Finding Your Niche
After graduating from the University of Pittsburgh nurse practitioner program in June of 2003, I immediately had job offers. I had been doing my clinicals in a rural family medicine office and (fortunately) enjoyed what I did. I knew I was carrying my own weight, and the pay was acceptable for my first job out of school. So I stayed.
However, I could not make any real decisions about the practice. I felt really limited and sometimes unappreciated!!! I also had trouble dealing with the fact that as a new practitioner in an old office I had to sell myself to the patients. There were many other frustrations such as labs and specialists addressing letters and results to the physician in the practice. This frustrated me because the doctor had never even seen the pt.
So after 2 and a half years it was time to open my own practice. This was a pretty bold venture, but I was prepared. For the past 2 and a half years I had been treated as though I could handle all my cases on my own, and this empowered me.
When thinking about opening your own practice, you must identify the niche or the need of the community your new practice will fill. I looked at the problems with health care and decided to do what I could in my own practice to alleviate these problems. The intent was now evident, and the tools I needed to do the job safely and effectively had been honed during the last few years. The question was this: "Will I be successful, or will I fail?"
When I opened my first office in 2006, I had no one to ask, "How do I do this?" It is key to have a mentor. My life would have been so much easier if I'd had just had someone to ask!
Remember this when you open your own practice. A physician can graduate from medical school, hang their shingle and just start working. The doors are wide open for physicians. They have been doing this forever, and it is the mainstay of medicine at this point.
As new kids on the block, NPs must prove themselves and in some cases like mine, pave the way. I have made major strides in what I now do. I have respect from the community and other physicians. I get referrals from three different hospitals in the area, many doctors' offices, and even other urgent care centers!
You may ask, Why? Well, I offer what no one else does: affordable, quality health care for those who do and do not have insurance. I offer evening and weekend hours as well as slots for walk-ins. This is my niche!!!
When you decide to open your own practice, do your homework first. What can you do in your community that no one else does? Who can you ask to guide you in the right direction? How much opposition will you receive? Can you get credentialed in your state through insurance companies? Who will you need help with things like answering the phone, dictation, billing, advertising, etc.? What office equipment will you need to get started? Where will you locate this office?
Many of these questions will be answered and altered to suit as time goes by, but preparation is essential. These are just a few areas to consider prior to jumping in with two feet. It is also helpful if you can work part-time somewhere to assist in your office expenses as well as home expenses until things really take off.
And remember, "What one practitioner can do, another can do." I now operate two practices and moonlight for a local D&A rehab. The sky is the limit, and as long as you are willing to take a chance and you have the confidence, you can make it happen!!!
Joseph F. Marra CRNP
Urgent Care Center (Owner)