What are the Pros and Cons of Being an Independent Contractor as an NP

TravelGtr · Jul 1, 2011

Gators1,

I've spent the past year traveling the country as a contract provider. The pros for me have been the flexibility(!!), my ability to write my own ticket so to speak (lots of room for negotiating fees for services), and the autonomy. By far, the biggest con has been filing taxes as an 1099 employee. You have to keep track of EVERY expense that is work-related and if you are not organized and do not have an awesome accountant, you risk forking out a ton of dough or, even worse, being audited. I learned the hard way and subsequently became incorporated (set up an LLC) to avoid the self-employment tax and that did alleviate the amount I owed for the next tax period.

In my experience, the clients I worked with would provide malpractice coverage and state licensure/DEA fees. Not having benefits wasn't a huge deal because I was able to find some affordable medical/dental plans online. I made a boatload more as an independent contractor, which helped make up for it.

Hope this helped.

TG

P.S. Based on your username, it looks as though you're a fellow Gator!

TigerBlood01 · Jul 2, 2011

Hi TravelGtr,

Yes, I am a fellow gator :) Thanks for sharing your experiences. I think the flexibility and autonomy of being an independent contractor will be truly liberating. As yourself, I will be able to set my own hours and fees. I was worried that I would not have a lot of job security doing this compared to being an employee. However, I am seeing that my services are in demand and do not think that lack of job security will be a problem.

Thank you for the advice regarding the taxes. I was planning on seeing an accountant and tax attorney to cover all of my bases. I definitely do not want to be audited or owe money to Uncle Sam.

I have a couple questions about the billing aspect. How do you do the billing? Is there a program that you use or recommend to keep track of your billing, submit claims, ect.?

Also, did you apply for a Medicare Provider Number? If so, how long did it take you to get it and how were you reimbursed while it was being processed? I heard it takes 3-4 months to get it. Does this mean you do not get paid until you have an actual number?

I apologize for all the questions. I wish that they had offered a class about billing, reimbursement, and the other business aspects of being a nurse practitioner in my graduate program. How did you learn about the business principles of being an independent contractor?

Thanks and it is inspiring to hear about other nurse practitioners like yourself that have started their own business and doing it successfully!

nick1 · Feb 17, 2018

Hi,

Do mind recommending some of the clients that you have used & was satisfied with? Also, which company did you find for affordable medical/dental plans?

Oldmahubbard · Feb 18, 2018

Many people are extremely naive about the tax and business aspects of working independently.

You need some heavy duty professional advice, which is not found on an online forum.

A good professional should be able to give you some solid information in context.

For example, cheap or affordable health insurance is usually high deductible. Which means you pay for your insurance, plus you still pay for everything medical, until there is a catastrophe.

A one or two hour consultation with a financial professional can give you a solid understanding of the realities of self employment, which I think you need.

Your hourly rate will be at the very minimum, 50% more than a non self employed person. Maybe 100%.

pocovan, MSN, RN, NP · Mar 1, 2018

I work as a FNP contractor and I enjoy the travel aspect. I go to areas that I may not have ever visited on my own. My kids are grown and my husband works remotely so he is able to travel with me.

Things to consider:

1. We do not own a house and live in the provided housing. This requires some flexibility on how much you can own. We are minimalists so it lends itself well to this life style.

2. You work for 3 months or more at a time and then start a new assignment or extend. If you like the area it is great! If you don't like it you are there for 3 months. í ¾í´¨

3. You can incorporate a rental car which is nice to have. If you fly across the country you may be living out of suitcases.

4. It is like starting a new job every 3 months. This takes flexibility, not belly aching about it and not being a regular team member. This sometimes makes you not feel connected. However, it also helps to avoid staying out of work personality conflicts.

During every assignment you have to keep your eyes open for the next one. This takes planning ahead to prepare.

Best wishes to you!

Dempster · Mar 1, 2018

Out in the mid and western, northern states, NPs practice 100% independently. They aren't stripped of skills or medications that the are educated about and use appropriately. There isn't a doc that considers you an extension of him.

It's nice to bounce off thoughts with another provider. We all do it. I've called former docs and NPs that I trust for certain things that are up their alley. I do the same for them.

In Knoxville, TN, a practitioner (pretty sure CRNA) partnered with one or two others to open an Anesthesiology clinic. They hired most of the anesthesiologists and CRNAs in Knox and surrounding counties. I think one of them worked PRN for giggles, but mostly they just raked in money. It was more than enough for overhead and such. It was brilliant. They inspire me! Screw opening my own family practice. Maybe one day I'll open up a specialty clinic and hire medical practitioners that will work out amongst the area!