I had the wonderful opportunity to be interviewed by ReachMD host, Mimi Secor, NP and I’m thrilled to share that  Seven Steps to Starting your own NP Practice, is being broadcast live on ReachMD this week.  The program can be heard on XM Satellite Radio Channel 160, on the live stream at ReachMD.com or via the MedicalRadio mobile app. The schedule is as follows:

This Week’s Schedule  (All times Eastern)

The program can also be heard on-demand, 24 hours a day, 7 days a week by clicking here.

Let us know what you think!

Nurse Practitioner Business Owner, hosted “Getting Started in your OWN Practice” teleseminar on Sunday April 25, 2010. There were RECORD numbers of Nurse Practitioners and Physician Assistants in attendance.  The questions sent in before and during the event were fantastic. I did not get a chance to answer all the questions, but watch this blog for updates and answers to questions.

If you missed it, you can listen to it here:  www.nursepractitionerbusinessowner.com/startupsystem-replay.html

On this teleseminar, we introduced the NPBO™ Practice Startup System Program which starts Wednesday May 5th. I’m so excited to be actually teaching this course – I’ve had so many requests for something like this, and I believe it will make a huge difference for the NPs that are already participating! You’re invited to check it out, but you’ll want to do so before May 1st at 12 midnight Pacific (hint: the special pricing ends then).

Hope you’ll join us on May 5, 2010!

Visit http://www.nursepractitionerbusinessowner.com/gettingstartedinpracticecall.htm

Nurse Practitioners who want to get started in business, with low overhead would do well to look at this business model. Listen in:

On a weekly basis, I am finding email, phone calls and letters from Nurse Practitioners who are looking for information on stating their own business.

This article is a synopsis of an article I wrote that was orginally published in Advanced for Nurse Practitioners. It has since been updated and can be found at NPBO.

1. Develop a support system.

None of us operates in a vacuum. It is essential that you develop a team of professionals to assist you. That team may starting with an business attorney and CPA in order to start you out on the right foot both legally and financially.

You will also want to network and mastermind with other NP Business Owners who have already traveled this road. It will likely save you time, money and frustration.

2. File the necessary paperwork.

The paperwork alone will keep you busy! You will need to file for the necessary business licenses and permits. You need to get an NPI number, which should correlate with your new Tax ID number. As soon as humanly possible, if not before, begin the credentialing process with Medicare. That one will take the longests. File the others as soon as you can.

3. Find an affordable location.

Where you want to locate your practice is an important decision. Consider how much space you need now and for futuer growth. In your mind, walk through your space to determine what you think you will need. Make sure it feels good as well as make good financial since. Considerations including leasing a medical office, buying and remodeling a space as well as building from the ground up.

4. Research budgetary projections.

As soon as possible, start gathering information about reimbursement rates from payers. With this information, you’ll be able to make some projections about your potential gross and net income. Don’t forget to factor in the lower reimbursements that many still pay NPs.

5. Scout around for insurance.

Shop early for your liability insurance. Almost all payers want to see proof of your malpractice coverage prior to credentialing you. This includes many of the plans you may already be credentialed with.

6. Hunt for affordable and functional equipment.

I don’t buy the idea that you have to spend a huge amount of money to open your business. Nor does everything need to be brand new. I did a lot of shopping at surplus retailers as well as eBay. Likely you will purchase both new and used equipment. Consider keeping your shopping list to those items that you will really needed initially, as well as those items that you can show a good return on investment (ROI).

7. Outline your staff strategy.

What roles will have to be filled as your practice grows. Who can you utilize in more than one positing as you get going? Remember, when thinking about staff, you will have lots of additonal fees and taxes associated with being an employer.

8. Learn all you can about billing.

If there is one thing I wish I had known more about before beginning this practice, it would be billing. Reimbursement is the cause of most of my business headaches, and has nearly closed more than one practice. I cannot emphasie this enough. Learn it, and then monitor those who are doing it for you.

9. Let people know about you.

Marketing! I once read that we only think we are in busines to provide whatever widge we are providng, when it truth, our true job is to market. We have no business without our clients and patients. The way they find us is marketing – yellow pages, word of mouth, referrals, insurance companies, websites, and newspaper ads to name just a few.

10. Look Ahead.

Take the time to identify your goals and keep them updated. Decide how you want to grow and when it is time for you to move on. Make sure, as much as possible that you build a business that fits you and your lifestyle.

I believe that more and more resourceful and creative nurse practitioners will make the jump into private practice. It only takes a few core steps to mark out the path to myriad opportunities.

SCORE is a wonderful website, and you can find all sorts of information to get you going in the right direction.

Recently I stumbled upon their interactive site. They are all sorts of topics around the subjects of starting your buisness, managing your finances and marketing.  You’ll need to register, but other than that…there is no cost to you.

This question is from NP Cecelia in Portsmouth (VA):

I have a question for you, I am leasing a new property that I will spend approx $34,000 in contract work to build the inside clinic. Is that the norm or should I expect some type of refund post my lease for the money I put into finishing my portion of the building?

My Response: This will depend on what was negotiated in the lease. Often times, especially on a new construction, the owners will “build to suit”. They have to finish the building to code anyway, and they will often do so in a way that will meet your needs. Mind you, if you want something particularly fancy or specialized, you will often have to pay for the extra.

A friend of mind did something similar here in WA State. It was a new construction for medical office space. She was able to work with his architect/designer and have the layout build to her specifications.

This is where your homework comes in. What is common in your neck of the woods as far as leasing new construction? How competitive of a market are you in? Is this a specialized place or is the entire building medically oriented?

Readers: do you have any comments about this? Have you been involved in this sort of situation before? What did you do?

A Nurse Practitioner in NJ has written in with a couple of questions regarding negotiation for office space and collaboraton fees.

Here’s my situation-I have been working as an independent contractor for the last 2 yrs seeing patients in their homes for disease management teaching/coaching. I wanted to expand that concept. I though of getting my own clients through advertising etc, but also wanted to be able to treat patients at home if unable to reach
their PCP and then ultimately have my own practice. I called a MD recently to try to see if he could be my collaborative physician for this venture. He wants a proposal. I thought I might work for him 1 day per month instead of paying him. What is the going physician fee for collaboration? Also how do we negotiate office space usage?. Looking forward to hearing from you.

For those of you who have experienced this, what have you found? Feel free to comment below, or contact me with your thoughts.

Jan, a Nurse Practitioner in NC, is opening a brand new clinic in Stokesdale. She asks this questions about water usage.

I am opening a clinic in an area that is on a septic tank and the owners are asking for water bills to try and figure out what my usage might be. I don’t have that information to give them and was wondering what your clinic’s average water bill/usage is. I will have 3 exam rooms, a lab and 2 bathrooms. The owners have to submit this information to the county before I can get approval.

Jan, you might try and get that information from existing clinics in neighboring towns. Look for clinics in similar size and traffic that you anticipate.  It’s really hard to estimate usage when you’ve not done this before…I know!  As far as my usage…I have no idea. My lease includes all utilities, so I don’t really know.

Anyone else?

When was the last time you visited the SBA website? Are you aware of the vast array of information there for businesses?

1. There is a Small Business Planner that is designed to help you plan, start and manage your business, as well as your exit strategy.

2. Under the Services tab, you’ll find information on financial assistance, where to find business counseling and assistance, contract opportunities, disaster assistance, laws and online training.

3. In the Tools section, there is a library and plenty of resources to keep you busy as well as an audio/vido section with podcasts on a variety of topics. They even have a monthly web chat and plenty of forms to keep the government happy.

4 Local Resources will point you in the direction of offices in your area.

Starting any kind of business takes lots of work. If you are starting or running your own practice, you know this. While the SBA cannot help you with the health care aspects, it can certainly help you with the business of running a business.