Build a Successful Continence Practice

I am frequently asked “what kind of business can I have”? While there are several forms of business, most NPs and PAs choose a clinical practice. And while most chose primary care, more are choosing a niche or specialty practice. One such niche is urinary incontinence (UI) care.

A continence practice is a fantastic opportunity for the advanced practice clinician. There are three very important factors for this type of business. First, there is a huge need; second there are few clinicians involved and finally, the evaluation, management and procedures are reimbursable.

A flexible, scalable model

What is nice about this type of practice is that it can be set up to work within office (yours or someone’s), a long term care facility and even within the home using a house call model. It can be full time or part time. And for those that already have a primary care practice, this is a great add-on service that can help build your practice revenues.

For those that like to work with a patient for a specified length of time, have them get better, and only see them back for “tune-ups”, an incontinence practice is ideal.

This business model is also scalable. You can start of doing it all yourself and as the business grows (if that is your plan), you can add additional providers and staff in order to accommodate your growing business.


Medicare and most insurance companies will reimburse for assessments and procedures that are done in an incontinence practice. This will include your initial assessment, urodynamic testing (simple or advanced), microscopy, ultrasound, laboratory testing (both send-out and point of care), patient counseling, pelvic floor rehabilitation and more depending on how you set up your practice.

Often, tools that patients might use are hard to find and this can be an additional source of revenue. You can offer hard to find items to your patients in your office or through your website.

A Day in the Practice

As with any practice, your day will vary depending on location (office vs long term care facility for example) and other factors, however the basics are the same. Your job will include (but is not limited to):

  • Evaluation of incontinence for pelvic floor dysfunction, overactive bladder or other issues that may be causing or contributing to UI. You will likely perform simple cystometrography as part of your workup.
  • Counseling patients regarding behavioral modification, prevention and treatment of constipation, diet modification, fluid management as well as exercise they can perform.
  • Treatment of the cause with medications and pelvic floor rehabilitation and electrical stimulation as indicated.

Getting Started

Like any business, you have perform the necessary analysis and evaluation to determine if this is the correct business for you. You’ll need to learn how to get reimbursed and how to maximize those reimbursements as well as know what it takes to operate a business. And of course getting started and finding your patients and referral sources (ie, the marketing) is key.*

Continence is a state that all people strive for. When it’s not present, it affects an individual physically, emotionally, financially and socially. This is an area that clinicians can make a huge difference in the lives of their patients. The need is great, the need is now.

For more information on building a business and building a continence practice, Helen Carcio, NP @ The Health & Continence Institute (HCI) offers an opportunity for the entrepreneurially minded NP to establish a lucrative continence care program of excellence.  She offers course intensive courses a few times per year and it’s a training well worth going to.

© 2011 Barbara C Phillips, NP


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