Many Roads to Practice Ownership
National Harbor, Md. -- Associate editor Jen Ford and I are at the annual conference of the American Academy of Nurse Practitioners. I just had an interesting afternoon of NP employment topics. I was struck that the audiences for "Marketing Yourself to Get the Job You Want" and "Starting and Running Your Own Practice" overlapped so much! It seems that practice ownership is no longer a crazy idea for NPs, but one that's considered a real option by so many.
The panel discussion on starting and running an NP practice included panelists Nancy Dirubbo, NP, who's owned Laconia Women's Health Center in Laconia, N.H,for the past 23 years; Luan Nguyen-Tran, NP, who owns The Geriatric Health andWellness Center, a house calls practice in Round Rock, Texas; and Maryclair Jorgensen, RN, who has helped countless NPs establish their own practices through her health care management consulting firm Jorgensen & Associates.
There were two main themes to this afternoon's discussion. First, you don't have to fit any particular NP profile to become a practice owner. Opening your own shop after 20 years of working for someone else is not, in itself, any better than breaking out on your own right from the beginning. Neither is there a single way start: Approaching an employer with a buy-in offer can work as well as scouting a new location and applying for loans on your own.
Second, when you work for yourself, you can work the way you want to. Don't imagine that owning your own practice means that you must work 80-hour weeks. Owners control their own patient loads and -- even better -- the length of an office visit and the mix of services. If you want to see patients for hour-long visits, mostly consisting of diabetes education, that's up to you. Nguyen-Tran has three children under 6, and she says she spends as much time with them as she likes.
Besides these two themes, there was a lesson, or a warning: Do your homework. If you're going to make your own practice work, you need to know what you're getting into. Know who your patients will be, what their conditions will be, what the reimbursement rates for those conditions will be, and what your overhead and other expenses will be for at least a year out. Talk to other owners (physicians and NPs), an accountant and an attorney.
Then let your imagination be your guide.