FNP - Their Own Clinic - California

NPinWCH · Jun 22, 2011

I don't know, since I'm not in California, but in Ohio the answer is yes.

EzraRn · Jun 22, 2011

NPinWCH thank you for your post but can people only reply regarding California. Sometimes replies can cause the thread to spin into something unrelated then the original question. But again thank you for your post and trying to help.

Dr. Tammy, FNP/GNP-C · Jun 26, 2011

Yes. There are no restrictions for opening a clinic like there are for PA's. There are several challenges, though. First, to be able to practice, you need to be covered under standardized procedures. Check the California BRN website as there is much information regarding this in position statements under advanced practice. Second problem is being able to get paid. Medi-Cal and Medi Care: no problem. Everything else: huge barriers. Most third parties will not contact with you--only your supervising physician. This, of course, is a huge impediment because now they are not only on the hook for supervising your practice, but also in how you bill. Third, referrals will not deal with you--they will report to your supervising physician for the most part. This causes many delays from radiology/lab to specialty physicians.

xInspiredx · Jun 27, 2011

I thought that NP's in CA can't practice independently?

EzraRn · Jun 28, 2011

Thank You Tammy.

Dr. Tammy, FNP/GNP-C · Jul 1, 2011

I thought that NP's in CA can't practice independently?

That is correct, hence the need for a supervising physician.

xInspiredx · Jul 2, 2011

That is correct, hence the need for a supervising physician.

I am confused then. So a NP can open a clinic, but can't practice independently?

Wouldn't the whole purpose of opening a clinic be to practice independently? I guess I'm missing something here.

linearthinker, DNP, RN · Jul 3, 2011

NPs can't legally practice independently in my state either, but they can hire MDs/DOs to work for them as their "supervising" physician. Basically, it is name only. A name for the insurance companies, as Tammy mentioned, a signature on charts to satisfy auditors. I have an acquaintance who does this. The "supervision" amounts to her physician employee showing up for coffee and donuts once a month while he signs paperwork. Otherwise they have no contact, and he has never laid eyes, much less hands or a stethoscope, on any of the patients.

It is ridiculous that she has to pay him for this. For all intents and purposes, she is practicing independently. The oversight is nothing but a way to pad MD pockets and doesn't have squat to do with concerns about patient safety.

Anyway, I assume the OP could do something similar.

EzraRn · Jul 3, 2011

It doesnt sound like it is worth the headaches and probably not that financially rewarding otherwise you would see a lot of clinics with just the NP's name on the sign. I dont recall seeing one here in Ca. All the extra schooling and problems with starting a new business dont seem to be outweighed by any major financial advancement.

Can a NP with their own clinic in California make over $100,000 a year? If not, then Im not seeing it being worth it. Ill stay where Im at. Maybe this should be my next thread.

nursetim, NP · Jul 7, 2011

Anybody can open a practice. I bet even a felon could open a practice. All you need is someone licensed to practice to treat people. Not having insurance paying you may not be all that bad. There are practices out there that do not accept ANY insurances and are doing quite well. I am not talking about concierge practices that specializes in diseases of the rich. I am talking meat and potatoes practices like an old country doctor.

One example is Access Healthcare in Apex NC. Tammy maybe familiar with this practice.

This example is owned by an MD, but it could also be owned by just about anybody using the same business plan.

hopebewild · Aug 15, 2011

Anybody can open a practice. I bet even a felon could open a practice. All you need is someone licensed to practice to treat people. Not having insurance paying you may not be all that bad. There are practices out there that do not accept ANY insurances and are doing quite well. I am not talking about concierge practices that specializes in diseases of the rich. I am talking meat and potatoes practices like an old country doctor.
One example is Access Healthcare in Apex NC. Tammy maybe familiar with this practice.
This example is owned by an MD, but it could also be owned by just about anybody using the same business plan.

I have often thought about going this route if I become a fnp. I just my bill from my son's 9month well baby check up. He was seen by a nurse practitioner and is healthy as a horse and my bill was over $500. Of course I have insurance so no worries on my end lol. But I often think about the people without insurance and it is no wonder why people dont go to see their regular doctor!

So i dream about setting up my own private little clinic that accepts no insurance kind of like the minute clinics. :)