Proposal for supervising physician

Hi all!

... but I am just unsure of exactly how to present the idea.

I recommend that you not start your business this way. Do it the old fashioned way. Do your market research and write a business plan FIRST. It doesn't have to be anything extravagant, but this is how you will get a reasonable idea of the potential financial viability of the business. Know the area and the demographics. Get a feel for different ways that you would be able to market the business to get clients. Be aware of competing services and determine if the area will support another service provider. Know exactly what your out of pocket startup costs (i.e. rent, malpractice insurance, etc.) and monthly expenses will be. Plan to lose money for at least the first several months before you turn a profit.

How you present your business idea to a potential collaborating physician doesn't necessarily have to be anything more than an informal conversation. Who you ask depends a lot on the legal parameters set up by your state BON. Do they really require that the collaborating physician be physically present at the place where you are practicing for the entire time while you are there? Or can the relationship be one whereas you can call or text the doc if you have a complicated case and need guidance? And/or you need the doc to review a certain percentage of your charts each month, or whatever. Do they require that the collaborating be practicing in the same specialty area in which you are practicing, or will any physician do? Most collaborating physicians who NPs hire to be their medical directors don't actually do much, and if you won't be doing any high-risk procedures that carry heavy potential liability issues for them then for the most part its easy money for them, and you really shouldn't have much difficulty finding someone to do it.

Network with other NPs and physicians and meet more people. CME conferences like Pri-Med or those luncheons and dinners that the drug company reps are always inviting us to are great places to exchange your business card and do your ask. If you're having trouble finding anybody then put an ad on Craiglist. Depending on your patient volume I will throw a number out there and say maybe several hundred dollars per month is a reasonable amount to pay, as a start. You could also contract on a per patient basis, or a percentage of the business profits (I strongly advise against the latter). It has to be enough to be worth their time though. If what you are going to offer is too little then you may not get any takers.

Since I am just starting out I don't know how much money I will actually bring initially. I basically need a supervising physician on premises per my state's BON and medical board.

See above. You shouldn't be starting up a business if you have no idea at all about the business' potential to earn money. You can either do a lump sump payment contract with your physician, or split up the payments however you feel comfortable. How much you pay your physician depends on how much money you will be earning. You also need to know that the business will generate enough profit to cover all operating overhead costs, pay your salary, and still have cash left over to put in the bank.

You will need a professional services agreement (which is different from the collaborating agreement that the state requires NPs to have with physicians if independent practice is not allowed). You will find good tips and examples in NP books like Carolyn Buppert's Nurse Practitioner's Business Practice and Legal Guide. You can buy the 5th edition cheap on Amazon. It explains the how-to for NP's who want to start their own practice, and more. And the book contains sample contracts and collaborating agreements that you can customize according to your needs.

i know in my state your collaborating physician must have the same specialty as you. Not sure if it's the same everywhere, but I think the point of having a collaborating physician is that they are your backup if something goes wrong, so they need to be skilled in the same things you are doing. Therefore, you would need a dermatologist, for example. It may be tricky to find a physician to collaborate with to open your own practice because you are seen as their competition.