How Economically Viable is it to Start Your Own Nursing Practice?

In today’s turbulent economy, having one’s own business or source of income has become a compelling prospect. Many nursing professionals in the healthcare industry have begun to explore the possibility of practicing independently. Many have started their own practices and are now maintaining their own healthcare provision facility or service. However, beginning this journey can present as many challenges as opportunities.

Independent nursing practice

Before deciding to set up your own private practice as a professional nurse practitioner (NP), it’s important to carefully gauge the viability of such a venture. Here are a few tips and areas for consideration that will help you do that.

Does Your State Restrict Practice Scope?

Throughout the USA, states allow differing amounts of leeway to nurse practitioners that provide independent services. Before considering opening an independent practice, it’s important for nurses to check the restrictions in their operating state to make sure they’d be able to legally practice at the capacity they are planning to.

Roughly half of the American states have granted full practice rights to nurse practitioners, meaning that they are able to operate completely independently of physician or MD supervision and provide any of the services they’d normally be able to provide in a hospital or outpatient setting in their own independent practice. Any states that do not allow full practice designation for NP’s have opted for allowing either reduced or restricted practice.

A reduced practice state designation allows NP’s to provide limited services without physician supervision in that state. However, some aspects of care provision are not allowed. For instance, in many reduced practice states, independent NP’s can provide care but cannot prescribe medication without physician oversight.

Finally, restricted practice states allow little to no practice rights to NP’s operating outside a physician’s supervision. There are 11 states that operate this way as of this writing. Obviously, if an NP is interested in beginning his or her own independent practice but is licensed in a restricted practice state, he or she would likely need to consider transferring to another state that allows more freedom for NP’s to practice independently to make that viable.

Is an Advanced Degree Economically Viable in Your Situation?

Though you may already have the degree you’d need to begin practicing independently, many NP’s need or choose to earn more advanced degrees to remain competitive or to be able to provide a wider range of services for their patients. This is important to consider before launching your own independent practice.

If you need an advanced degree, would you be able to complete it alongside your other current responsibilities? Would you need to complete this degree before being able to start your own practice or is it something you can do down the road once you’re established? Are you in a financial position to be able to invest in this level of professional development?

Another important question to consider is whether you should think about pursuing a practice specialty. NP specialty areas can include family practice, neonatal, acute care, pediatrics, women’s health, psychiatry, and more. While you can operate independently without a specialty area, some NP’s opt to focus on a particular service area when they’ve honed their interests or because it is a specialty that’s not currently offered in their area.

To determine if any degrees or additional schooling may be necessary or advisable for you if you were to begin your own practice, check any state or regulatory requirements first and then also do a “marketplace analysis” in your area.

What kinds of medical care aren’t readily available? If there are independent NP’s already practicing in your location, what degrees do they have? If you have access to a local university or college that offers healthcare degree programs, could you arrange a meeting with an advisor or professor to get his or her perspective on the process?

Getting an expert’s insights can help mitigate mistakes and identify the strategy that is most likely to succeed as you start your own venture.


Do You Have What It Takes to Start and Operate a Private Practice?

As you evaluate whether an independent practice is viable for you, it is imperative that you consider the processes required for establishing a practice before you begin. Initiating your own independent practice takes a number of steps and can often require a significant upfront investment of time and money.

Regulatory requirements

Your independent practice will need a state license to operate legally. It will also need a Drug Enforcement Administration (DEA) number to be able to hold, prescribe, or distribute controlled substances and medications.

Location and administration

Your practice will need a location. This requires renting or owning space that is zoned appropriately and situated in a place that is accessible for the patients you plan to serve. You’ll also need to create systems and processes for operating your practice. This will include necessary equipment, bank accounts, software systems for billing and client management, payment processors, accounting systems, and more.

Insurance and hospital contracts

To provide effective service, you’ll need to establish referral relationships with other healthcare providers (for instance, hospitals and specialists) so that you can refer patients to more appropriate providers when they need different care than you can offer. You’ll also need to negotiate rates with insurance providers so that you can accept your patients’ insurance coverage.

Fiscal resources

Starting your own practice usually requires significant startup costs to put each of the elements listed above in place. Unless you have this capital in hand already, this will often require investment or a bank loan in order to get started. Do you have access to these kinds of resources? If not, are you willing to take on the risk of loans and interest rates while establishing your practice?

Though starting an independent nursing practice can be a large task that isn’t possible for everyone, it can be a hugely rewarding and beneficial experience if you enter the process knowing what it will cost upfront and have assessed the journey for viability first.

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