Advice from a Nurse Practitioner on Opening Your Own Clinic

I'm always in awe of nurse practitioners who decide to branch out and open their own practices.  Opening your own practice is a lot of work and I admire the commitment of these NPs to their profession.  What better way to lean in and take advantage of laws working in favor of our profession. 

Chris Salter, a nurse practitioner in Bowden, Georgia is one such nurse practitioner.  With 22 years of emergency medicine and family practice experience, Chris is taking his practice to the next level.  In November, Chris plans to open his own practice, Bowden Family Medicine.  I asked Chris if, based on his experiences with the process of going out on his own, he would answer a few questions to help NPs who also aspire to open their own clinics.  Here are his responses:

What made you decide to open your own clinic?

I think most people would say autonomy but that's not really it.  I just want to play more of a role in how the practice operates and how it is presented to the community.  Autonomy is great, but it leaves room for mistakes.  If you make mistakes, all nurse practitioners will suffer the consequences.

What kind of hurdles have you encountered in opening your own practice?

There have been many hurdles along the way.  Setting up a business structure was the first one to overcome.  Some nurse practitioners want to go into practice in part to own their own business.  But, finding people to help in this process and letting them play a role in the business (i.e. ownership) has been important for me. In my case, I have a long time friend who has worked as a pharmaceutical rep for years.  He is an awesome person and salesman who is also able to help initially support the practice financially.  I can't think of a better person to help promote my practice.  I have another friend joining with me.  She is a nurse, knows medical coding inside and out and is very proficient in the credentialling department.  These two individuals have been a part of the process from the beginning and are a major part of the business.  I could not have accomplished opening my own practice alone!

Many states require physician supervision or collaboration for nurse practitioners.  Did you have to set up an agreement with a physician to open your own practice?  If so, how did you go about finding a collaborating physician?  What kinds of details did you need to work out?

Collaboration laws are different in every state so if you are opening your own practice, be careful.  State and federal laws seem to contradict themselves in several areas.  For me, the main thing in finding a collaborating physician was to find someone who was not an employee, but rather a partner in the business.  This physician should be a part of the business to whatever percentage the two of you agree upon.  This physician acts as the medical director in my practice.  Both the MD and NP must come to an agreement on patient care criteria and protocols.  Finding a good collaborating physician partner will make the practice stronger and hopefully a long term entity. 

Many MidlevelU readers are currently NP students or are early in their careers.  You have a lot of NP experience.  At what point in one's career do you feel that nurse practitioners are experienced enough to go out on their own?  Are there any tips you have on becoming more confident and independent in your practice?

Most NPs have a lot of experience working as nurses even before starting their NP programs.  But, I think five years would be a good starting point before ever attempting to go out on your own.  Over confidence can really be a killer and get you into trouble.  Make it a point to try to learn something new everyday.  As long as you are learning you will continue to build your confidence and be mindful of your professional and personal limits.

What advice do you have for nurse practitioners who hope to open their own clinics in the future?

If your hope is to open your own clinic, go for it!!!  But, you should look at the process more of opening a clinic that you will work as a part of rather than own.  This makes the process much easier to accomplish.

A big "Thank You" to Chris for sharing his experiences. 

Comments

Nurse practitioners are interprofessional collaborations everyone comes together from various disciplines and have a common goal of increasing patient care outcomes using evidence based medicine.

From the time this article was written I am confident you are own your way to the continuation of providing cutting edge nursing care. Thanks for making a difference.

Tamiko Molet Np-c

tamiko molet

Yes, stop refering to us as midlevels, a term coined by physicians to diminish the status of nurse practitioners. Extremely condescending.

Eleanor Kelly

Chris Anderson, I have to choke back my annoyance at the title of this site every time I read something. Unfortunately, I am exploring opening my own practice, and there are some useful articles here.

Julie L.

I regret not starting anuring practioner program sooner

HEATHER HARPER

Thank you for sharing Chris's experiences. I am still an RN and will be going to obtain my NP next May. My long term future is to open my own practice, but thanks to this report i have now learned that it will be more of a "shared" practice rather than my own. I have a lot to research and many years ahead of practice, but i am very excited to continue in the journey of healthcare. Thank you MIDlevelIU for sharing this story.

Deimys Vigil

I find the whole terminology "midlevel" poor. We are not midlevel.

Chris Anderson

Thank you!

W.C.