Another exhausting week …
You spend less and less time with patients and more on administrative tasks.
Decisions that affect your patients are made by bureaucrats who have never met or spoken with the people they are affecting.
Disillusioned and disappointed, a recurring thought keeps coming back into your mind: “Why don’t I start my own practice?”
It’s not uncommon to ponder starting a practice after a challenging stretch of time at work.
After all, owning your own practice offers you autonomy, more flexibility, and the opportunity to build something aligned with your values.
But not so fast …
While starting a practice has many benefits, ask yourself this:
Do you truly want to start your own practice, or are you tired of a job that no longer works for you?
The distinction is an important one ….
Are you moving toward something you truly want, or are you running away from something?
Dissatisfaction Makes a Poor Business Plan
Frustration is a powerful motivator, but it’s hardly enough to start a business.
Feeling dissatisfied and unhappy in your job may help you recognize what you no longer want. You may realize that your current role is too restrictive, too stressful, or no longer aligned with your professional goals.
However, realizing that you want to leave a job is different from knowing that you want to start a business.
Perhaps you feel exhausted by the constant productivity expectations and pressures baked into the organization you work for.
You imagine that once you’re in your own practice, you’d be able to spend more time with patients and get away from everyday corporate pressures.
While that’s possible and achievable …
Your practice will have demands too. There will be:
- bills to pay
- employees to manage
- marketing to fill the practice
- billing to deal with
- policies to enforce
- systems to build
- financial decisions to make
Starting your own practice will remove some employment frustrations, but it also comes with its own set of responsibilities and headaches.
I don’t say this to discourage you from starting a practice, but to encourage you to choose with your eyes wide open.
Wanting Independence Is Not the Same as Wanting to Own a Business
Most NPs are drawn to practice ownership because they want independence.
They want to decide how to care for their patients, exercise control over their schedules, choose which services to offer, and determine the overall patient experience.
All good reasons for starting a practice.
However, when you own your practice, you may have more control, but you also carry more responsibility.
You’re no longer “just” the clinician.
Now you’re also the decision-maker, problem-solver, planner, financial reviewer, marketer, policy-setter, and sometimes the person who takes care of whatever did not get done.
Gaining independence is empowering, but it can also be challenging. The question is not whether you want more freedom and independence, but whether you are willing to accept the responsibility that comes with it.
Before You Start, Ask Yourself…
Before you decide whether to start a practice, take a good, honest look and examine how ready you are.
Start with your finances
Do you know your personal financial obligations?
Do you know how much money you need to live on each month? Do you have savings or another source of income to help you through the startup period? Are you prepared for the practice paying you inconsistently in the first few months?
Consider the Risks
Starting a practice is not the same as acting recklessly, but it does require tolerance for uncertainty.
Your patient base may grow slowly. Expenses may be higher than expected. Your cash flow may feel like a roller coaster before it stabilizes.
How comfortable are you with uncertainty? How do you respond when outcomes are not guaranteed?
Lifestyle Considerations
Some NPs view practice ownership as a path to greater life balance, which it can deliver in due time.
However, the early stages often require extra time, resources, and emotional resilience.
Are you prepared and willing to work on the business after clinical hours? Can you tolerate the extra time and energy it takes to build the practice before it feels stable?
Consider Responsibility
When you own your practice, “the buck stops with you.”
The decisions you make come back to you; you own them. That includes decisions about money, policies, patient expectations, staffing, marketing, and compliance.
While you don’t need to know everything before you start, you need to be willing to learn and take full responsibility for your decisions.
Before You Commit
… first test your idea.
Get clear on the type of practice you want to start. Who would you serve? What problem would you solve? What services would you offer?
Would your business model be insurance-based, cash-pay, hybrid, telehealth, mobile, specialty-focused, or something else?
If possible, talk with other NP practice owners and ask about their startup experiences; what were their biggest challenges, what surprised them most, and what recommendations and advice do they have for you.
Consider getting some basic business concepts under your belt.
Learn to estimate startup costs, understand the credentialing process, research local demand and competition, and create a simple business plan.
Develop an understanding of basic marketing, finance, and operational concepts.
Evaluate your interest in owning and running a business by how you respond to business tasks.
Are you curious about marketing, finances, operations, and systems? Or do they feel that’s something you’d prefer to avoid completely?
While you don’t need to love every aspect of business, you must be willing to engage with the business side enough to make informed decisions.
Not Sure If You’re Ready?
Feeling unsure about starting a practice doesn’t mean you should abandon your idea altogether.
In fact, some uncertainty is healthy. Starting a practice is a big decision; it will affect your finances, time, family, professional identity, and future options for years to come.
The goal is not to eliminate every fear before moving forward. The goal is to listen to and understand what those fears are telling you.
Some fears tell you where you need more information. Others point to skills you need to develop.
Some may let you know that the timing is not right yet. And some are simply the natural unease that comes with major change.
Feeling ready doesn’t mean you have all the answers. But it means being willing to ask better questions, prepare, and take responsibility for what you are building.
A Better Starting Point
If your biggest reason for starting a practice is, “I cannot stand my job anymore.”
Stop, and pay attention to how you feel.
However, escaping employment is not a good enough reason to carry you through the demands of practice ownership.
A stronger starting point sounds more like:
“I want to start my own practice. I see a need I want to serve. I understand that ownership includes both freedom and responsibility. I am willing to learn about the business side. I accept there will be uncertainty and ups and downs. I want to build a sustainable, thriving practice.”
That’s a very different starting point!
Practice ownership can be a rewarding path …
It can offer autonomy, creativity, and the chance to deliver care in a way that reflects your values. And that decision deserves careful thought and preparation.
We’d love to know your thoughts on starting a practice… Please share your comment below.
By Johanna Hofmann, MBA, MAc., regular contributor to the NPBusiness blog and author of “Smart Business Planning for Clinicians.”