Many nurse practitioners (NPs) would like to work for themselves, but think that starting a primary care practice is overwhelming. While starting a practice is quite a challenge, it is not impossible. Thinking through your options and saving yourself time and money can go a long way toward success as a selfemployed NP.
Look for Opportunities
Always check your state's nurse practice act to be sure that what you want to do is legal. If you are unsure, seek legal assistance.
Purchasing an existing practice saves you the trouble of the initial setup. Nurse practitioners who own their own practices may decide to bring in a partner who will buy the practice at retirement. There have also been NPs who purchased their practices from physicians they worked for.
If you want direct patient care but do not want to struggle with hospital privileges, after-hours coverage, complex billing systems, and third-party contracts, consider opening a convenient care center. Look for opportunities in your community. Is there a vacant office space adjacent to a pharmacy? Is there a healthcare practice that might rent out space to use during early mornings, evenings, or weekends? Do you live in a tourist area that could support a strategically located walk-in center for part of the year? Operate it as a cash business so that you do not have to negotiate third-party insurance contracts. Find out what percentage of people in your community have no insurance, high deductibles, or high co-pays. Would they be willing to pay out-of-pocket for convenient, friendly service?
Are there elders in your community with no family nearby? You could set up a practice as an NP care manager. Your knowledge of the medical community and its resources, combined with strong communication skills, would make your services very desirable to worried family members living far away. This could also be a cash practice to avoid insurance issues. Your overhead could be quite low. You could have a home office and keep your records on your computer, using a software program to manage your business.
Other opportunities for direct care exist in occupational health, school health (especially private schools and colleges), and the mental health field.
Beyond Primary Care
There are opportunities in other settings, too. Many NPs are highly skilled educators. Consider starting a continuing education practice. You could practice locally, regionally, nationally, or even internationally. You could provide the education services directly or hire other professionals to teach. The legal community needs NPs to assist in healthcare cases. Medical device companies, pharmaceutical companies, and biotech firms employ NPs as research consultants.
Alternative healthcare offers another venue for NPs to combine modalities and offers a different blend of healthcare services. Open a wellness center that offers massage, nutritional therapy, aromatherapy, naturopathy, and chiropractic services. Clients expect to pay out-of-pocket for these services because most third-party insurers do not cover them. Medical day spas offer microdermabrasion, laser hair removal, Botox injections, and other cosmetic dermatological care. Some are available as franchise opportunities. You could hire your own medical director and estheticians. Practices that specialize in weight reduction and exercise could be offered by NPs. An NP could also own a freestanding mammography center.
These are just some of the many opportunities that exist for NPs to be their own boss either part-time or full-time. Talk to NPs who are already self-employed for more ideas. Look at your community from many different angles and think about how much an NP could contribute as a self-employed provider in your community.