Patience and Persistence
Owning an independent practice as a nurse practitioner can be very fulfilling. It can also be very stressful. Some NPs may be fortunate enough to open an independent clinic staffed with medical assistants, secretaries, billing personnel, a coding company, and so on to take care of the issues as they arise. However, many of us start as a one person show. This situation can present with many problems that require patience and persistence of the new independent NP.
Although I am generally near the top on my own priority list, I am generally near the bottom with important contacts I do business with. This has been a frustrating fact to deal with since day one. My patience was first tried as I tried to obtain a building license from the city to build my clinic. Over 2 months I was rejected twice because of parking issues. I didn't give up. I couldn't figure why they had a problem with the parking. I reviewed the plans and figures and finally found out that the city had a math error that figured one more parking spot than actually was needed based on square footage. I showed them the error and obtained the permit.
A few months after opening I decided it would be profitable to have a consulting physician so I could bill more insurance companies that would only pay me if I had one. I didn't know any in the area so I picked one and took him out to lunch. He said no. I still felt he was best for the position so I stopped by his practice every week to answer any concerns and to help him get to know me better. Six weeks later he signed on as my consulting physician.
With him on board, I could bill more insurances than I could have previously. However, I still wanted to contract with the largest insurance agency in Utah. This insurance agency refused to pay NPs in private practice. I joined a coalition of other NPs who had been writing and calling this insurance company to convince them to credential us. We professionally, but sternly, talked to them for months. Finally in July 2008 they agreed to credential NPs. This insurance alone will increase my patient population 30% to 40%.
There are several other issues from being an independent clinic owner that I have encountered. Some, like the examples given, I have been successful with. Others I have not been so successful with. I've had to be patient, but have persisted. As you run into various government, state, insurance or other regulations, stand up and fight. Be professional and courteous, and realize that change takes time, but don't give up.
Finally, don't just stand on the sidelines and think that other NPs or other associations will do the work for you. We need to elevate the practice of nursing. The only way we can do that is if we all stand up together for our profession.