Starting my own practice...

Specialties NP

Published

I live in a saturated area for NPs and I'm so sick of hearing lack of experience as a reason for not being hired. I have found a supervising doctor willing to work with me and rather than let my DEA and NPI numbers keep running without any use I assume it would look better if I at least had my own business.

Anyway, I'm seeing a few patients on my own but I'm ready to expand with my own cash only clinic. I was going to try to work it all by myself but can see I'll need to hire an MA. I also need to tie up some other loose ends. What I'm wondering is there anyone running an independent practice who can offer some pointers and other resources to help other NPs running their own practice?

Another frustration is that a couple of my patients are pushing the envelope with me as far as seeing what I will prescribe. I actually got a phone call late one night a couple of weeks ago asking if I could prescribe 90 10mg tabs of valium and 30mg of Adderol...I apologized but declined, then I got mad. I know how paranoid (I mean thorough) the pharmacies are around here as it is, not to mention it's my license, not theirs. What do I do with these patients?

Thanks.

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You tell those patient exactly what you will and will not do. Does your state pharmacy board track patients also? If so, let patients know you will be checking the website. I did when I was in New Mexico.

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I live in a saturated area for NPs and I'm so sick of hearing lack of experience as a reason for not being hired. I have found a supervising doctor willing to work with me and rather than let my DEA and NPI numbers keep running without any use I assume it would look better if I at least had my own business.

Anyway, I'm seeing a few patients on my own but I'm ready to expand with my own cash only clinic. I was going to try to work it all by myself but can see I'll need to hire an MA. I also need to tie up some other loose ends. What I'm wondering is there anyone running an independent practice who can offer some pointers and other resources to help other NPs running their own practice?

Another frustration is that a couple of my patients are pushing the envelope with me as far as seeing what I will prescribe. I actually got a phone call late one night a couple of weeks ago asking if I could prescribe 90 10mg tabs of valium and 30mg of Adderol...I apologized but declined, then I got mad. I know how paranoid (I mean thorough) the pharmacies are around here as it is, not to mention it's my license, not theirs. What do I do with these patients?

Thanks.

I echo what zenman has said - make it clear to your patients what you are comfortable doing/prescribing from the onset and don't waiver. My website makes it very clear what my policies and practices are surrounding controlled substances, disability paperwork, medical cannabis etc. If my practice philosophies are not a good fit for the patient, they know this before they schedule an appointment and are free to find a provider that is a better fit for their care. I also outline my approach to treatment in my informed consent that every patient signs to again serve as a reminder to patients as to what they can expect in my practice. I use my state's prescription monitoring program before I ever write a controlled substances prescription (and I also place a copy of this report in their EMR). If an existing patient desires a treatment plan that I am not clinically comfortable with, I provide them with education using current literature and if they are still insistent, I provide them with a referral to a colleague in the community that I am familiar with who might be more comfortable with the patient's desired treatment approach. Private practice is tough, especially without a lot of experience as you mention - hopefully you can develop a network of colleagues who you can run issues by (this has been helpful to me). Best of luck!

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I echo what zenman has said - make it clear to your patients what you are comfortable doing/prescribing from the onset and don't waiver. My website makes it very clear what my policies and practices are surrounding controlled substances, disability paperwork, medical cannabis etc. Best of luck!

Can you pm me your website? Always like to check out my buds!

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Specializes in ER, HH, CTICU, corrections, cardiology, hospice.

Shoot, I'd give up my DEA number if I was in primary care. Not worth the hassles.

Good luck.

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