Frequently, small business owners live on a never-ending rollercoaster; Nurse Practitioners practice owners are no different.
One month, their schedule is packed, even double-booked. They work late to get everything done. And even though it’s tiring, they’re fine with it because the practice brings in revenue.
But here’s what happens next…
A few weeks later, the calendar opens up. Cancellations increase. Follow-ups drop off. New patient calls slow down, and a feeling of doom and gloom sets in.
This is the feast-or-famine cycle.
It’s common. It’s stressful. It’s anxiety-producing.
And… it is avoidable.
What’s behind the Feast or Famine Cycle?
The cycle has been around for a long time. It’s not random but somewhat predictable.
It is a symptom…
It usually points to a marketing problem: marketing only happens when things are slow.
When the schedule is full, marketing stops. You tell yourself you are too busy. Marketing can wait.
And when the schedule becomes slow again, anxiety and fear return, and marketing restarts.
It’s this gap between starting and stopping that creates the roller-coaster effect and leads to instability in your business.
Let’s compare marketing to a pipeline… to work efficiently, the pipeline must be on and running continuously.
But when the pipeline is turned off and then turned back on, not only does it take time, it also consumes more resources to reach previous output levels.
Keep in mind that marketing does not produce instant results.
Typically, there is a delay between your efforts and the outcome. The marketing you do today may not show up in your schedule for 30 to 90 days.
This is because people don’t come across your practice and book an appointment right away. Most go through some form of customer/patient journey before they book their first appointment with you.
If you only market when you are slow, you create long gaps in your marketing pipeline.
Marketing cannot be optional in a service business (or any business)… it must be ongoing.
Think of Marketing like this…
Your practice is like a garden, and marketing is like planting seeds. You reap what you sow.
If you only plant seeds when you’re hungry, you’ll always experience famine. If you stop planting, your schedule eventually dries up.
The goal is to maintain an active marketing pipeline, which means:
- New patients are discovering you consistently.
- Referral partners hearing from you regularly.
- Your online presence continues to attract traffic.
- Your reputation is compounding over time
But without an active pipeline, you’re dependent on random events like:
- Insurance directory updates
- A single referral from a provider
- Word of mouth
And that’s not a strategy. That’s hope.
As a Nurse Practitioner, you were trained to care for patients, not to build a business. And that’s why marketing often feels uncomfortable, even optional; it gets pushed aside when clinical duties feel more urgent.
But in private practice, marketing is not optional.
To some extent, it’s even part of patient care because without it, there will be no practice to serve them.
Create a Marketing Machine
Marketing cannot be something you do… sometimes. It’s not something you do because you feel like doing it.
It must become something you do automatically and consistently, just as you do with reconciling your accounts or submitting claims.
Marketing Must Become Routine!
Marketing must become something you do on a schedule, not something you do when patient appointments drop off.
You don’t file taxes because you feel like it, nor do you submit your claims only when cash flow drops. And marketing must be treated the same way.
When it becomes routine, it stops feeling overwhelming and chaotic; it becomes reliable and predictable.
What Ongoing Marketing Looks Like
Ongoing marketing does not mean posting randomly on social media every day, nor does it mean spending thousands of dollars on ads.
It means choosing a few clear, consistent strategies that move the needle and committing to executing them weekly, bi-weekly, or on a schedule that works for you.
For example:
- You might set aside time each week to nurture referral relationships: sending a short update email to colleagues, checking in with therapists and other providers in your network, or sharing an educational resource.
- You might commit to publishing one educational article per month on your website. Over time, those articles improve your visibility online, answer patient questions before the first appointment, and build trust.
- You could create a simple follow-up system to retain patients: send birthday wishes, automated reminders for annual visits, and reactivation emails for patients who have not been seen in six months.
Retention, retaining current patients, is often overlooked. However, it is just as important as attracting new patients to your practice.
Track What Is Working
You can’t hit a target you can’t see, no more than you can improve what you don’t measure.
How do patients find your practice?
Every new patient should be asked: “How did you hear about us?”
Record the answers and review them regularly; over time, patterns will emerge. You will see:
- Whether your website is generating calls.
- Which referral partners send you patients.
- Whether insurance listings are helping.
When you have data, you stop guessing.
Now you can double down on what’s working and stop doing what doesn’t.
Not only does this build confidence, but it also prevents you from wasting time and money.
A Simple Plan
Have I convinced you to try a more organized approach to your marketing?
Great…
Start small, and don’t let yourself get overwhelmed.
Set aside one hour each week for marketing… that’s all.
Spend part of that time nurturing relationships, improving your website, or creating informational content.
Whatever you do to market your practice, do it consistently…
Just 60 minutes per week can prevent months of stress later.
Small, steady action beats oversized but occasional efforts every time.
The Bigger Picture
Getting stuck in the feast or famine cycle doesn’t mean you’re not cut out for business; nor does it mean you need a business degree to get off the rollercoaster.
However, it does indicate you need better systems that work for you.
Consistent marketing, building your pipeline, is the ticket to getting off the rollercoaster.
Once marketing becomes focused and consistent, revenue becomes steadier, too.
And steady revenue brings something every Nurse Practitioner business owner wants… Peace of mind!
Let us know what you think… leave your comment below.
By Johanna Hofmann, MBA, MAc., EAMP; regular contributor to the NPBusiness blog and author of “Smart Business Planning for Clinicians.“