Tips for FNPs Starting a Private Practice

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Nurse completing paperwork

Family nurse practitioners (FNPs) have the legal authority in some states to open independent practices to act as primary care providers, managing patients from birth through adulthood. In opening private practices, FNPs must also utilize business acumen to develop a strategy for a successful company.

Opening an FNP practice takes more than successfully completing a Master of Science in Nursing (MSN) program. Nurse practitioners who open practices have to create business plans, iron out legal and financial issues, and evaluate funding options, among other things.

There are many reasons to become a family nurse practitioner and open a private practice, but taking those initial first steps may be challenging.

Barbara C. Phillips, FNP, said practitioners who want to open an independent practice should understand the business side of medicine. Phillips, founder, and CEO of the Nurse Practitioner Business Owner consulting agency said inadequate experience and poor planning could sink a practice before it starts.

“Unfortunately, there is a steep learning curve when you first start your practice. This may delay progress and hinder the stability and growth of the business,” Phillips said in “What are the risks for Nurse Practitioner Private Practices?” “And sometimes, a business will get off to such a wrong start that it’s hard to recover from it altogether.”

The first step for any advanced practice registered nurse (APRN) to begin work as an FNP is to complete an online MSN FNP program successfully. Through Duquesne University’s online MSN Family (Individual Across the Lifespan) Nurse Practitioner program, registered nurses can take the next steps to become providers who offer primary care services.

Opening an Independent FNP Practice

Business and healthcare leaders say entrepreneurial FNPs should first look to their state regulations when considering opening a private practice. In almost half of the states in the nation and the District of Columbia, FNPs have the legal authority to open private practices to provide primary care services and prescribe medications and controlled substances. In the other states, FNPs must practice under the supervision of a physician and may not have full prescriptive authority.

Experts say independent FNPs should consider these tips before opening their businesses:

  • Draw up a business plan: In developing a document that outlines business objectives and strategies, FNPs can narrowly focus their goals. The U.S. Small Business Administration (SBA) said a good business plan guides entrepreneurs through the many stages of starting and managing a business. The traditional plan contains an executive summary of intent, a market analysis, an outline of the organization and marketing plan, and financial projections.
  • Determine a legal structure: Several types of legal structures offer varied liability protection and financial implications. Among them are sole proprietorships, partnerships, limited liability corporations (LLCs), and professional corporations. All business structures are state-specific. The easiest is the sole proprietorship, which is free to begin and does not require any complicated paperwork or processes. However, a sole proprietorship does not offer any asset or liability protections. Other types of business structures offer a variety of liability vulnerabilities and safeguards. Consult with an attorney or financial advisor before going forward.
  • Finance startup costs: An FNP practice has financial considerations that include leasing office space, purchasing office furniture, getting property and malpractice insurance, and acquiring medical equipment. Other overhead costs include hiring an office manager and support employees and purchasing or leasing electronic health record (EHR) systems, medical billing services, transcription services, and credit card processors.

To pay for the initial expenses, many FNPs turn to small business loans guaranteed by the SBA. The loans, for $500 to $5.5 million, can be used for most business purposes. State and federal grants programs are also available, particularly for FNPs who open practices in underserved communities.

  • Develop a network of advisors: Communicating with other providers who have “been there, done that” is a good way to establish a network of mentors and consultants. Margaret Jean Wear, FNP-C and owner of Adolescent Healthcare Associates in Glenwood Springs, CO, said an essential resource for opening a private FNP practice is to have supportive relationships along the way, including while earning a degree through an online MSN FNP program.

“What I would say to folks is don’t overlook those valuable academic relationships that were formed in grad school,” Wear said in “The Essential Resources for Opening your Own NP Clinic.”

  • Create a patient-friendly atmosphere: Phillips, who has been teaching NPs about the business of healthcare since 2006, said independent FNP practices should have all the infrastructure in place to make sure patients can be served effectively. That includes determining who will interact with the patients, creating policies and procedures to help patients, and providing quality healthcare from the moment patients walk in the door.

Nurse Practitioners Beginning Work in Private Practice

Carolyn Zaumeyer, an NP and the author of How to Start an Independent Practice: The Nurse Practitioner’s Guide to Success, said NPs must identify their strengths and weaknesses before opening the doors to their independent practice. The best way to do so is to work under the supervision of a doctor or other FNPs initially.

Zaumeyer, in an interview on XM satellite radio station ReachMD, said FNPs should be “comfortable and confident” in their role before taking on the added responsibility of the private practice.

“You want to practice safely and know that you are doing the right thing for your patient as well as yourself,” Zaumeyer told show host Lisa D’Andrea.

Filling the role as a private practice FNP requires a strong educational background that includes classroom and clinical expertise. Duquesne University’s online MSN FNP program prepares APRNs to become primary care providers. Students engage in coursework that covers management, leadership, and business concepts, the transition to independent practice, and issues exclusive to the FNP role.

About Duquesne University’s Online MSN Family (Individual Across the Lifespan) Nurse Practitioner Program

Duquesne University’s online MSN FNP program prepares APRNs for the American Academy of Nurse Practitioners Certification Board (AANPCP) and American Nurses Credentialing Center (ANCC) Family Nurse Practitioner certification examinations.

The university’s Family (Individual Across the Lifespan) Nurse Practitioner program prepares APRNs for a career working alongside physicians and in private practice. Duquesne also offers two other MSN specializations — Forensic Nursing and Nurse Education and Faculty Role — for comprehensive career options.

Additional Reading:

Duquesne University, “Removing Practice Barriers for Nurse Practitioners”

Sources:, “What are the risks for Nurse Practitioner Private Practices?”
American Association of Nurse Practitioners “What’s a Nurse Practitioner (NP)?”
Small Business Administration, “Write your business plan”
Business News, “How to Open a Private Medical Practice, Step by Step”
Nurse Practitioner Business Owner, “How Do I Choose The Legal Structure For My Practice”
CMF Group, “The Essential Resources for Opening your Own NP Clinic”
American Association of Nurse Practitioners, “What’s a Nurse Practitioner (NP)?”, “Seven Steps to Starting Your Own NP Practice”