Owning your own practice?

  1. Hello,

    I was going to go into the CRNA field but now I'm considering the NP route.
    A girl in my class (BSN program) mentioned that she was going to go the NP route. She mentioned that NP's make the most out of nurses and I told her that CRNA's make substantially more. She mentioned that you can write your own prescriptions for patients. This didn't really have an effect on me. However, she also mentioned that you could own your own practice. Hold on a second. . .

    You can own your own practice as a nurse practitioner? Meaning, myself, or a group of NP's, could purchase a location, get all the licenses and what not, and actually see patients like an immediate medical facility or what not?

    I have a friend who's a pharmacist and she did something similar. While she was in school, her and four other students made plans to open a pharmacy in Queens when they graduated. It was a success. If this is possible for an NP to open a practice, how much is the start up cost? I'm thinking 250-500k.
    Are there such places? I know a lot of facilities/practices now hirer NP's and PA's to perform the same tasks that an MD would perform. This is more economical for the facility. However, it's the organization that's paying the NP's. The services themselves still cost the same regardless of who performs them, correct? This is why it's economical to hire NP's, correct? It's kinda sketchy what I'm getting at, but basically, the health insurance companies HMO's and/or the patients themselves are going to be paying the facility the same amount for the service they receive regardless of who performs the practice. So, a practice consisting of NP's would be more economical, correct?

    Basically, she mentioned that her father's a Doctor and she wants to take over his practice. It's funny, we're both in the same boat. She's got a BS in biology just like me, we both just started this year, and we're neck and neck at the top of our class (so far). Too bad she's got a boyfriend or I'd propose, haha.
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  2. 6 Comments

  3. by   lalaxton
    Yes it is possible for NP's to open their own practice. The details would depend on what state you are in, how independent you can be, etc. Owning a practice is like owning a business with all the pros and cons associated with it. Check with your states BON and talk to some local NP's.
  4. by   cgfnp
    Quote from Critical Care-Bear
    Hello,

    I was going to go into the CRNA field but now I'm considering the NP route.
    A girl in my class (BSN program) mentioned that she was going to go the NP route. She mentioned that NP's make the most out of nurses and I told her that CRNA's make substantially more. She mentioned that you can write your own prescriptions for patients. This didn't really have an effect on me. However, she also mentioned that you could own your own practice. Hold on a second. . .

    You can own your own practice as a nurse practitioner? Meaning, myself, or a group of NP's, could purchase a location, get all the licenses and what not, and actually see patients like an immediate medical facility or what not?

    I have a friend who's a pharmacist and she did something similar. While she was in school, her and four other students made plans to open a pharmacy in Queens when they graduated. It was a success. If this is possible for an NP to open a practice, how much is the start up cost? I'm thinking 250-500k.
    Are there such places? I know a lot of facilities/practices now hirer NP's and PA's to perform the same tasks that an MD would perform. This is more economical for the facility. However, it's the organization that's paying the NP's. The services themselves still cost the same regardless of who performs them, correct? This is why it's economical to hire NP's, correct? It's kinda sketchy what I'm getting at, but basically, the health insurance companies HMO's and/or the patients themselves are going to be paying the facility the same amount for the service they receive regardless of who performs the practice. So, a practice consisting of NP's would be more economical, correct?

    Basically, she mentioned that her father's a Doctor and she wants to take over his practice. It's funny, we're both in the same boat. She's got a BS in biology just like me, we both just started this year, and we're neck and neck at the top of our class (so far). Too bad she's got a boyfriend or I'd propose, haha.
    You can still propose. )

    Owning your own practice can be done by whomever wants to get into that business. You can do that without a high school diploma. You can just hire all the help, as in any other business. If you want to practice in it, that depends on the state.

    NPs get reimbursed a little less than docs (85%) from medicare. Some insurers will pay the same, some won't pay at all for NP services. 250-500K is quite a big practice. If you lease office space, you shouldn't need near that much. I'd say $50-100K should be plenty. But you also need to prepare to not make money for a few months at least while it builds.

    I will own my own practice some day, somewhere. I have a specialty niche that will make it work very well and make lots of $$$ so it won't be as hard as opening a primary care clinic. I just have to get in a place so I'm able to do that financially as well as make a move to another state where I won't have to have a doc on my back so heavily like in Missouri.
  5. by   sirI
    Quote from Critical Care-Bear
    Hello,

    I was going to go into the CRNA field but now I'm considering the NP route.
    A girl in my class (BSN program) mentioned that she was going to go the NP route. She mentioned that NP's make the most out of nurses and I told her that CRNA's make substantially more. She mentioned that you can write your own prescriptions for patients. This didn't really have an effect on me. However, she also mentioned that you could own your own practice. Hold on a second. . .

    You can own your own practice as a nurse practitioner? Meaning, myself, or a group of NP's, could purchase a location, get all the licenses and what not, and actually see patients like an immediate medical facility or what not?

    I have a friend who's a pharmacist and she did something similar. While she was in school, her and four other students made plans to open a pharmacy in Queens when they graduated. It was a success. If this is possible for an NP to open a practice, how much is the start up cost? I'm thinking 250-500k.
    Are there such places? I know a lot of facilities/practices now hirer NP's and PA's to perform the same tasks that an MD would perform. This is more economical for the facility. However, it's the organization that's paying the NP's. The services themselves still cost the same regardless of who performs them, correct? This is why it's economical to hire NP's, correct? It's kinda sketchy what I'm getting at, but basically, the health insurance companies HMO's and/or the patients themselves are going to be paying the facility the same amount for the service they receive regardless of who performs the practice. So, a practice consisting of NP's would be more economical, correct?

    Basically, she mentioned that her father's a Doctor and she wants to take over his practice. It's funny, we're both in the same boat. She's got a BS in biology just like me, we both just started this year, and we're neck and neck at the top of our class (so far). Too bad she's got a boyfriend or I'd propose, haha.
    Hello, Critical Care-Bear,

    I see you now have the bug. That epiphany you had hit you smack dab beteen the eyes, didn't it?

    Yes, I have a few NP friends who are in a combo practice. One has actually bought into the practice with 3 physicians.

    I had a practice in OB for awhile a few years back. The overhead was horrendous as well as the liability premiums.

    Anyway, I am now FNP and have worked in a practice with physicians for awhile now. Not as partner, however.

    I have another (medical legal) business that I am nurturing now.

    But, to answer your question, yes, you can own a practice. The seed money should not be as steep as you quoted, however. As for 3rd party reimbursement, medicare is, as stated above, 85%. And, a few insurance companies still do not recognize the NP, but, they are becoming less and less.
  6. by   Papadoc
    Hi All!
    Great topic. I've been wondering also how realistic this is. I'm in NY (Brooklyn). We have docs almost literally sitting on each other here, bunch of all kinds of area specialties. I just can't imagine someone (who has any type of coverage) going to an NP even for the most routine things. But I know few NPs in D.O ran practices. They seem to be happy. I guess it's LLL (location). But even if it wasn't so saturated here, in general who would think of NP when they get sick? We have some snobs here who think that D.Os aren't "real" doctors.So from the business standpoint who do you get the foot in the door, if you are going solo? What would you write on your shingle? I suppose something like "comprehensive health services",and not "internal" or "family medicine." I know it flies in Manhattan "Columbia University" all NP-owened/ran practies. But it's rather an exception from the rule around here. Please share some thoughts on it, esp on "what the future holds" for NP-owned practices.

    Thanks
  7. by   spaniel
    Just a quick opinion here. I can think of areas in which it would"fly"" perhaps better than others. Psych is one of them,especially if you are in a community where a good reputation goes 'round. There's a practice near where I live that has a slew of uro-gyno NP's... This practice does very well.
    I be that NPs who might specialize in diabetes might do well especially if they gear themselves for the teaching aspect.
  8. by   JACKMAC
    Papadoc,
    It is interesting to hear your perspective from an urban area, a saturated market. It isn't unrealistic at all in rural areas for NPs to start a practice. Where I live is also saturated since we have 2 medical schools, 2 NP schools, and 1 PA school. But I have heard several NPs in the state speak at conferences and they have started their own practices in more rural areas. There are areas of the South that are hurting for health care. There are probably areas of New York City that lack the type of access you have. An NP could open a practice there. I don't know the rules for NY but in my state we still have to have a collaborating physician but after a grace period of time, he or she does not have to be in the building with you. That is how NPs in my state have started their own practices. At this point I have no desire to start my own practice. I am not a risk taker but I would love to be employed by a NP someday.

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