Starting A Practice: Questions Every Nurse Practitioner Should Ask

There was a time when we didn’t have the option to start an independent practice. Unfortunately, in almost half of US states, we still don’t.

But times are changing, and I am confident the number of states with full practice will increase.

While full practice is not required to start a practice, not having to secure a collaborator or deal with supervision certainly makes life easier.

A New Challenge

However, stepping into a new territory can be challenging, and starting a practice is no exception.

You see, when you step out on your own, the world you know is about to change.

When you were employed, you did what you were told, even though you may have had some latitude in how you practiced.

But when you start a practice, it’s up to you to set boundaries, create the rules, and shape the business overall.

It’s a lot of responsibility and can feel overwhelming, and you want to be ready for what’s ahead.

So, before you start working on your practice, here are a few key questions to ask yourself.

#1 Why?

It may be the most essential question to ask yourself.

What are your reasons for wanting to start a practice?

  • Does starting a practice seem like a great idea, or is it something you’ve wanted to do all along?
  • Are your reasons for starting a practice to escape a less-than-perfect job or because you crave the freedom to work on your terms?
  • Are you tired of stale salaries? Or do you want to generate more income, create a real asset, and build a business for yourself?

Of course, there are no right or wrong answers here.

However, you must know, without a doubt, why you want to do this.

Starting a practice takes work, time, and a roll-up-your-sleeve attitude.

Things will not always go according to plan. There will be ups and downs, and you are responsible for making it work.

It takes grit, commitment, and a willingness to figure it out.

Challenge yourself with these questions…

  • Are you clear about what you will give up (the opportunity cost) to do this?
  • Do you have the support of your family, significant other, or friends?
  • Do you know your strengths and weaknesses?
  • Are you willing to learn and educate yourself about business?
  • Do you have clear personal and business goals?
  • Are you clear on the type of practice you want to create?

While reflecting on your reasons for starting a practice is essential, it’s also important to acknowledge that even the best-laid plans will likely change.

Ideas, plans, and opportunities will change over time. Are you willing and able to adapt to potential changes?

Are you still sure that starting a practice is right for you?

#2 Resources


It takes resources, aka money, to get the practice off the ground.

But unlike what you may have heard, it doesn’t have to take vast sums of money (but it will take some).

Your biggest upfront costs will be space and equipment.

Office space is expensive, so you must find something that fits your needs and budget.

Finding a suitable space can be challenging, but you will find it if you’re willing to spend the time looking.

One option is sharing an office with an NP or other provider. Alternatively, you could rent one room in a clinic or use the space when the clinic is closed.  


The other upfront cost is equipment, which is also expensive if bought new. However, there are many options for buying used office equipment and furniture, even though it will take some time to find them.  

Startup costs vary greatly depending on the type of practice to build. Create a business plan so you will know your estimated startup costs and expenses, along with projected income.

Many Nurse Practitioners have built successful practices on a shoestring budget. Anyone can if they are willing to adjust their plans for the practice to their budget.

Some NPs continued to work part-time while building their practice. Others opted to take out a loan or borrow against their home equity.

You can start small, build a patient base, and slowly increase the practice.

One question you want to ask yourself is about your financial readiness.

What do I mean?

  • Are you in a position, financially, to perhaps go without income for a few weeks or even months?
  • Can you keep paying your bills if no money comes in, and for how long?
  • How will you pay the office rent and utilities until the money from reimbursements comes in?
  • What is the state of your credit report? If there are any problems, now is the time to address and correct them.

You may consider opening a line of credit with a credit union or your bank to draw on it if necessary.

Because when it comes to lending money, banks are funny: it’s harder to get money when you need it than when you don’t.  

#3 Timing

As I said before, a lot of effort goes into starting a practice. Chances are you will spend your time on:

  • Creating a comprehensive business plan that includes market analysis, services offered, and financial projections.
  • Locating the best option for financing your practice.
  • Structuring the optimal service offering to meet your patients’ needs and your practice’s goals.
  • Creating positive patient experiences, from scheduling appointments to follow-up care, to grow the practice.
  • Navigating the credentialing process in a timely manner so you can accept commercial insurance and Medicare/Medicaid.
  • Deciding what types of insurance (malpractice, liability, property) you need and how to choose the proper coverage.
  • Implementing effective financial and operational systems that will be followed consistently.
  • Developing effective marketing strategies to attract new patients and retain existing ones.

You will juggle many different plates when you’re in the beginning phases of starting your practice.

And that’s why you want to ask yourself if the time is right.

Do you have the time and resources to start your practice now? Or would it be better to start it later?

For example:

  • Are you dealing with challenges in your personal life, like illness, divorce, or custody issues?
  • Has your household lost income due to your spouse’s job loss?
  • Is your credit in good shape, or are you working on improving it?

Life provides all of us with a wealth of challenges.

That’s why sometimes, waiting to start the business may be better because the timing is not right.

In Conclusion…

Please don’t think I’m trying to discourage you from starting a practice; nothing could be further from the truth.

I’m simply trying to give you a well-rounded picture of what’s involved.

A deeper understanding of the startup process will help you come to a better decision about whether and when to start your practice.

To get a complete list of what it takes to start a practice, click here for our free “Practice Startup Checklist.

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