Nurse practitioners are advanced-practice nurses who can provide comprehensive, holistic care to their patients. In many states, they can act as a primary care provider, managing patients from birth through the aging process (depending on their specialty).

One exciting prospect of becoming a nurse practitioner is the concept of opening his/her own practice. Nurse practitioners enjoy autonomy by merely becoming an NP, and owning their own practice further enhances their independence. The following are steps needed for nurse practitioners to start their own practice:

  1. Determine the practice requirements. The first step an NP should do is determine the practice requirements in their state. Not all states allow for independent practice, so NPs must find out if opening their own practice can be done, if a physician needs to be on-site, or a physician needs to be nearby and accessible.
  2. File the paperwork. NPs must also file the required paperwork. Opening a practice is a business, so permits and licenses need to be obtained.
  3. Become credentialed. NPs need to apply for an NPI number to be able to bill Medicare. Becoming credentialed with Medicare can be daunting, and NPs are encouraged to visit their website to start the application process.
  4. Create a plan-both business and financial. The NP should determine which specialty they wish to focus on- which might be primary care, pediatrics, aging adults, family practice, etc. Usually, it's based on their population foci and certification, but NPs might choose to narrow down their specialty further. Financially, startup costs are needed to start any business to cover location, application/licensing fees, equipment, advertising, and staffing. Securing startup costs is essential.
  5. Choose a location. As with any business, location is vital. It can reflect credibility. For example, a patient may be more reluctant to visit a healthcare provider in a strip mall than in a business park.
  6. Determine insurance reimbursements. Most patients don't pay out of pocket for insurance. An NP wishing to open an independent practice should determine which insurances will be accepted, what the compensation is, and what services are covered.
  7. Malpractice insurance. The NP should carry malpractice insurance and should know what specifically is covered/ not covered.
  8. Determine which supplies are needed. Exam tables, office supplies, blood pressure monitors, computers, etc. are items that are necessary for starting a private practice, and they can be pricey. The good news is that there is no requirement that the equipment is new. Equipment can be purchased second-hand or through surplus companies.
  9. As with any business, advertising is critical. In today's digital and social media age, advertising online is essential. However, printed advertising is also important; phone books, newspapers, even flyers can help build a practice.
  10. Determine staffing needs. As a business grows, inevitably staffing needs increase as well. NPs may eventually need to hire ancillary staff such as receptionists and medical assistants to help with the growing practice. Along with hiring staff comes determining pay wages, health insurance coverage, labor laws, and training.

Many providers feel restricted in how they practice. They are limited by the facility or organizational restrictions, policies, and requirements, and often can't practice how they wish to provide the highest quality care patients deserve. For example, cramming a physical exam in a required 15-minute block of time is something most practitioners argue is unreasonable and for the most part, impossible. Owning and operating a medical practice allows for the autonomy and freedom to render care for patients in a practitioner's own style.

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