenge. It’ll all be worth it to enjoy the enormous professional achievement of nursing under your own name. Best of luck!
WCU provides career guidance and assistance but cannot guarantee employment. The views and opinions expressed are those of the individuals and do not necessarily reflect the beliefs or position of the school or of any instructor or student.
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