Whenever we look at a practice, whether successful or struggling, we usually focus on external factors… location, reimbursement rates, costs, staffing issues, regulations, billing challenges, competition, etc.
While all are important, something else is at play that rarely receives attention.
It’s the practice owner’s beliefs about money.
The Stories We Tell Ourselves
Whether we realize it or not, the stories we tell ourselves about money influence everything we do in life.
In business, our money beliefs:
- Influence how services are priced
- How cash flow is managed
- Determine the degree of planning
- If business investments are made
Our beliefs about money can either support a stable, successful practice or slowly undermine it.
Your Beliefs Are Formed Long Before You Open the Doors
Your money beliefs are not shaped during your clinical or business training.
They are shaped early in life and reinforced over time by culture, family, work environments, and professional identity. They quietly shape much of our lives, often more than our actual income does.
Here’s how money beliefs tend to affect us:
1. They influence our behavior
Our money beliefs impact how we interact with money:
- If you believe “money is scarce”, you might hoard, stress, or avoid spending, even when it’s reasonable.
- If you believe “money comes and goes easily”, you may take risks or spend freely.
- If you believe “I’m bad with money”, you’re more likely to avoid budgeting or financial decisions altogether.
Frequently, beliefs become self-fulfilling habits that get reinforced.
2. They affect our emotions and stress levels
More often than not, money beliefs are emotional rather than logical.
- Guilt, fear, shame, or anxiety can come from beliefs picked up in childhood.
- Someone raised around ongoing financial conflict may associate money with danger or tension.
- Others may associate money with self-worth, feeling “successful” or “failing” based on the level of their financial success.
For many, it’s not just about numbers, but about how safe or threatened they feel when it comes to money.
3. They shape the opportunities we pursue (or avoid)
Our beliefs around money can limit or expand what we think is possible.
- The belief that “People like me don’t get rich” probably leads to taking fewer risks, fewer asks, and fewer opportunities.
- Whereas the belief that “Money is a tool” probably leads to a greater willingness to assume risk and take more calculated chances.
What we think we should do or deserve matters in what we attempt and/or pursue. Henry Ford famously said, “Whether you think you can, or you think you can’t – you’re right.”
4. They’re usually inherited
Our strongest beliefs about money have been passed down to us and come from many directions:
- Family attitudes (“Money doesn’t grow on trees”)
- Cultural or religious messages (“Money is the root of all evil…”)
- Past experiences, such as debt, poverty, or loss
- Friends and peer group, while not passed down to us, peer pressure, ranging from instant gratification to accumulation of wealth, impacts us
The bottom line: we absorb most of these beliefs long before we ever earn our first paycheck.
5. The good news: beliefs can be changed
Once you identify your money beliefs, you can question and, if they no longer serve you, change them.
Ask yourself:
- Is this belief true, or is it just familiar?
- Has this belief been helpful in the past, but does it hinder me now?
- What belief would be more helpful in the future?
Changing a belief doesn’t happen overnight, and it doesn’t magically change your bank account.
However, it often changes the way you think about money and gives you different options,… and that’s where the real transformation starts.
Money Beliefs and NP Practice
Why is it important to be aware of one’s money beliefs as a business owner?
Because when you start a practice and transition into ownership, these beliefs don’t disappear; they follow you into the business.
Your Money Beliefs Matter More When You Own a Practice
When you work as an employee, money decisions are handled mainly for you.
Services, pricing, compensation, billing, and collections are someone else’s responsibility. You don’t need to worry about it.
However, once you own a practice, it becomes your responsibility, and your beliefs will, to some degree, influence your decisions.
Over the years, studies have shown that financial stress and avoidance behaviors are widespread amongst the population.
- A majority of adults report anxiety related to money
- Many avoid reviewing financial statements or account balances
- Lower financial confidence correlates with poorer planning and decision-making
In a practice setting, this may show up as:
- Avoiding reviewing financial reports because they feel overwhelming
- Delaying difficult financial decisions, such as fee schedules or staffing
- Underestimating the true costs of running the practice
- Reacting emotionally instead of strategically during cash-flow dips
Money beliefs don’t just influence how you feel about money, but more importantly, they shape how you interact with it.
How Limiting Money Beliefs Can Hurt Your Practice
1. Underpricing Services
It’s not uncommon for practice owners, including NPs, to struggle with establishing market-driven pricing, especially in patient-facing roles.
If you believe that charging fairly is somehow incompatible with caring for your patients, you may underprice your services.
The result? Your practice may experience:
- Chronic cash-flow shortfalls
- Difficulty hiring or retaining staff
- Limited ability and/or willingness to invest in technology
While some NPs may feel uncomfortable with setting their rates at market, underpricing services doesn’t help patients in the long run; it actually weakens the practice that serves them.
2. Avoiding Financial Visibility
Beliefs like “I’m not a numbers person” or “I’ll deal with it later” can lead to financial avoidance.
While one would assume that people engage in avoidance behavior to reduce stress, research shows that avoidance increases anxiety rather than lowering it.
In business, it also means that:
- Problems are discovered late, often too late
- Decisions are reactive instead of proactive
- Opportunities for improvement are missed
The reason is simple… You can’t manage what you don’t see.
You must review practice financials regularly, either by yourself or with the help of a professional.
3. Resistance to Investing in the Practice
If money feels scarce or unsafe, investing can feel risky, even when it’s necessary.
This unwillingness to invest may lead to:
- Delaying software upgrades
- Forgoing professional help (accountants, consultants, advisors)
- Postponing marketing to grow the practice
- Making needed operational improvements
Ironically, the fear of spending money often keeps practices stuck in inefficiency and falling behind.
4. Blurred Personal and Business Finances
Beliefs about money often affect boundaries.
Some practice owners struggle to keep their personal and business finances separate, especially when they feel guilty about earning too much or are uncertain about the business’s sustainability.
This makes it more challenging to:
- Assess the true profitability of the practice
- Plan for taxes and retirement
- Remain in compliance
- Make clear business decisions
Clear separation of personal and business finances is essential, not only to stay within the law but also to protect personal assets and maintain a professional image.
Positive Money Beliefs Can Strengthen a Practice
If you realize that your money beliefs are not what you’d like them to be, you can take steps to change them.
Becoming aware of them and determining whether they help or work against you is the first step.
The next step is to actively change them; money beliefs are learned and can be relearned.
Practice owners who develop healthier money beliefs tend to:
- View money as a tool, not a moral scorecard
- Price services to reflect value and sustainability
- Use financial data as information and feedback, not as criticism
- Plan for both short-term stability and long-term security
Financial confidence tends to improve with education and active participation.
Developing small, consistent habits, such as reviewing monthly financial statements and tracking cash flow, reduces anxiety and improves decision-making over time.
Why This Is Especially Important for Nurse Practitioners?
Because most nurses enter the profession to help people, not to “make money.” Sure, they expect to earn a good income… and rightfully so.
And true to their roots, NPs tend to enter private practice with a strong identity based in care, advocacy, and service.
Those values are strengths; however, without conscious attention to money beliefs, they can create internal conflict.
Because most NPs were never trained to:
- Read financial statements
- Understand cash flow vs. profit
- Set business-appropriate pricing
- Plan for owner-based retirement
And when beliefs about money go unexamined, the practice can suffer, even when the clinical care is excellent.
But a sustainable practice need not be at odds with compassionate care. In fact:
- Financial stability supports continuity of care
- Healthy profit margins allow for better staffing and tools
- Ongoing planning reduces burnout and stress
When you reframe money as a support system rather than a threat, financial decisions become less emotional and more strategic.
So…
Your practice doesn’t fail or succeed based on numbers alone.
Practices succeed or struggle based on:
- The beliefs that guide decisions
- The habits that shape financial behavior
- The willingness to engage with money proactively and with consistency
By examining and reshaping your beliefs about money, you not only improve your finances but also strengthen the foundation of your practice.
And that benefits everyone involved: the practice owner, the staff, and the patients.
We want to hear from you… leave us your comment below.
By Johanna Hofmann, MBA, MAc., EAMP; regular contributor to the NPBusiness blog and author of “Smart Business Planning for Clinicians.”