Family Nurse Practitioner
Family Nurse Practitioner – Thanks to the Full Practice Authority legislation, family nurse practitioners across the United States now have more responsibility and autonomy than ever.
This means if you’re looking to become a family nurse practitioner, you could end up starting your own private practice without the need for supervision from a physician.
According to the AAMC, there will be 55,000 extra primary care doctors needed by 2032. The deficit can be softened by more family nurse practitioners being able to run their own practices.
But where do you even start with owning your own practice?
1. Become a Family Nurse Practitioner (FNP)
Of course, the first step to owning your own Family Nurse Practitioner as a nurse is to actually be an Family Nurse Practitioner.
You need to graduate from one of the thousands of on-campuses and online FNP programs available in the US, as well as gaining your state and national licensing credentials.
This will require you to complete your education, choose a specialism and do a monitored residency of 720 hours in the field. The complete process can take among two to four years to complete.
2. Get National Certification of Family Nurse Practitioner
You can only begin working as a family nurse practitioner once you’ve been certified by a national board such as the American Nurses Credentialing Center. In order to get certified, you’ll need to submit an online application with all required documentation and pass an exam. Certification is legal for five years and then will need to be renewed.
3. Get Certified in your State
In a similar way to national certification, family nurse practitioners also need to be licensed to work in their state. This certification will entail you to complete an application with reference to your FNP education and professional history. You’ll also need to have your registered nurse licensing verified.
4. Create your Business Plan
Starting your own private practice as a family nurse practitioner is just like starting your own business. As such, you’ll need to create a business plan that gives you a guideline into how you’ll operate and grow, where you’ll find funding, and who you’ll recruit.
Your business plan should be as detailed as possible so that you can avoid bumping into any issues along the way.
The US Small Business Administration states that most business plans feature nine separate sections:
Executive Summary of Family Nurse Practitioner
Here you’ll summarize the purpose of your practice, why it’s needed, and why it will be a success. You might also want to add your employee structure and what services you plan on offering.
Company Description
The company description will outline a bit more about your business: what your strengths are, who your audience is, and what will set you apart from competitors.
Market Analysis
As with any business idea, you need to analyze the current market to see if there is a need for your practice, how other practices are working, and how yours can outperform them.
Organization and Management
This section will summarize both the legal and management structures of your business. You will need to determine whether your practice will be a corporation, partnership, or LLC. You can also add job responsibilities into this section, as well as any resumes from your potential employees.
Services and Products
While you may have already highlighted some of the services your practice will offer, the services and products section of your business plan will dive deeper into the details. It’s important that you make sure to only offer services that you’re certified to do. Family nurse practitioners can offer immunizations for children, physicals and health maintenance screenings, and more.
You may also want to include which insurance providers you will accept and how you’ll take payment from patients.
Marketing
No business can succeed without marketing. In order to do good with your private practice, you need to have patients.
The marketing section of your business plan will include your marketing budget as well as any tactics you’re thinking of using. It is continually a good idea to have a website at least so that those searching online can find your business. You might also need to send out an e-letter or newsletter to invite people to a patient referral program.
You will also need to think of how you will measure the success of your marketing budget. Key metrics may be the number of patients onboarding, number of appointments, or even number of inquiries.
Funding
Unless you have savings to start your practice, it’s inevitable that you’ll need to have a plan in place to secure funding. In order to have your application for funding accepted, you’ll likely need to highlight what type of funding you’d like (debt or equity), how much you’ll need, where the funds will be spent, and how you plan to repay the lender or investor.
Projections and Forecasting
Having some solid projections in place can really help to strengthen your funding application, as investors will gain better insight into your capabilities for repayment. You should try to forecast the next five years – but these figures are likely to change when you’re established.
When forecasting, start with project income, cash flow, and capital expenditure budgets.
Appendix
The appendix will simply offer you a place to insert any documentation that can help with running your business. This could include your licenses and permits and a copy of your credit history.
5. Secure Funding by Family Nurse Practitioner
With your business plan in place, you’ll be in a much better position to secure funding for your new business venture.
There are a diversity of ways to fund your business. The first is, of course, self-funding. You might be able to speak to friends and family about contributing to the funding, or you may have been able to save a small deposit yourself. Self-funding, for any business project, is always preferred, as it gives you full control over your practice. However, that’s not to say it doesn’t come with its own risks.
Another way to deposit your business is through loans. Loans can come from banks, credit unions, or even private investors. With loans, you’ll keep full control of your business – as long as you keep up with the repayments.
Finally, there may be an opportunity to cover some of the costs with a small business grant. Grants don’t have to be repaid but often restrict what you can actually spend the money on rather than allowing you to spend it wherever you see fit.
Even the federal government offers grants for small businesses. www.grants.gov is run by the Office of Management and Budget and is a great place to search for funding opportunities.
Before you dive in with an imaginary number, it’s a good idea to put together a plan of how much you think you’ll need to start your practice. Some payments like premises and legal guidance may be a one-time fee, while utilities, insurance, marketing, and permits may be regular payments you need to cover.
6.Find a Premises
Now for the exciting bit – find where your practice will be based!
No matter where you decide to be located, you’ll need to check the financial and legal implications.
In order to find a location that will give your practice the best chances of success, it’s a good idea to consider an area where there is demand, low business taxes, and a decent average salary for family nurse practitioners.
A key area that will seriously benefit from a family practice is rural America. These locations typically have limited access to healthcare, meaning there is a dire need for a local practice. By establishing yourself in a rural area, you’ll have much less marketing to do, as you’ll be offering a service that isn’t readily available rather than attempting to compete with others.
In terms of set up expenses, different regions will have different set up fees for insurance, licensing, and utilities. There will also be varying minimum wage laws for both you and your employees. Take a look at the average FNP salaries for different areas in your state. You may be surprised by impartial how much they can differ.
As a business owner, you’ll be required to pay taxes. These include income tax, sales tax, property, and corporate tax. These necessity to be accounted for in your cash flow projections.
Different cities and counties have different tax climates, with some being more business-friendly than others. According to the Tax Foundation, the best, business-friendly states are Wyoming, South Dakota, Alaska, Florida, and Montana.
7. Choose your Legal Structure for Family Nurse Practitioner
In order to be officially established, you’ll need to decide what legal structure your business will take. Liable on what type of legal structure you choose will change the way your business operates and how your finances will work.
There are several structures to choose from. Each comes with its own risks, costs, and requirements, but also different benefits.
The three main structures are:
Partnership
As the name suggests, partnerships are for businesses with more than one owner. Limited partnerships require one of the partners to pay self-employment taxes while the other partner has less control and liability for the company.
Limited Liability Partnerships, on the other hand, mean that owners are not accountable for other owners’ actions.
LLC
LLCs (limited liability company) are exempt from paying corporate tax but do have to pay self-employment taxes. This type of legal structure protects you, as the owner, from personal liability in the unlikely event of bankruptcy.
Corporation
Corporations offer the most protection again personal liability for business owners. The corporation is entirely separate from the owners; however, there are high startup costs and corporate income tax to pay. You’ll also stay required to maintain extensive record-keeping.
There is a special type of corporation that means you don’t have to pay corporation tax. This is called an S corp.
8. Apply for Business Licenses and Permits
Once you’ve determined which legal structure you’ll follow, you will then need to gain the permits and licenses needed to establish your business.
Whichever structure you choose, you will first need a federal tax ID from the IRS and to register your business. If your state requires you to pay income and employment tax, you’ll need a separate state tax ID number.
9. Take out Malpractice Insurance
Malpractice rates for nurse practitioners of any kind are very low; however, it is better to be safe than sorry.
Malpractice lawsuits can be incredibly expensive. Payouts can be anywhere between $200,000 to $1.5million if found at fault. Even a defense attorney could set you back by up to $40,000.
For the practice of insurance, it’s definitely worth taking out a malpractice policy. Just in case.
The insurance will protect both you and your employees from negligence claims, errors, and financial losses from malpractice.
10. Order your Supplies by Family Nurse Practitioner
There are a huge number of medical supplies and equipment you’ll need to run your private practice smoothly and successfully.
The World Health Organization has created a useful guide on what you’ll need.
In order to find the right equipment and medical supplies, here are a few things to consider:
- Quality
- Cost vs. quality (factoring in tax, delivery, installation, and training)
- Manufacturer source
- Warranties
- Materials (easy to clean worktops, medications that don’t spoil quickly)
- Reusability (compare disposable vs. reusable equipment and check your local policy)
You’ll then need to consider how much you’ll need per month and where you’ll store your supplies and equipment. You may also want to implement an inventory checking system.
For reusable equipment, it is worth speaking to the supplier regarding the correct way to clean and sterilize items between use.
For disposable items, you will need to research collection and disposal services for medical equipment.
11. Start the Recruitment Process of Family Nurse Practitioner
While you might want to keep costs to a minimum while you’re finding your feet, there will be certain specialist staff that you need to employ to ensure your practice runs smoothly.
For example, it may be a good idea to hire an accountant and receptionist so that you can focus on attending to patients while they handle bookings and bookkeeping. You may also want to consider hiring a phlebotomist and a medical assistant at the bare minimum.
To recruit the right person for each position, you can either use an agency or advertise the positions yourself.
Once everything is in place, you’re ready to take on your first patient. It’s exciting, nerve-wracking, and your time to shine. With every positive experience, you’ll gain a better reputation, and soon you’ll have your own fully-established, busy practice where you can help an endless number of people.