Every day you’re at work, you assess, diagnose, treat, educate, and advocate for the patients you work with.

What’s an issue for many NPs, however, is whether they’re ready to run a business.

Most schools focus on clinical training alone and don’t include even basic business education.

While business skills are not especially difficult to learn, they do take some time to pick up through “on-the-job training.”

The good news: you don’t need an MBA to open a practice. However, it’s to your benefit to have a basic understanding of a handful of core business functions.

Here’s what matters most.

1. Finances

You don’t need to become an accountant, but you do need to know how money moves through your practice.

At a minimum, you need to understand the four terms that get used loosely but mean different things:

• Revenue (what you bill or take in)
• Expenses (what it costs to operate the practice)
• Profit (what’s left after expenses are paid)
• Cash flow (the timing of money moving in and out of the practice)

Here is why it matters …

A practice can be profitable on paper and still have no money in the bank.

Even though your schedule is full and your claims are submitted on time, insurance reimbursements may be slow, and your bank balance is low, even though the business is technically healthy.

That’s a cash flow problem, not a demand problem, and it’s a distinction new owners often miss.

So, before you open your doors, learn to read a financial statement. Understand how to project your monthly expenses and find your break-even point.

Gain a realistic sense of how long it’ll take for the practice to break even and pay you consistently.

2. Marketing

Many NPs dislike the word “marketing” because they associate it with hype or hard selling.

In practice, however, marketing is just communication: telling people who you help, what you offer, and why they should choose you.

If patients and referral sources don’t understand what your practice does, they can’t choose it, no matter how good your care is.

The strongest marketing in healthcare tends to be the least “salesy, using clear, honest, patient-centered language.

The more clarity you have, the better:

• Can you describe the problems you solve in plain terms?
• Can you explain what makes your office different?

Clarity serves two functions: it markets the practice and builds trust at the same time.

3. Systems and Operations

A practice can’t run on memory alone; to run smoothly and effectively, it needs systems.

Even simple systems like checklists and templates reduce errors, save time, and ensure a consistent, predictable patient experience.

At a minimum, you want to create processes and systems for:

• new patient intake
• scheduling
• payment collection
• insurance verification
• claim follow-up
• lab results
• handling refills
• patient messaging
• cancellations/no-shows and
• scheduled financial reviews

Without these, every situation becomes another decision, which is exhausting and produces inconsistent results.

Systems keep your practice running smoothly, even when you’re not managing every detail.

4. Human Resources

If you plan to hire, even just a front desk person, a medical assistant, or a part-time biller, HR becomes a real function rather than an afterthought.

That includes job descriptions, interviewing, onboarding, payroll setup, employment law basics (overtime rules, at-will employment, required postings), and performance conversations when something isn’t working.

This is an area where many owners underestimate the time and liability involved. A single misstep, misclassifying a contractor as an employee, skipping required documentation, or handling a termination poorly, can cost far more than the time it would’ve taken to do it right.

If you’re bringing on staff, it may be worth a short consult with an HR professional or employment attorney before your first hire, not after your first problem.

5. Decision-Making Without Perfect Information

Your clinical training emphasizes careful assessment before making decisions and taking action.

Business ownership rewards something different: the willingness to decide with incomplete information, take actions, and correct later.

Most likely you’ll:

• Pick software before you know your workflow.
• Set fees before you know demand.
• Choose vendors before you know how well they perform.

The skill isn’t avoiding imperfect decisions, but is noticing when something isn’t working and taking corrective action.

A billing service that looked fine on paper but has poor follow-up six months in isn’t a failure on your part; it’s part of practice ownership and needs to be corrected.

6. Time Management as a Business Resource

As an employee, your schedule was mostly set for you; as a practice owner, that’s no longer the case.

Now, time is one of your most precious and scarce resources, and to a large degree, it’s under your control.

Clinical hours are only part of it. Administrative work, billing questions, prior authorizations, supply orders, and bookkeeping all take real time, and new owners consistently underestimate how much.

If you don’t plan for that work explicitly, it will eat into your evenings and weekends.

Before opening, think through what you’ll do yourself, what to outsource, what you can automate, and what deserves a standing block of time in your calendar.

7. Knowing When to Get Help

You know that you don’t have to do everything yourself. Trying often costs more in time, money, and opportunity costs than it saves.

An accountant, attorney, billing professional, and business coach can be worth the expense long before you feel “ready” to afford one.

Bringing in help isn’t a sign of weakness or that you’re unprepared. On the contrary, it’s usually a sign you understand what business ownership actually involves.

8. Staying a Learner

No one opens a practice knowing all of this on day one.

The practice owners who do well tend to be the ones paying attention to their numbers, their patients, their own strengths and weaknesses, and their mistakes.

They adjust as they go, stay open to improving their skills, and learning new ones.

To Sum Up …

Clinical skills are the foundation of your practice.

But your business skills are what keeps it open, organized, and financially sustainable long enough for your clinical skills to matter.

You don’t need to master all of this before you open the doors, but it’s worth starting to work on them now.

We’d love to hear from you…

Tell us what you think; join the conversation by leaving a comment or question below

By Johanna Hofmann, MBA, MAc., regular contributor to the NPBusiness blog and author of “Smart Business Planning for Clinicians.”

The post The Business Skills You Need Before Opening Your NP Practice appeared first on Nurse Practitioners in Business.

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.”

The post Are You Ready to Start a Practice or Just Tired of Your Job? appeared first on Nurse Practitioners in Business.

For our profession, it’s an opportunity to think about another kind of independence: professional practice authority.

To this day, nurse practitioners across the US do not all practice under the same rules.

In a little more than half of states, NPs have full practice authority.

They are free to independently evaluate patients, diagnose conditions, order and interpret tests, and initiate treatment, including prescribing medications.

However, in the other states, NPs still face reduced or restricted practice requirements, often requiring physician collaboration, supervision, or formal agreements, even though they provide the same services as NPs in full practice authority states.

Which begs the question …

How is it that an NP may be trusted to practice independently in one state, while just across the border, that same NP may be required to maintain a contractual relationship with another professional to provide similar care?

It doesn’t make much sense, no matter how you look at it.

Why?

So now the question is, why are we still dealing with this?

The reasons are complex and multifactorial.

Historical Reasons

State practice laws developed over time, often long before today’s healthcare shortages, access challenges, and modern NP education standards.

However, once laws and regulatory structures are in place, they are slow to change … but not impossible.

Professional Reasons

Those who oppose NP full practice authority argue that physician oversight is necessary to protect patients because NPs have limited training and scope of practice.

However, supporters of full practice authority point to decades of NP practice, research, and patient outcomes showing that NPs provide safe, high-quality care within their scope of education and certification.

Research and patient outcomes are well documented and available to anyone who cares to look at the data.

Other Reasons …

Some economic and structural factors cannot be discounted.

Collaborative agreements may have a price tag, providing a side income for the collaborating physician.

In some instances, collaboration fees are reasonable; in others, they are exorbitant, creating a significant financial burden for NPs, especially those opening small practices in rural or underserved areas.

Additionally, some agreements limit where NPs can practice and how they can respond to community needs, ultimately determining whether the practice may remain viable at all.

For patients, this means limited access to care or delayed care, fewer local options, or no care close to home at all.

Cooperation not Isolation

Independent practice is not the same as practicing alone, and that’s an important distinction.

Full practice authority doesn’t mean NPs work in isolation.

No one works alone. It’s common practice for providers to exchange ideas and information and share their clinical expertise when asked. 

Like other providers, NPs routinely work and collaborate with NPs, physicians, pharmacists, therapists, specialists, hospitals, community agencies, and other healthcare professionals to achieve better outcomes for their patients.

Collaboration is a normal and necessary part of good patient care.

Collaboration should not be mandated by law through a formal agreement that may not reflect the actual care being provided, but must be based on patient needs and professional judgment.

Responsibility

For all healthcare providers, including NPs, professional independence comes with responsibility.

It requires strong clinical judgment, ethical decision-making, clear documentation, appropriate referrals, ongoing education, and a commitment to quality care.

And for those who operate their own practices, it also requires a certain level of business professionalism.

Change …

What can NPs do to facilitate change in their professional status?

First, it’s essential that all NPs fully understand their state practice environment.

Not all are clear on whether their state is considered full, reduced, or restricted practice. Knowing the law is the first step toward changing it.

Second, NPs must support their state and national professional organizations.

Scope-of-practice change rarely happens because of one person. It happens through organized, consistent advocacy.

Most State NP associations monitor legislation, educate lawmakers, coordinate testimony, and build coalitions.

If you are not a member, support your profession by joining your state and national organizations!

Third, collect and tell patient-centered stories.

Lawmakers don’t respond to abstract professional arguments. What they understand and respond to are real-life examples:

• patients who cannot find a primary care provider
• rural communities without enough clinicians
• mental health patients waiting months for care
• an NP-owned clinic, delayed because of outdated regulatory barriers

Fourth, build relationships in your community.

Business leaders, patient advocacy groups, senior organizations, rural health coalitions, employers, and community leaders all have a stake in healthcare access.

When the conversation moves from “NPs want independence” to “communities need access,” the message carries more weight.

Finally, avoid NPs versus physicians.

In fact, that stance is rarely helpful…

A more powerful message is:

“Access to healthcare increases and patients benefit when every qualified healthcare professional can practice to the full extent of their education, training, and licensure.”

In Conclusion …

Independence Day reminds us that freedom and responsibility go hand in hand. This is true for the citizens of a country as it is for healthcare providers.

For Nurse Practitioners, professional independence is not about rejecting collaboration or practicing outside one’s scope.

It is about removing outdated barriers so all NPs can practice to the full extent of their qualifications, and serve their patients and communities more effectively.

Independence, in this context, is the freedom to bring our full education, judgment, and commitment to the patients who need us.

P.S.: If you’re ready to start your own practice but don’t know how, we can help. The Essentials of Starting a Practice includes everything you need to get started and grow your practice; click the link and see for yourself!

Your thoughts about the state of NP Independent Practice across the US? Let us know, share your thoughts in the section below…

By Johanna Hofmann, MBA, MAc., regular contributor to the NPBusiness blog and author of “Smart Business Planning for Clinicians.”

The post The Future of NP Practice: Independent Practice for All? appeared first on Nurse Practitioners in Business.

One that all humans share is a physiological blind spot in each eye.

It’s a natural gap in our vision, because the area where the optic nerve passes through the retina lacks light-detecting photoreceptors.

Under normal conditions, we don’t notice it because the brain fills in the missing gap, along with the visual field of one eye compensating for the blind spot of the other.

Amazing, isn’t it?

Aside from physical blind spots, there are others, including:

• Cultural ones
• Strategic ones
• Technological ones
• Regulatory ones
• Operational ones
• Metaphorical ones
• … and more

These blind spots are areas that cannot be seen or understood from a given perspective. This includes aspects of ourselves that others can see but we can’t, such as biases, thinking patterns, or behaviors.

And here is the amazing thing…

Our brain does the same for us as it does with our visual blind spots: it fills in the gaps, compensating, often in the form of assumptions.

For NP practice owners, blind spots can appear across many different areas, including practice finances, marketing, operations, patient experience, compliance, and decision-making.

Blind spots are a fact of life and business. The problem is that just because you can’t see them, it doesn’t mean they don’t affect your business.

Blind Spots in Your Business

A business blind spot is an area that needs your attention; however, you either don’t recognize it, underestimate it, or assume it’s not a problem.

Here are examples:

• You assume your patients know all the services you offer; however, most don’t, because your website doesn’t clearly explain them and your staff doesn’t talk about them, resulting in lost revenue.
• You’re under the impression that your practice is profitable because there is money in the bank, all the while your expenses are quietly increasing, leaving your practice vulnerable and unstable.
• You put a no-show policy in place and think it’s working. However, the policy is weak and rarely enforced. No-shows and missed appointments are lost revenue.
  

Blind Spots Hide in Plain Sight!

They may look like small frustrations at first:

• Frequent no-shows and cancellations
• Billing delays
• Denials and non-payments
• Rising supply costs
• Inconsistent staff performance
• Marketing without the expected results

Left alone, these issues can be annoying and quickly become expensive. However, once identified, they can be addressed and resolved.

Do NPs experience more blind spots than other business owners?

I don’t think so, however, since NPs are clinically trained and typically don’t receive much business education, perhaps they do.

Additionally, most practice owners wear too many hats.

From morning to evening, they see patients, answer questions, review labs, manage staff, handle insurance issues, make business decisions, and try to keep everything moving.

When you’re that close to the day-to-day work and operations, sometimes it becomes difficult to step back and see the bigger picture.

Avoiding Discomfort …

Blind spots can also develop when we try to avoid uncomfortable topics.

• If financial reports are unclear or feel confusing, it is easy to put off looking at them.
• If marketing feels uncomfortable and disingenuous, it is tempting to put it off or ignore it altogether.  
• If a staff issue feels awkward, it may be easier to stick your head in the sand and hope it improves on its own.

But unfortunately, avoiding something rarely makes it better or disappear. More often than not, the things we avoid only get bigger.

How to Identify Blind Spots?

The tricky thing about blind spots is that, by definition, you don’t know you have them.

However, there are often warning signs, some subtle and some not so subtle.

Here are some indications of potential blind spots in your practice:

• You may be busy, but not every month is profitable.
• Your revenue is inconsistent, and you can’t explain why.
• You avoid reviewing your numbers, and have difficulty keeping up with all expenses.  
• Your collections are slow. Patients owe the practice a significant amount of money that some may never pay.
• You feel overwhelmed but cannot pin down the root cause.

One question to ask yourself is this:

Where am I surprised by the results I’m getting?

Feeling surprised by an outcome often points to a blind spot. If you expect a certain result but keep getting another, something deserves a closer look.

How Blind Spots Impact Your Practice

If left unaddressed, blind spots can affect your practice in several ways.

Financially, blind spots can be a drain on your business.

Outdated or poorly designed fee schedules, missed charges, poor billing and collections practices, excessive overhead, or untracked expenses over time will erode your profits.

You may be working hard, seeing patients, and generating revenue, yet still wondering why there is not more money left at the end of the month.

Operationally, blind spots create inconsistency.

Without clear systems in place, your practice must rely on memory, habit, or the constant involvement of a key employee (often the owner!). Inconsistency leads to unnecessary stress, confusion, and preventable mistakes.

Blind spots in marketing may keep your practice invisible.

If people don’t know your practice exists, who you serve, or why they should choose your practice, they may go elsewhere, even if you provide excellent care.

Blind spots in your marketing can prevent you from growing your business and can even make it challenging to keep the doors open.

Blind spots in the patient experience.

Blind spots can also affect the patient experience. Poor scheduling, unclear policies, inconsistent follow-up, and communication can erode trust. Patients may not complain directly, but eventually, they may leave the practice or stop referring others.

Blind spots lead to burnout.

When you have a sense that something isn’t working as it should, but you can’t identify the actual problem, you may try to fix the wrong issue.

Alternatively, you may respond by working harder, adding more hours, and pushing yourself more, without anything truly improving.

How to Deal with Blind Spots

The first step is to slow down long enough to look at your practice as objectively as possible.

Ask yourself:

• What issues keep repeating?
• What do I keep avoiding?
• Where do I feel confused, frustrated, or surprised?
• What problems seem to come back no matter how many times I address them?

Next, look at your numbers; they often give you a clearer picture, one not distorted by emotions.

Review your monthly revenue, expenses, profit, cash flow, patient volume, no-shows, collections, and marketing results. If you don’t currently track these numbers, start collecting the data.

If possible, get outside input, get another perspective. Others can often see what we cannot.

Once you identify a blind spot and find a solution, turn it into a system.

That could be as simple as creating a monthly financial review process, a patient onboarding checklist, a no-show follow-up process, a marketing calendar, a written policy, or a set routine for reviewing the billing.

Finally, make checking for blind spots part of your regular business reviews.

Once a quarter, ask yourself: What is working? What’s not working? What am I avoiding? What has changed in the last 90 days? What needs attention before it turns into a bigger problem?

It’s About Progress, Not Perfection …

Blind spots don’t mean you or your practice are failing. They simply point out areas in your practice that need more attention and can be improved.

Once you identify a blind spot, you can make better decisions, put more effective systems in place, protect your revenue and profit, reduce stress, and create a more stable business for yourself and your family.

In other words, blind spots are an opportunity to improve things in your business!

What are the blind spots in your practice, and what have you done about them? Let us know, leave your answer below …

By Johanna Hofmann, MBA, MAc., regular contributor to the NPBusiness blog and author of “Smart Business Planning for Clinicians.”

The post Blind Spots in Your NP Practice: Hidden Opportunities? appeared first on Nurse Practitioners in Business.

She picks a location close to home and signs a three-year lease, only to discover the area is already saturated with competing providers and the demographics don’t match her specialty.

It’s a costly mistake, and it’s more common than you might think.

Good decisions require good information!

Regardless of where you are on your journey, ready to start a practice or looking to expand one, researching your market can mean the difference between a thriving practice and an expensive lesson.

Before and Now

Traditionally, market research was a time-consuming process. To assess future demand and viability, providers would manually review census data and healthcare reports, analyze competitors’ websites, and study demographic trends.

Valuable? Yes. Realistic for a busy NP? No.

Fortunately, today, we have AI (Artificial Intelligence) to help us!

AI tools can help practice owners gather information, summarize large amounts of data, identify patterns, and uncover opportunities in a fraction of the time it used to take.

And when used properly, AI helps NPs make more informed decisions when starting, growing, or pivoting their practice.

Think of AI as a highly capable research assistant that asks better questions and finds information faster.

But AI is not a crystal ball. It cannot guarantee success and should never replace your critical thinking or local knowledge. But it can dramatically accelerate the research process and surface insights you might otherwise miss.

Popular AI tools you can start with today include ChatGPT, Claude, and Gemini. For research that requires current, web-sourced information, Perplexity AI is particularly useful because it actively searches the web and cites its sources.

A Word of Caution Before You Start

AI returns better results when it has context to work with.

Here’s an analogy …

Imagine a new employee starting her first day. You greet her, immediately ask her to update your office’s policies and procedures, and then walk away.

She won’t know how to start or what to do. She needs clear instructions, as basic as where the policies are kept, and what exactly you want her to update.

The same is true for AI, with one important difference …

Unlike your new employee, AI will always return a response, even if it lacks specifics. And sometimes it will fill in the gaps with fabricated information.

To get the best results:

• Tell the AI who you are, what type of service you provide, and what you’re trying to accomplish.
• The more detail you provide, the better the output.
• Working with AI is iterative: rephrase questions, add context, and refine as you go.
• Always verify important facts, especially statistics and data points, before making major business decisions.
• Never enter patient-identifiable information into AI tools. Even for market research purposes, keep your prompts free of any protected health information (PHI) to stay HIPAA-compliant.

Here’s one more important note to keep in mind …

Most AI tools have a cutoff date for knowledge, meaning they may not have access to the most recent data.

For real-time local information, such as recent provider openings, current population statistics, or new healthcare legislation, cross-reference AI insights with live sources, such as the HRSA Shortage Area Finder, your state health department dashboard, or Google Maps reviews.

Start With Your Target Market

One of the most critical questions to ask yourself is: “Who is my target market, my ideal patient? Who do I want to work with and serve?”

Many NPs make the mistake of defining their audience by specialty: family practice, primary care, or women’s health.

While useful as a starting point, those labels don’t tell you who your potential patients actually are, how old they are, what problems they want solved, or what they’re looking for in a provider.

That’s where AI can help.

AI can summarize demographic data, healthcare concerns, consumer behavior patterns, and patient expectations.

Instead of spending hours searching, you could ask:

“What healthcare concerns are most common among women ages 45 to 65 living in suburban communities in [your state]?”

Or:

“What challenges do rural Medicare patients in [your state] commonly face when accessing primary care?”

Within seconds, AI can provide a starting point for understanding patient needs and identifying potential service opportunities; information that can help guide everything from service selection to marketing messages.

 Assess Market Demand

NPs sometimes choose a practice location based on convenience rather than opportunity.

Here’s where AI can help you assess whether sufficient demand exists before making decisions and significant investments.

AI can help you analyze publicly available information related to:

• Population growth and age demographics
• Physician and provider shortages
• Chronic disease prevalence
• Healthcare access challenges
• Community health needs

Suppose you are considering opening a practice in a growing suburban area.

You can ask AI to summarize local population trends, identify healthcare shortages, and highlight emerging community needs.

What may have taken days or even weeks before, AI can organize the information into actionable insights within minutes.

The goal is not simply to confirm that people need healthcare; you know they do.

The goal is to determine whether there is sufficient unmet demand for your services in your location.
 

Analyze Your Competitors

Today, every healthcare market has competitors.

These may include other NP practices, urgent care clinics, retail clinics, telehealth providers, physician-owned practices, and hospital systems.

In the past, competitive analysis meant reviewing websites one by one, reading through patient reviews, and comparing comparable services.

Now you can ask AI to help you synthesize that information faster.

For example, you could ask:

“Based on publicly available information, what are the most common patient complaints about primary care practices in [city/region]?”

If patients consistently complain about long wait times, poor communication, or difficulty scheduling appointments, those frustrations may represent real opportunities for your practice to differentiate itself.

Their weakness …your opportunity.

Stay Current With Healthcare Trends

Healthcare is constantly changing. New technologies, reimbursement models, patient expectations, and treatment approaches emerge every year.

NPs who stay informed are better positioned to identify and capitalize on new opportunities.

You can ask AI to help you monitor changes in areas such as:

• Telehealth adoption and regulation
• Direct-pay and membership-based care models
• Remote patient monitoring
• Weight management services and GLP-1 trends
• Consumer healthcare expectations
• AI adoption in clinical and administrative settings

For example, if you’re considering expanding your practice, you could ask AI:

“What healthcare services are expected to experience significant growth over the next five years?”

Or:

“Which healthcare trends are currently influencing patient expectations in primary care?”

AI can quickly summarize reports, articles, and industry analyses, giving you a broader view of where the market is heading without requiring hours of reading.

Identifying Opportunities

One of AI’s most valuable capabilities is helping you connect dots that aren’t obvious at first glance.

By combining data on demographics, healthcare shortages, patient needs, competitor weaknesses, and industry trends, AI can generate ideas worth exploring.

For instance, you could ask:

“Based on aging demographics, provider shortages, and growing chronic disease rates in [your region], what types of NP-led services may be underserved?”

AI might identify opportunities such as:

• Women’s health services in underserved suburban communities
• Chronic disease management programs for aging populations
• Weight management clinics in areas with high obesity rates
• Rural healthcare access solutions via telehealth
• Membership-based care models in markets underserved by insurance-based practices

These opportunities still require your own validation and judgment; however, AI can point you in directions worth investigating, often ones you might not have considered on your own.

In Summary

Starting or expanding your practice requires a clear understanding of your patients, your market, your competitors, and where healthcare is heading.

In the past, gathering that information required weeks of effort. Today, AI allows NPs to do it in a fraction of the time.

Utilize AI to collect and organize information, identify patterns, generate questions for further investigation, and explore ideas you might not have considered.

Always verify important facts, verify AI insights against your local knowledge, and apply your own professional judgment before making major, far-reaching decisions.

NP business owners who embrace these tools will be better equipped to reduce uncertainty, uncover opportunities, and build practices that truly serve their communities.

We’d love to hear from you…

Do you use AI in your practice? If so, how? Please let us know by leaving a comment below…

By Johanna Hofmann, MBA, MAc., regular contributor to the NPBusiness blog and author of “Smart Business Planning for Clinicians.”

The post How Nurse Practitioners Can Use AI For Better and Faster Market Research appeared first on Nurse Practitioners in Business.

What you almost certainly didn’t do was read through reviews, scroll through Facebook, or click on a sponsored search result.

For Nurse Practitioners building a practice today, it’s worth understanding where healthcare marketing came from, because the fundamentals haven’t changed as much as you’d think.

They Refused to Advertise

For most of American history, healthcare marketing didn’t exist.

Because the one organization with perhaps the greatest influence in shaping US healthcare considered it unethical.

The American Medical Association’s (AMA) first Code of Ethics, established in 1847, explicitly condemned advertising as “derogatory to the dignity of the profession.”

Physicians who solicited patients publicly were lumped in with snake oil salesmen who plastered newspapers with claims of miracle cures.

The AMA was drawing a clear line: we are not them. A physician who advertised was, by professional consensus, placing himself in questionable company.

That stigma has persisted for over a century and continues to influence how healthcare providers think about marketing today.

While the AMA revised its Principles of Medical Ethics in 1957, it still considered soliciting patients unethical, and physicians who violated the norm risked censure and professional ostracism.

The prohibition wasn’t merely a guideline; it was a cultural identity. Medicine was based on public trust. It was not a commercial transaction, and advertising would have implied otherwise.

What finally ended the ban on advertising wasn’t a change of heart, but a lawsuit.

FTC Intervention

In 1975, the FTC accused the AMA of restraint of trade, arguing that the advertising ban was anticompetitive.

By 1982, the Supreme Court agreed, and almost overnight, the very rule medical professionals had followed for 135 years became outdated and no longer matched the law.

But adoption was slow at first.

Many physicians remained personally resistant to advertising, viewing it as beneath their professional standing.

The first to change were hospitals, driven by the rise in for-profit competition and managed care. Another factor was the steady increase in patient involvement in making their own healthcare choices.

How Practices Grew

So, how did small practices start and grow before advertising as we know it today existed?

They had only a few channels at their disposal, which had to do most of the heavy lifting.

Interestingly, most of them may look familiar to you.

Word of Mouth

In a pre-Google world, a provider’s reputation traveled through personal networks.

Neighbors talking over the fence, coworkers recommending a specialist, or a family member sharing a trusted name.

For smaller practices, reputation was everything.

A provider known for competence, kindness, and accessibility could build an entire practice through referrals alone, especially in smaller towns where relationships often spanned generations.

Physician Referral Networks

These networks were the most formal marketing channels at the time. Primary care providers referred patients to specialists they trusted, and specialists would refer back to providers if someone needed one.

Those relationships were built over time through hospital privileges, medical society memberships, and professional familiarity.

A new provider in town would visit local practices, introduce themselves, and build personal rapport that would eventually lead to referrals.

These networks took years to build and couldn’t be easily replicated by competitors.

Yellow Pages

Before Google, patients turned to the back of the phone book to find healthcare providers.

A display ad, not just a one-line listing, could successfully set a practice apart from others.

For many smaller practices, the Yellow Pages functioned much like a Google Business profile does today. These ads were more condensed,  listing the most important details about a practice.  

Pre-Internet, practices were built by speaking at various clubs, sponsoring a Little League team, giving public health talks, writing a newspaper column, or volunteering at a health fair.

Community Involvement

While none of it looked like advertising, it accomplished the same thing: building trust and visibility.

Interestingly, this mirrors closely what we now call content marketing. While the channel may have been different, the goal was the same.

Traditional Advertising Joined the Mix

Once healthcare marketing gained greater acceptance, local newspapers became the go-to for announcing new services or locations for a practice.

Direct mail campaigns, including flyers and postcards, grew in popularity for wellness reminders and educational materials.

Radio was used effectively for elective or cash-pay services, such as dentistry, chiropractic, and vision care.

Billboards and signs were also used successfully. A well-placed sign near a busy intersection or hospital was its own form of raising awareness and trust.

Why It Matters for NPs Today

The digital era may have transformed how marketing is done today: the channels, the volume, and the targeting.

However, as you may have noticed, the underlying dynamics are essentially unchanged:

• Patients seek trusted recommendations
• Providers compete on reputation, and
• Good provider-patient relationships drive referrals

For NPs and other providers alike, knowing this history can be useful.

It points out that the practice that did well before the internet did so by becoming respected, visible, and a trusted member of its community.

And the same applies today, even though it may be through participation in new community events and organizations.

• The Yellow Pages? Your Google Business profile is the new Yellow Pages.
• Your patient reviews are the new word of mouth.
• Your LinkedIn article or community health seminar is the new newspaper column.
• Sending coupons via direct mail is the new Facebook marketing.

While the internet and social media may have replaced the neighbor’s fence, they haven’t replaced what the neighbor said. Your neighbor telling you, “You can trust this provider; they really listen, they took good care of me,” is still what drives everything.

Building a successful, thriving practice has always started with earning trust. The tools may have changed, but the foundation hasn’t.

How do you feel about marketing your practice? Love it, hate it, or somewhere in between?

Let us know; leave your comment below.

By Johanna Hofmann, MBA, MAc., regular contributor to the NPBusiness blog and author of “Smart Business Planning for Clinicians.”

The post Healthcare Marketing: From Phonebook to Facebook appeared first on Nurse Practitioners in Business.

Many small practice owners, including Nurse Practitioners, feel intimidated and overwhelmed by what they see…

• Large hospital systems that dominate the market and keep acquiring small practices
• Corporate healthcare groups that keep expanding
• Urgent care chains and retail clinics that seem to be springing up everywhere
• Private equity firms that are increasingly investing in healthcare organizations
• And… the growing presence of telehealth

To make matters worse, most organizations don’t just open up one clinic.

They open up multiple locations, with up-to-date technology and equipment. They come with large advertising budgets and strong brand recognition.

As a result, small practices feel pressure from these competitors with deep pockets and greater visibility.

It’s understandable why small practices may feel intimidated.

Who wouldn’t be?

Some NP practice owners even assume that small practices cannot compete long-term.

But that’s an assumption, and it may not be accurate.

Small practices don’t need to outspend large healthcare systems to compete successfully.

They have something that works in their favor; something they tend to minimize, if not overlook altogether.

In fact, independent NP practices have advantages that large organizations struggle to replicate.

While large healthcare systems may dominate through scale, independent practices win by bringing trust, relationship-building, flexibility, and a better patient experience to the table.

A Common Mistake

Here is a common mistake some small practices make: they try to look like a large organization.

They think they must appear bigger, more corporate, or more technologically advanced to remain competitive.

However, patients usually don’t choose an independent practice because they want a corporate experience.

They choose a small practice with an independent provider because they want the opposite.

They want and value:

• Personalized care
• Better communication
• Shorter wait times
• Greater continuity
• Feeling heard and respected

These are areas where small practices typically outperform larger organizations.

“We Listen, We Care” was the USP Barbara Phillips, of NPBusiness.org, chose for her first practice because her patients repeatedly told her they felt listened to.

So rather than trying to “look big,” focus on maximizing the advantages of being small to stay competitive.

Your Unique Advantage

One of your greatest strengths, as an independent NP practice owner, is the opportunity to build stronger relationships with your patients.

Larger healthcare systems often struggle with rushed, short appointments and high provider turnover.

Patients may see a different provider at each visit; some feel they are just another number in a big machine.

But your small practice can provide a different experience.

Patients like and appreciate:

• More personalized attention
• More time with the provider
• Consistent follow-up
• Familiarity and continuity
• Direct and open communication

These relationship-driven experiences build trust, which strongly impacts loyalty and referrals.

Most patients don’t simply want healthcare.

They want to work with a provider who genuinely listens and cares.

Small Practices Can Adapt Faster

Another advantage you, as a small provider, have is flexibility.

Larger organizations typically move more slowly because of policies and organizational red tape. Small practices can usually adapt far more quickly.

A small, independent practice can:

• Add a new service without needing approval
• Quickly adjust scheduling
• Change communication systems as needed
• Respond to patient feedback fast

This built-in flexibility allows a small practice to respond to patient needs much faster than a larger organization.

Community Connection Creates Trust

Small practice owners often have a deeper connection to their communities.

They may participate in local events, support community organizations, and support nearby businesses.

That local connection creates familiarity and trust that larger systems find difficult to establish.

Community visibility also helps with marketing. Often, patients are more likely to trust providers who participate in local activities, educational events, or community outreach.

While larger healthcare organizations focus on branding and advertising, patients increasingly want to work with someone they can trust.

People want better access to care, providers who remember them, and healthcare that feels personal.

Trust is becoming a competitive advantage for smaller practices and creating a tremendous opportunity for independent NP business owners.

While large healthcare systems may have bigger budgets, small practices can often create stronger emotional connections with patients.

Marketing Creates Visibility

You can’t grow your practice if no one knows you exist.

That’s why marketing is so essential.

Fortunately, effective marketing doesn’t require an enormous budget or complicated strategies.

Educational marketing works well for small practices. Things like helpful articles, newsletters, FAQs, patient handouts, videos, and community education all help establish credibility and trust.

Local visibility is equally important.

That means optimizing your Google Business Profile, improving your website to communicate your practice’s benefits clearly, collecting patient reviews, and participating in community events to increase awareness of your practice.

The majority of patients search online before scheduling appointments. A strong online presence helps smaller practices compete against larger organizations.

Consistency Matters

Don’t assume that marketing must be expensive or complicated to be effective.

Simple and consistent marketing often works best… keep it simple.

Small providers don’t need fancy advertising campaigns.

What they need, however, is to stay visible, trustworthy, and, if possible,  connected to their communities.

• An educational article published regularly may outperform expensive advertising over time.
• Consistent patient communication may create more loyalty than expensive branding campaigns.

The key is consistency.

Summing up…

Small independent practices can compete with larger organizations.

The competitive advantage lies in being different.

Embrace it and use it to your advantage.

Some patients may choose larger organizations for convenience.

Still, many stay loyal to a small practice for trust, relationships, communication, and personalized care, the very qualities that are difficult to create consistently in large organizations, but come naturally to small practices.

And when combined with simple, consistent marketing, these strengths allow independent NP practices not just to compete, but to thrive.

Worried about competing against well-funded healthcare systems?

Share your thoughts and experience; leave your comment below…

By Johanna Hofmann, MBA, MAc., regular contributor to the NPBusiness blog and author of “Smart Business Planning for Clinicians.”

The post How Can A Small Practice Compete With Large Healthcare Systems? appeared first on Nurse Practitioners in Business.

For many Nurse Practitioners, along with other small practice owners,  the phrase “pen-testing”, or penetration testing, sounds intimidating, expensive, and technical.

And that reaction is understandable.

Because the proposed updates to the HIPAA Security Rule and broader healthcare cybersecurity initiatives increasingly point toward annual penetration testing as part of an ongoing cybersecurity program.

Relax…

No law has been passed, and nothing is set in stone… yet.

But regardless, there are a few problems with the proposed rules, a major one being the added expense for small practices.

Because most Nurse Practitioners and other independent practice owners do not have:

• IT departments
• Cybersecurity experts on staff
• Large cybersecurity or compliance budgets
• Enterprise-level infrastructure in place

But not all is lost…

The good news is that small practices can still implement effective penetration testing and improve cybersecurity without spending enormous amounts of money.

The key is understanding what the government is actually expecting and taking a practical, risk-based approach.

The Proposed Rules

Under the proposed HIPAA Security Rule updates, all healthcare organizations may eventually be required to conduct:

• vulnerability scanning at least every six months
• and penetration testing at least once every 12 months

The government also increasingly emphasizes the importance of:

• ongoing risk management

• vulnerability identification
• up-to-date documentation
• and reasonable security practices

For small practices, this is important because the expectation is not perfection.

The expectation is that small healthcare organizations make a reasonable, ongoing effort to identify and reduce cybersecurity risks.

What is Penetration Testing?

Penetration testing, often called “pen testing,” is a controlled cybersecurity exercise where authorized professionals attempt to identify weaknesses in systems before criminals do.

A penetration test may evaluate components like:

• Internet-facing systems
• Firewall configurations
• Password security
• Wi-Fi security
• Remote access
• Access to patient information
• Email vulnerabilities
• Employee phishing susceptibility
• Weaknesses inside the office network

Again, the goal is not perfection, but to identify major risks and reduce them before hackers find them first.

Under the proposed HIPAA Security Rule updates, penetration testing would likely be required at least once every 12 months.

While no requirements are in place at this time, it’s important to take steps now to make your office as safe as possible from cyberattacks.

Focus on the Basics Before Pen-Testing

Before investing in penetration testing, practices should first implement the core protections the government is already emphasizing:

• using strong passwords
• keeping all software updated
• remove all unsupported software
• use of multi-factor authentication (MFA)
• use of encrypted devices
• using secure backups
• providing employee cybersecurity training
• Tracking all devices and software in use
• Removing access to systems when no longer required

These are weaknesses a pen-test will uncover. So, fixing obvious issues will reduce both risk and testing costs.

There’s no need to pay for advanced cybersecurity services before addressing basic security problems.

What is a Vulnerability Scan?

The proposed rules also emphasize routine vulnerability scanning in addition to penetration testing.

These are two different things.

Pen-Testing involves evaluation by a professional, whereas a vulnerability scan is a piece of software that searches a system for known weaknesses.

There are numerous options on the market; some are standalone software, while others are subscription-based for vulnerability scanning.

When selecting vulnerability scanning software, be sure it is HIPAA-compliant and has a proven track record in healthcare.

Work With Smaller Cybersecurity Firms or Freelancers

With respect to pen-testing, don’t assume you must hire a large cybersecurity company to perform penetration testing for your practice.

A smaller independent practice may be well served by:

• a qualified cybersecurity freelancer
• a cybersecurity consultant
• or a smaller healthcare-focused security company

The key issues are qualifications and documentation.

The proposed HIPAA guidance refers to testing by “qualified persons” with appropriate cybersecurity knowledge and experience.

As always, do your due diligence and ask questions:

• What healthcare experience do you have?
• What type of penetration testing do you perform?
• What systems are included?
• Will you provide a written remediation report?
• Do you retest after vulnerabilities are corrected?
• Can you scale services for small practices?

Avoid vendors that immediately push expensive, long-term contracts before understanding the practice’s actual size and complexity.

Leverage Free Government Resources

At this time, May 2026, no scans or pen testing are mandated.

However, it is recommended that you get a head start on what’s coming down the pike.

Why not start by using the federal government’s resources?

Many practices overlook the fact that the federal government already provides substantial free cybersecurity guidance.

The Cybersecurity and Infrastructure Security Agency (CISA) offers:

• healthcare cybersecurity guidance
• ransomware prevention resources
• vulnerability advisories
• phishing education
• incident response materials
• and security checklists

Similarly, HHS HIPAA Security Rule Guidance provides security guidance specifically for healthcare organizations.

Small practices should not underestimate the value of these free resources.

Documentation Is Becoming Critically Important

And finally…

One of the clearest themes emerging is the importance of up-to-date documentation.

Because even basic documentation can demonstrate good-faith compliance efforts.

Increasingly, regulators likely will ask:

• Did the practice identify risks?
• Did it conduct testing?
• Were vulnerabilities addressed?
• Was corrective action documented?

This means your practice should maintain things like:

• Penetration test reports
• Remediation records
• Vulnerability scan results
• Software update logs
• Employee training records
• Cybersecurity policies

Cybersecurity Is Becoming an Ongoing Effort

Perhaps the most important takeaway is this…

Cybersecurity is no longer a one-time project.

In the future, all healthcare organizations will be expected to demonstrate continuous security efforts rather than an occasional activity.

But don’t let that intimidate you.

We all need to implement stronger cybersecurity practices at the personal, business, and government levels.

That doesn’t mean your small practice has to turn into a cybersecurity company.

However, it means implementing manageable, yet simple routines, including regular:

• Testing
• Software updates
• Employee training
• Backups
• Ongoing documentation

Small, consistent improvements are often far more effective than expensive one-time security projects.

The practice that begins implementing these habits now will likely be in a much stronger position as healthcare cybersecurity requirements continue to evolve.

Join the conversation by leaving a comment or question below.

Let us know if you have any questions or would like more information on specific topics.

By Johanna Hofmann, MBA, MAc., regular contributor to the NPBusiness blog.

The post Cybersecurity: What Every NP Must Know Part 5: Pen-Testing appeared first on Nurse Practitioners in Business.

We all know, or at least sense, that life unfolds in patterns and seasons…

• birth, growth, death
• spring, summer, fall, winter
• dawn, day, dusk, night

As chaotic and random life can be at times, there is some predictability.

Healthcare is no exception…

While demand for healthcare never disappears, it tends to fluctuate in somewhat predictable patterns throughout the year.

For small NP owned practices, understanding these patterns can be the difference between struggling to keep the doors open and operating with a sense of control and stability.

Seasonal patterns repeat, are real, and predictable. And with a bit of planning, you can anticipate and leverage them to grow your practice.

Seasonal Patterns in Healthcare

Healthcare isn’t delivered evenly across the calendar. Instead, it follows patterns tied to:

• The weather
• Human behavior
• The economy
• Insurance rules
• Public health concerns

Flu Season

One of the most predictable patterns is the fall and winter surge in respiratory illnesses.

Every year, cases of influenza, COVID-19, RSV, bronchitis, and pneumonia increase as winter approaches and temperatures drop.

According to the Centers for Disease Control and Prevention, flu activity typically rises in the fall and peaks between December and February, though it can last into spring.

The CDC recommends vaccination in early fall, generally September or October, in preparation for the seasonal wave.

As it gets colder outside, people spend more time indoors, kids are in school, and holiday get-togethers increase close contact… all perfect conditions for respiratory viruses to spread easily.

Why not plan an official “flu clinic” event at your office, or start offering the vaccine during appointments as the flu season approaches?

It’s simple to implement, is beneficial and convenient for patients, and it adds to your bottom line.

Most people will get vaccinated…  why not in your office?

Allergy Season

Another predictable seasonal cycle happens in spring and fall, when allergy-related conditions are on the rise.

Tree pollen, grasses, weeds, ragweed… and more, are on the loose for much of the year.

For some, allergies are a mild inconvenience. But for others, they cause real health problems and lead to increased healthcare utilization.

The CDC estimates that pollen exposure contributes to billions of dollars in healthcare costs annually, driven by increased visits, medications, and complications such as asthma exacerbations.

For many primary care and specialty practices, these periods bring a noticeable uptick in visits for sinusitis, allergic rhinitis, and asthma-related issues.

Allergies happen predictably every season…

So why not integrate allergy-related services into your current service offering?

Chances are you already do that, but the question is… do your patients know about it?

Include all allergy-related services you offer in your marketing materials, and let your patients know that you can help them get through the next allergy season.

Summer Season

The summer season sees a different mix…

With kids out of school, people travel or spend time away on vacation. Naturally, families shift their focus away from healthcare unless a clinic visit becomes necessary.

While the season tends to be a bit slower and many practices see a dip in routine visits, often, there is still some seasonal demand for healthcare.

Summer visits may bring more heat-related injuries or dehydration to your office, in contrast to the illness-driven visits during winter.

At the same time, depending on the type of office and the services provided, there may be an increase in appointments for travel care or for the treatment of minor injuries associated with increased outdoor activity.

Many offices see an uptick in school and sports physicals during late summer as people prepare for kids to return to school.

For some practices, especially pediatrics and family medicine, this can create short bursts of activity within an otherwise slower season.

Make it a point to remind patients of all the services your office provides. Send emails, create a newsletter, send flyers, and make patient education materials available in your waiting room.

Unless people are aware of everything you offer in your practice, they can’t utilize it.

Mental Health

Seasons and patterns aren’t limited to physical health. Mental health also follows recognizable patterns.

Take SAD (Seasonal Affective Disorder) as an example.

The National Institute of Mental Health tells us that SAD  typically begins in late fall or early winter and tends to improve in spring or summer.

Another example is the increase in depression and anxiety for some individuals around the major holidays.

Both patterns may lead to increased demand for mental health services around major holidays and during darker months, particularly in regions with shorter daylight hours.

Insurance Rules

Aside from weather, biology, and holidays, insurance can play a major role in healthcare seasonality.

January often brings a slowdown in appointments, as people face post-holiday bills and must meet insurance deductibles before visits and care are covered again.

Once deductibles have been met, healthcare demand often increases again toward the end of the year. For some practices, this pattern creates a surge in Q4 visits, followed by a slowdown in Q1.

Of course, this dynamic applies primarily to offices that accept Medicare and commercial insurance.

Seasonal Patterns: A Double-Edged Sword

For small practices with limited personnel, seasonal demand fluctuations can create operational challenges.

While seasonality cannot be eliminated, it can be managed and even used strategically to grow your practice.

Since every practice is different, it’s important to know and understand your own data.

Start by reviewing the number of patient visits, revenue, and payer mix over the past 12 to 24 months. From there, you should be able to create a simple seasonal calendar that shows you the expected highs and lows.

Next, focus on using slower periods intentionally.

Instead of passively allowing patient visits to decrease, plan to offer preventive and recall-based care during slow times.

Annual wellness visits, chronic disease follow-ups, medication reviews, and screenings can be scheduled proactively during quieter months.

Create seasonal campaigns, including flu vaccine reminders in early fall, allergy preparation in late winter, and sports physical reminders in early summer, to level patient visits and improve clinical outcomes.

Healthcare is inherently unpredictable, so remaining flexible is important. Remember that seasonal patterns are not set in stone and can shift due to factors such as pandemics, natural disasters, or changes in insurance policies.

Predictable… If You Plan For It

While shifts in healthcare demand may seem random, they are not.

Seasonal patterns in healthcare simply reflect a combination of human behavior, environmental conditions, and financial realities that are built into the system.

For small NP-owned practices, recognizing and working with these patterns can create opportunities to grow the business.

Instead of being blindsided by sudden volume swings, you can prepare for them, balance practice workloads, and stabilize or even increase your revenue.

While much of healthcare may feel unpredictable, seasonality is something you can actually plan and prepare for.

Are you tuned in to the seasonal patterns in your practice? Or do you see them now after reading the article?

Let us know in the comments below…

By Johanna Hofmann, MBA, MAc., EAMP; regular contributor to the NPBusiness blog.

The post How to Leverage Seasonal Patterns to Grow Your Practice appeared first on Nurse Practitioners in Business.

If that’s not bad enough for patients, it creates a ripple effect challenge for practices.

What used to be collected from insurance is now sitting in your accounts receivable, waiting to be collected from your patients.

But without a clear, consistent process in place, those balances stay on the books far too long, or disappear entirely.

Today, collecting patient balances is no longer a small part of billing, but a significant part of your income.

Why Collections are Challenging

Most practices don’t struggle with collections because they don’t make an effort. They struggle because it’s uncomfortable, and they lack effective systems.

Nurse Practitioners were never trained to talk about money.

And…  Isn’t it a contradiction to talk about money in a healthcare setting?

That’s certainly what most of us have learned; not because of what was said, but rather what wasn’t…

Money, the cost of healthcare, was never discussed!

The subtle message was that discussing money in a clinical setting is distasteful, even inappropriate.

As a result, financial conversations are often delayed, softened, or skipped altogether.

And on top of that, many practices operate without a clearly defined financial policy or one that’s not consistently enforced by everyone in the office.

One team member collects at check-in, another forgets, and another hesitates in enforcing the policy if the patient pushes back.

Over time, this inconsistency trains patients to think it’s okay not to pay when they come to an appointment.

So the clinic relies on billing after the visit. Not only does this create an additional expense for you, but by then, the patient has left, the urgency is gone, and collection becomes significantly more challenging.

The best time to collect payment is at the time of service!

Set Clear Expectations

If you want to improve your collections, start by setting clear expectations and repeating them often.

Your practice must have a written financial policy that clearly explains what patients are responsible for and when payment is expected.

This includes co-pays due at the time of service, as well as any applicable deductible or co-insurance amounts.

But having a financial policy isn’t enough.

Patients need to see it, hear it, and be reminded of it. That means including it in your intake paperwork, referencing it in appointment reminders, and making it easily accessible on your website.

When expectations are clear, collections become less confrontational and more routine.

The Best Opportunity: Upfront Collection

As mentioned earlier, the single most effective way to improve collections is to collect at the time of service, before the appointment.

This may require a shift in mindset… for clinic staff and patients.

While short-term credit in grocery stores, pharmacies, and other establishments was common years ago, the days of “put it on my tab” are long gone.

Instead of hoping to collect later, your team must collect payment upfront, just like in other industries.

For a clinic, it starts with verifying insurance and estimating the patient’s responsibility before the visit, whenever possible. Even a rough estimate is better than saying nothing at all.

Equally important is how the conversation is handled. A simple, confident approach works best: “Your estimated responsibility today is $75.”

Patients take their cues from you and your staff. When you communicate insecurity, patients pick up on it.

But when you approach payment as standard and expected, most patients will handle it without hesitation.

While most financial conversations should happen at check-in, there are times when they need to happen during the visit.

If additional services are recommended that may increase the patient’s cost, it’s important to communicate that clearly. Patients don’t like surprises, especially when it comes to their bills.

After-the-Fact Collections Still Matter

Even with strong upfront systems, there will always be balances that need to be collected after the visit.

And this is where consistency is critical.

Claims should be submitted promptly.

Patient statements must be clear and easy to understand, and be mailed as soon as patient balances become available.  

Confusing bills are often ignored, as are bills mailed weeks or even months after the date of service.

Establish a regular billing cycle (30, 60, and 90-day) and stick to it.

Make it Easy for Patients to Pay

Offer multiple ways for patients to pay their balance.

Make both in-office and online options available so patients can easily manage their financial responsibilities.

Also, consider offering structured payment plans when appropriate, or connect with a third-party financing provider.

And here is the key… follow-up!

A simple reminder, whether by text, email, or phone, can significantly improve collection rates.

People are busy, and some do forget…

What to Do When Payments Don’t Come In

No matter what you do, though, some accounts will remain unpaid.

This is where knowing what to do next comes in handy.

Decide in advance what the cutoff is for moving accounts from internal follow-up to external collections. And when that point has been reached, turn the overdue account over to collections without delay.

Be sure to include in your financial policy that delinquent accounts are turned over to collections.

Initially, I didn’t want to involve a collection agency; I gave people all the benefit of the doubt…

However, after just a short time in practice, it became clear that working with a collection agency was the only way to recover payments from a few people.

Using a third-party collection agency can be effective, but it should be a last resort. The goal should be to collect while maintaining a healthy patient relationship, which likely will be lost once the account is turned over to the collection agency.

Use Technology to Your Advantage

Today’s tools can make a significant difference in your collection process.

Practice management systems can:

• automate eligibility checks
• estimate patient responsibility
• send reminders.

Establishing card-on-file policies can streamline payments, especially for ongoing care.

Equally important are your reports.

Track metrics like:

• Days in accounts receivable
• Collection rates
• Total patient balances, etc.

to help you identify where you stand, if your process is effective, or if it’s breaking down.

The idea is: what gets measured gets improved.

Train Your Team

Lastly, train your staff to normalize the conversation.

One of the most overlooked aspects of collections is training.

You and your team need more than just a script; you need confidence.

Speaking with confidence (instead of an apologetic tone) comes from practice, consistency, and a clear understanding that collecting payment is part of delivering care in our current healthcare system.

Finally…

Patients are feeling the pressure of rising healthcare costs, and it’s important to acknowledge that. However, your practice cannot function without consistent cash flow.

The goal is to strike a balance, offering reasonable flexibility when appropriate while maintaining clear, consistent policies. And when you make exceptions, they should be intentional, not accidental.

Improving your collections doesn’t mean you have to use aggressive tactics or engage in uncomfortable conversations. However, it requires clear expectations, clear policies, and consistent processes.

When collections become a repeatable system, your cash flow stabilizes, your stress decreases, and your practice becomes more sustainable.

And that ultimately allows you to focus on what matters most, caring for your patients.

Is everyone in your office enforcing your financial policy? Do you collect payment at the time of service without exception?

Please share your knowledge and experiences with us… Share your input via a comment below.

By Johanna Hofmann, MBA, MAc., EAMP; regular contributor to the NPBusiness blog.

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