Some are pleasant; others can be devastating.

When an emergency hits and stresses you out, you may scramble for essential information, critical supplies, and the money to pay for it all.

Emergencies may be medical, environmental, natural disasters, or property-related. They catch you off-guard and require a fast response when it’s hard to think clearly,

And that’s where an emergency fund can be a lifesaver.

Your Current Emergency Fund

Where are you with building an emergency fund?

Do you have separate emergency funds for your practice and personal life, only one, or none at all?

If you haven’t set money aside for emergencies yet, it’s time to start.

Most money experts recommend keeping 3 to 6 months in reserve for emergencies, for both business and personal use. Using emergency fund calculators can help you fine-tune that number.

If you’ve set aside money for emergencies in both your practice and your personal life, great… you’re ahead of the game.

But here is the trap: when you think about handling an emergency, do you mentally combine those two account balances?

It’s an understandable habit. You own both accounts, and it may feel like money you can access if you need it.

That’s fundamentally correct, but the problem is that the dollars in each account have different jobs.

Your personal life needs financial protection, and so does your business. But when you count the same money toward both, you may be less protected than you think.

As an NP practice owner, building two separate financial cushions is a sensible way to protect the life you’re supporting (with your practice) and the practice you’re building.

Your Personal Emergency Fund

A personal emergency fund covers unexpected expenses or income disruptions for you and your household.

That could be a major home repair, an unexpected medical bill, or essential living expenses when your income drops.

The Consumer Financial Protection Bureau describes emergency savings as money specifically reserved for unplanned expenses and financial emergencies.

For practice owners, income disruption matters even more.

Without employer-provided paid leave or personal income protection insurance, if you cannot see patients, your earnings may drop while your mortgage, groceries, utilities, and other obligations continue.

Your personal emergency fund gives you room to manage that situation without immediately taking more money from a practice that may already be struggling.

This fund also helps you make thoughtful business decisions…because when covering household bills depends on taking every available dollar out of the practice, it becomes harder to leave enough money for the practice.

Your Practice Emergency Fund

Your business emergency fund helps cover essential operating costs when revenue is interrupted, or you face an unexpected expense.

For your NP practice, that could include a delayed reimbursement, a critical equipment failure, or moving offices. Payroll, rent, software subscriptions, insurance, and loan payments will continue even when patient visits or collections drop off.

Ideally, keep your emergency fund in a separate interest-bearing account, because money in your checking account isn’t a reserve if most of it is already committed to upcoming bills.

Your emergency fund gives your business time to respond and recover while meeting all financial obligations.

At the same time, money set aside for taxes, annual insurance premiums, or a planned equipment purchase already has a purpose, and shouldn’t count toward emergency savings.

One Event…

… is all it takes.

Imagine there are two providers in your office: you and another NP. Now, suppose an injury keeps you from seeing patients for several weeks.

Depending on the business model, the practice’s income may not drop immediately, but it will eventually.

You still need money for living expenses, and the practice still needs money for its lease, essential staff, and other continuing costs.

Suppose your essential household expenses are $5,000 per month and the practice’s continuing obligations are $12,000. A combined $30,000 emergency fund would cover less than two months of those combined expenses if no other money were to come in.

While the $30K of emergency money would cover six months of household expenses, it would not cover six months of household and practice expenses.

That is the trap of viewing the funds as interchangeable: the same dollars may look like they provide more security than they actually do.

But with separate funds, the limits are clear. You can see how long your household could manage and how long your practice could continue operating.

Set Separate Targets

Start with two calculations.

For your personal fund, total your essential monthly household expenses. Include housing, food, utilities, insurance, transportation, and required debt payments. Consider how much dependable income would continue if your practice could no longer pay you.

For the practice emergency fund, identify the obligations that would continue during a disruption. Include essential payroll and related costs, rent, utilities, insurance, software, and debt payments. Some expenses may fall if visits stop; others will stay the same.

As mentioned earlier, a common guideline for business and personal reserves is three to six months of expenses, but the appropriate amount depends on the business’s costs, stability, and risks. The number is simply a planning range, not a guarantee of total protection.

For both emergency funds, consider realistic scenarios.

How vulnerable is the practice to your absence? How concentrated is your work with a few payers? Does your household have another reliable source of income?

Be clear about owner pay, too. If your business reserve assumes you will pause your compensation, your personal emergency fund must account for that lost income.

Don’t Wait for the Perfect Time

Start building and contributing to your two emergency funds now.

It may feel overwhelming, especially when you’re starting, but you don’t have to fund them at once.

Set up separate, clearly labeled accounts: a personal emergency fund account and a reserve account for your practice. Choose safe, ideally interest-bearing, accessible accounts; emergency money needs to be available when you need it.

Then set manageable milestones… such as working toward one month of essential expenses in each fund before building further.

Include the contributions in your cash flow plan. Transfer an affordable amount regularly, and consider adding more after stronger months.

Set Clear Boundaries

Decide in advance what qualifies as an emergency for a withdrawal and how you will replenish the emergency account afterward.

An unexpected interruption in collections may qualify as an emergency, while a predictable seasonal slowdown should be planned for.

Here’s what to do next…

Write down two numbers: the emergency funds available exclusively to your household and the emergency funds available exclusively to your practice; exclude all money already committed elsewhere.

Those numbers will tell you how prepared you are for an emergency and what you need to do next.

Are two separate emergency funds reasonable or overkill? Let us know what you think…

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

The post Why You Need Two Emergency Funds: One Personal and One For Your Practice appeared first on Nurse Practitioners in Business.

Let’s assume an NP, perhaps you, is thinking about opening a practice…

Are you focusing on finding the right space, choosing an EHR, getting credentialed, finding equipment, and more?

While these are big decisions, there’s one question that must be answered first…

How will your practice provide care and bring in enough money to support you and the practice?

You have to answer this question first because many of the decisions you will make down the line will depend on it.

This is where the business model comes into play…

Already in Practice?

If you’re an NP with an established practice, you may think worrying about your business model is a moot point.

But it may still matter…

If you’re busy with a full schedule but your practice isn’t working as well as you’d like, especially if you struggle to pay yourself or spend every evening catching up, it may be time to rethink your business model.

But first…

What Is a Business Model?

A business model describes how a business creates, delivers, and provides value to its customers, and how it generates profit.

The definition is the same across all industries. It applies whether it’s a restaurant, a software company, or a healthcare practice.

Every business needs customers who value what it offers; at the same time, the business must generate enough revenue to deliver that value.

Healthcare is somewhat unique. It adds some complexity because the person receiving care isn’t always the one paying for it.

So, as an NP in private practice, your business model still shapes how your practice serves patients, meets their needs, and generates enough revenue to support that work, with one small additional consideration: who pays you.

A Side Note…

Often, people assume the business model and the business plan are the same.

But that’s not the case…

Ideally, the business model comes before the business plan; however, businesses don’t always start that way. Often, someone has a product or business idea and runs with it.

The business plan describes how you will build and operate the practice based on the services you plan to offer and the population you want to serve.

Also, a business model is not to be confused with a legal structure, such as an LLC or corporation.

Your legal structure defines your personal liability, tax obligations, and who controls the business. It has nothing to do with the value you provide through your business… taxes are due whether you sell services or widgets.

Do You Need to Choose a Business Model?

No, not all businesses start with a clear business model.

However, every business and practice has a business model, whether the owner deliberately chose it or followed a familiar example.

You don’t need the label…

However, you do need clarity about what you want to do and whether your choices will work well together.

Here’s an example…

Let’s say you want your practice to offer longer appointments, same-day access, a low-fee structure, and pro bono care for individuals who can’t pay.

Your patients may value most of these goals, but your practice may not be able to support all of them. Because together, they require time and resources your revenue goals likely won’t support.

And without looking at the big picture, you may end up filling the gap with unpaid work.

Thinking through your business model and various scenarios helps determine what you can promise, how many patients you can serve, what staffing you need, and whether it is sustainable.

Approaches to Getting Paid

People often use “business model” to describe payment arrangements; while important, they’re only part of the picture.

For most practices, common approaches include:

Traditional Insurance-Based (fee-for-service):
The practice bills insurers for covered services and collects the patient’s applicable responsibility. Sustainability depends partly on reimbursement, collections, visit volume, and billing costs.

Cash-Only (Direct-Pay):
The practice doesn’t accept insurance, and patients pay directly for individual visits or services. Here, fees must cover the services, and enough patients must be willing and able to pay.

Membership Model:
Patients, or sometimes employers, pay recurring, monthly fees for certain defined or unlimited services. Direct primary care generally replaces traditional insurance billing for those services. Membership revenue must support the care and access promised.

Concierge:
Patients pay a retainer for specified benefits or access, and practices may also bill insurance for covered services. This differs from the usual DPC arrangement.

Employer Contracts:
Here, an employer contracts and pays for defined healthcare services or access for employees. To be profitable and sustainable, the practice must price the agreement around the required workload and resources.

Hybrid Approaches.
Practices may combine revenue sources, such as insurance billing and separate direct-pay services; adding more options can increase the complexity.

How Care is Delivered

How you deliver care, combined with your payment approach, shapes your practice.

In-office visits, telehealth, and home visits describe how you deliver care, while primary care, women’s health, and other areas of focus describe what you offer and whom you serve.

For example, an NP offering office and virtual women’s health visits could bill insurance, accept direct payment, or use a combination.

Each choice creates different costs, administrative requirements, and patient expectations.

That’s why using descriptors such as “virtual practice” alone doesn’t explain how the business earns money or whether it can support its owner over time.

How Established Practices Can Benefit

Reviewing your business model can be especially useful once you have real experience and financial records.

Here are a few scenarios:

• Perhaps your practice has grown, but your compensation hasn’t.
• You work too many hours and struggle to pay all bills.
• Patients may need more between-visit support than you anticipated.
• A service you added may consume substantial staff time while contributing little toward the bottom line.

Reviewing your business model can help you examine the assumptions behind those problems and help you find solutions.

Start with what actually happens:
Review your collections, expenses, visit patterns, and staff workload. Include your own time spent in addition to seeing patients.

Look for services or processes that are poorly supported by current revenue.

Identify what has changed:
Your patient population, costs, staffing, and personal goals may be different from when you first opened.

The model that was built around your willingness to work evenings and weekends may no longer work for you.

Identify and choose an adjustment:
You might adjust your schedule, improve collections, reconsider underused office space, or evaluate whether offering a particular service still benefits the practice.

However, before making any changes, review the potential impact the adjustment has on your patients and practice.

Track and Test:
Specify what the potential improvement should look like.

Whether it’s better owner compensation, less after-hours work, or more reliable cash flow, track patient experience and response alongside your financial results.

You may find that your current business model is sound, but that your execution needs improvement.

Alternatively, you may realize that working more efficiently won’t fix a fundamental mismatch between the value you provide and how you get paid.

Make Your Model Deliberate

Whether you’re planning a practice or reviewing an established one, write down whom you serve, what you offer, how you deliver it, and how you get paid.

Then ask yourself…

Does my current revenue support the total cost of providing those services, including paying myself enough?

Your business model should make good care possible and sustainable for your patients, your practice, and for you.

Join the conversation… leave your questions and comments below.

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

The post Is Your Business Model Right for You? appeared first on Nurse Practitioners in Business.

But here is the reality…

Your practice can be busy and show a profit on paper, but still struggle to bring in enough cash to stay afloat.

And that’s why monitoring your cash flow is so important!

What is Cash Flow?

Cash flow is simply money coming in and going out of your business.

When more money comes in than goes out, the practice has room to operate. However, when revenue is late, or expenses are due before revenue comes in, even a successful practice may struggle financially.

Cash is to a business as blood is to the body!

Just as the body can’t survive without blood, a business can’t survive without cash.

Often, NP business owners can improve cash flow without seeing more patients or adding new services, because the biggest improvements often come from managing the money you’re already earning more effectively.

Three Simple Strategies

Here are three practical and simple strategies that can make a big difference to your bottom line.

One of the fastest ways to improve cash flow is to shorten the time between providing a service and receiving payment.

That sounds simple, but many practices lose valuable time to slow billing, incomplete claims, delayed or no follow-up, or too many patient balances sitting for too long.

So take steps to tighten your revenue cycle:

• Verify insurance and benefits before the visit whenever possible.
• Collect copays, deductibles, and patient-responsibility amounts at the time of service, before the visit.
• Submit completed claims promptly.
• Review rejected and denied claims quickly rather than allowing them to age.
• Keep a close eye on accounts receivable.

1. Get Paid Faster

Often, the longer a balance stays unpaid, the harder it becomes to collect.

That is why you should regularly review how much money you’ve earned but not yet collected.

This step is important; all unpaid balances require regular follow-up.

Practice owners often assume a cash-flow problem means the practice needs more patients.

But sometimes the real issue is that too much money is tied up in unpaid claims and outstanding balances.

Before you add more patients to the schedule, make sure the practice collects efficiently from the work it already does.

Otherwise, more patients means more unpaid balances.

2. Control When and How Much Money Goes Out

Improving cash flow is not only about speeding up collections.

It is also about being mindful about when and how much money leaves the practice.

Every practice has necessary expenses: payroll, rent, insurance, software, supplies, professional services, and other operating costs.

But over time, expenses tend to grow: a new piece of software, another vendor, or a monthly service no one uses anymore.

Individually, those costs may seem insignificant, but together they can unnecessarily strain your cash flow.

So, review your current expenses regularly:

• Is this expense helping the practice?
• Can this contract be renegotiated?
• Is there a less expensive option?
• Do we need to make this purchase now?

The objective isn’t to cut costs for the sake of cutting costs, but to ensure every major expense is intentional and supports the practice.

Also, consider the timing of expenses.

If possible, coordinate larger expenses with the times cash collections are typically stronger.

At the same time, don’t make large purchases simply because extra money is sitting in the bank.

It’s easy to forget that cash in the account today may already have another job tomorrow.

3. Forecast Cash Before You Need It

One of the best ways to manage cash flow is to look ahead.

A cash-flow forecast is simply an estimate of how much money you expect to receive and spend over the coming weeks or months.

And it doesn’t have to be complicated.

Even a simple spreadsheet can help you anticipate:

• payroll
• tax payments
• insurance premiums
• rent
• loan payments
• large purchases
• seasonal drops in patient volume
• slower reimbursement periods

The purpose isn’t to predict the future, but to avoid surprises.

Let’s say you know a large annual insurance payment is due in six weeks.

If you are watching your cash flow, you can start setting money aside now instead of struggling to find the cash for one big payment.

Or perhaps you know your patient volume tends to slow during a certain time frame. If you’re mindful of cash flow, you can prepare instead of waiting until your bank balance drops.

Forecasting also makes it easier to build and protect a cash reserve.

Without a reserve, every unexpected expense can feel like an emergency.

However, a reserve gives your practice the flexibility to handle slower periods, delayed reimbursements, equipment repairs, or other surprises.

Cash Flow Problems Tend To Build Slowly

Cash-flow problems usually don’t happen all at once, but develop little by little.

• Claims take longer to pay.
• Patient balances are allowed to grow.
• Expenses creep up and up.
• A tax payment is larger than expected.
• A slow month follows a strong one.

On their own, none of these may seem serious, but together, they can create significant financial pressure.

That is why you should review your cash flow regularly, not only when money feels tight.

Watching the numbers gives you time to make small corrections before the problem becomes too big.

Collect. Control. Forecast.

You don’t need a complicated system to improve your cash flow.

Keep it simple; start with these three questions:

1. Are we collecting the money we have already earned as quickly as possible?
2. Are we managing our expenses carefully and intentionally?
3. Do we know what our cash needs are coming next?

Those three questions will tell you a great deal about the financial health of your practice…

Improving cash flow isn’t necessarily about working harder or seeing more patients. Sometimes, it’s more about controlling expenses and their timing, and collecting what you’ve already earned.

These simple strategies can help you build a stronger, more stable practice and give you the freedom to make better business decisions.

Share your thoughts and let us know your strategies for improving cash flow… leave your comment below.

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

The post 3 Simple Strategies to Improve Your Cash Flow appeared first on Nurse Practitioners in Business.

Patients need to know your practice exists, what you can do for them, and, specifically, how you can help.

That’s what marketing is all about…

In the past, business owners advertised in newspapers, the Yellow Pages, and magazines to get customers through the doors.

Today, most use some combination of content marketing, digital advertising, social media, online reviews, search engine optimization (SEO), and information published on their own website.

Of all these strategies, your own website gives you the most control over reaching potential clients…

As long as people can find it!

To get your website found, you can buy ads that take people directly to your site, or structure it so that search engines and AI agents will include it in their search results.

These strategies are called SEO (search engine optimization) and AEO (answer engine optimization).

SEO has been around for years, while AEO is the new kid on the block.

Search Engine Optimization (SEO)

SEO is the process of improving a website’s discoverability and visibility, so it appears as high as possible in the search results for a particular keyword.

It’s also called organic search because it brings website owners free traffic instead of paying for ads.

SEO centers on using keywords or key phrases in your website’s content,  publishing helpful information, and organizing the site so it’s easy to navigate and visitors can find what they’re looking for.

Here’s an example of using keywords/key phrases…

One of our articles, titled “Protect Your NP Practice Against Workplace Violence,” uses the key phrase “NP Practice workplace violence” to get found in search engines.

Ideally, the keyword or key phrase is included in the title of the article and a few times throughout the body, if possible. This particular article included the key phrase in the title and a couple of times throughout the text.

But search is Changing…

More and more, people use AI to ask specific questions, locate businesses, and find new providers. If you want to appear in search engine results and AI searches, your website must adapt.

Answer Engine Optimization (AEO)

Even though AEO seems to be overtaking search, there is good news…

SEO is not obsolete, but AEO builds on good SEO.

While SEO helps search engines find, understand, and return relevant websites in the search results, AEO tries to answer the question asked directly.

Although they are different, the two approaches overlap…

SEO answers questions by returning a list of relevant websites, while AEO tries to return a direct answer to a specific question.

As an example, let’s look at two searches:

“Primary Care Nurse Practitioner in Portland”

“Where can I access primary care in Portland without insurance?”

The first question will likely return a list of NPs in Portland, while the second will try to return a comprehensive answer, including provider, address, services, and the like.

Changes to Make

To increase the likelihood of being included in AEO searches, start by expanding or creating content around the questions you get in your practice.

Think about the typical questions people ask when they email or phone the office; usually it’s the same questions over and over.

~ Answer the Questions People Already Ask

Try to be as concise and clear as you can with your statements.

Avoid using general statements like “We provide compassionate, personalized care.”

While it may describe your approach to providing care, it doesn’t provide much detail or answer questions like…

• What services do you offer?
• What ages do you see?
• Where are you located?
• What are your hours?
• Do you accept new patients?
• What payment options are available?
• Which insurance do you accept?
• How soon can I be seen?

Compare these two made-up descriptions:

Vague:
“We offer comprehensive care for your whole family.”

Specific:
“Our nurse practitioner–owned practice, located in the historic Old Town district of Portland, provides primary care for adults. We welcome new patients and accept the following insurances… We also offer self-pay visits for people without insurance. Call our office @ (123) 456-7890 for current fees and appointment availability.”

The second description gives a prospective patient much more detailed, useful information immediately.

Your website likely already has some of the information mentioned, but not in one central place.

~ Create a FAQ Page

Keep this principle in mind: Don’t make people think or do extra work.

Make information easy to find and understand. No one wants to search through a website for essential information that should be easy to locate.

Create a FAQ page that makes it easy for patients and AI search to find relevant information quickly. The page should answer the most common questions your practice receives.

Clearly structure the page, and depending on the length, consider breaking it into categories.

Put yourself in the shoes of a new or established patient… what questions would you have? Be sure to include them.

~ About Page

People want to know more about who they may choose as their healthcare provider and what their expertise and experience are.

Your website should make it easy to find out.

Include provider biographies, credentials, relevant experience, and the populations you serve.

Also introduce your staff (if applicable) so that prospective patients have a sense of familiarity with the office.

No need to be overly formal; explain everything in plain language, in a conversational tone without being too casual.

~ Practice Details Page

This may seem unnecessary; however, sometimes people need practice details that could be listed on a separate page, saving them the effort to comb through the FAQs to find the answer.

Make sure to keep all practice information current.

Having an old phone number, outdated office hours, or inaccurate insurance information can confuse people, so they may not even call your office.

Check your website against your Google Business Profile and relevant directory listings. Your practice name, location, contact information, and hours should agree.

Google identifies relevance, distance, and prominence as major factors in local results.

Get AEO Ready – One Page At A Time

There’s no need to make drastic changes to your website.

You can start slowly, making the suggested changes.

And you don’t have to add several pages either. You may decide to include most of the information on your FAQ page, broken out by topic or section.

You decide…

In Conclusion…

Start with your existing FAQ page, or create a new one.

Write down the questions patients commonly ask before making their first appointment or when scheduling return visits.

Does the page answer their questions clearly? Are the details current, and are the next steps obvious?

A website that helps patients understand their options provides both people and search tools with better, more useful information.

AI is here to stay, and for now, so is AEO search.

However, as AI develops and changes, search will likely continue to evolve, and your website will too.

Ready to incorporate AEO search? Let us know your plans in the comments section below…

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

The post NP Practice: Is Your Website Ready for AI Search? appeared first on Nurse Practitioners in Business.

But before we get into the updates, let’s make sure we’re on the same page…

What is Incident-To?

“Incident to” is a Medicare Part B billing provision that allows services performed by non-physician practitioners to be billed under a supervising physician’s National Provider Identifier (NPI), when certain requirements are met.

Providers whose services may be billed incident-to include Nurse Practitioners, Physician Assistants, Certified Nurse Midwives, and Clinical Nurse Specialists.

Notably, a service provided, for example, by an NP, but billed incident-to under the physician NPI, is eligible for reimbursement at 100% of the physician rate.

However, the same service provided under the NP’s own NPI will only be reimbursed at 85% of the allowable (remember that incident-to is a Medicare billing provision).

The only exception is Oregon, which reimburses NPs on par with physicians at 100%.

Required Conditions for Incident-To

To qualify for incident-to billing, a few conditions must be met, as outlined in 42 CFR 410.26.

• Setting: The service must not be provided in an institutional setting, such as a hospital or a skilled nursing facility.

• Not standalone: The service must be an integral part of the physician’s service in the course of diagnosis or treatment, and cannot be a standalone service a patient asks for.

• Supervision: A qualified professional or physician must directly supervise the staff, except in certain areas that require only general supervision.

• Initial Exam/Service: The physician must have performed the initial service or exam and must remain actively involved over the course of treatment.

• Common Service: The service must typically be provided in an office setting, without a separate charge.

• State Law and Scope of Practice: The service furnished must be included in the scope of practice of the supervised provider and permitted under state law.

• Employment Relationship: The NP (or other professional) providing the service must be an employee of the office or organization, or must have some contractual relationship with the physician or group.

What Has Changed?

Not much…

The most significant change is how direct supervision is now defined.

According to CMS, direct supervision means the supervising provider must be immediately available via real-time audio and visual interactive telecommunications. However, the supervising provider no longer must be physically present in the same office suite.

Be aware that audio-only communication is not part of the new definition and does not count.

Concluding this Brief Update on Incident-To…

To use incident-to billing, the NP must be employed by, or have some form of contractual relationship with, a clinic or medical office.

To qualify for incident-to billing, the NP must follow up on an established problem after a physician diagnosed it.

If the patient alerts the NP to a new problem and wants to be treated for it, incident-to billing can no longer be used.

In all likelihood, incident-to billing cannot be used in an NP-owned practice for the reasons above.

What’s your experience with incident-to billing…? Tell us in the comment section below.

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

The post Incident-to-Billing: What’s New and What Hasn’t Changed appeared first on Nurse Practitioners in Business.

And for some business structures, it’s not just good advice, but a legal requirement. Businesses that ignore it risk personal exposure to creditors and potential piercing of the corporate veil.

But regardless of your business’s legal structure, maintaining separate bank accounts and records for personal and business finances is good practice.

But keeping the money separate doesn’t mean your personal finances and practice finances are unrelated.

Frequently, they are closely connected, and household expenses, personal debt, and other financial obligations influence decisions you make in your practice more than you may realize.

That’s why it’s important to understand both sides of your financial life.

Keep it Separate, but Understand the Connection

From an accounting, practice management, and legal perspective, your personal and business finances should be kept separate.

But of course, you stand in between, aware of and affected by both.

Your practice must support itself, build reserves, and eventually provide you with income.

At the same time, your personal financial needs may influence how much money you must have from the practice.

For example:

• If your household expenses increase, you may feel pressure to take more money from the practice than is prudent.
• If you have little personal savings, a slow month in the practice may cause you anxiety and produce fear.
• If you are carrying significant debt, you may feel it’s urgent to increase your revenue.

None of these correlations are unusual, but they are important to recognize.

Personal Financial Pressure Affects Business Decisions

The problem isn’t debt or high expenses; it’s the level of pressure and financial stress they create.

For example, if you have large monthly household expenses, student loans, and credit card payments, it’s likely to influence any number of business decisions:

• The amount of money you take out of the business.
• How quickly you can grow the practice.
• If you can afford to hire staff.
• If you can qualify to lease or purchase more equipment.
• If you can afford to add new services.
• Whether you qualify to take on additional debt.

Sometimes the impact is not obvious. You may think you’re making a strict business decision when the real reason is your personal financial situation.

That doesn’t make the decision wrong, but you should know the real reasons behind it.

Ideally, business decisions should be based on what the practice can support and what makes strategic sense, and not on the owner’s current financial needs.

Household Expenses Matter

Everyone has personal living expenses that range from low to average to high.

Housing, food, insurance, transportation, childcare, healthcare, debt payments, and other expenses continue whether the practice has a busy month or a slow one.

As a result, two practice owners with similar practices may face very different financial pressure.

One owner may need $4,000 a month to cover personal expenses. Another may need $8,000.

Neither number is good or bad, but the difference matters.

That’s why a practice cannot be evaluated only by asking:

“Is the business profitable?”

A better question to ask is whether the practice can support the financial needs of its owner.

That means understanding what you personally need from the business and whether the business you are building can realistically support that over time.

Savings Give You Breathing Room

Starting a practice with personal savings gives the new owner something extremely valuable… time!

With a financial cushion on your side, you may be able to:

• Leave more money in the practice during a slow period.
• Wait longer before increasing your own pay.
• Give the new marketing strategy adequate time to work.
• Stop making rushed decisions because you need more money now.

While savings alone don’t eliminate uncertainty, they can reduce the pressure and stress around financial decisions.

An owner with little or no personal savings may have fewer choices, and even just a temporary drop in revenue can quickly become a household emergency.

And once that happens, every business decision comes with more pressure and urgency.

Personal Finances Can Influence Fees, Hiring, and Growth

The connection between personal and practice finances shows up in some of the most important decisions you, as the owner, will make.

• Fee Structure: With enough financial pressure, you may raise your fees simply because you need more income, or keep them too low out of fear of losing patients.
• Owner Pay: How much should you pay yourself? The question to ask is: “How much can the practice responsibly afford?”, not just, “How much do I need?”
• Hiring: Employees help grow your practice, but they also cost money. Payroll reduces the amount available to the owner, and it may be the reason some delay hiring, even when employees could help improve and grow the practice.
• Growth: Most practice owners want to grow their business. However, if there is too much financial pressure, the practice may grow too fast… adding services, staff, space, or debt before it’s ready.

Is It a Business or Personal Problem?

This may be one of the most useful questions to ask yourself…

Suppose you are thinking: “The practice is not paying me enough.”

This could mean the business needs more revenue, better margins, or lower expenses; but it could also mean your personal expenses have gone up and you need more revenue to pay your bills.

Alternatively, you may be thinking: “I need to grow the practice.”

The decision to grow the practice may be the right move… However, it could also stem from higher personal financial obligations rather than a strategic need within the practice.

So before changing anything in the practice, ask yourself this:

Is this a business issue, or am I asking the business to solve a personal financial problem? The answer to this question will give you much-needed clarity.

It’s About Choices

You don’t need to be rich or debt-free to make good business decisions.

However, it helps to know your personal financial situation: what you owe, what you spend, what you have saved, what you need from the business, and what the practice can realistically provide.

Knowing these numbers makes it easier to recognize when personal financial pressure is influencing business decisions.

Keeping personal and business money separate is essential, even if they are connected.

The money-smart practice owner keeps personal and business finances separate and has a good grasp on both.

Do you agree with the correlation between personal and business finances?

Let us know, leave your comment below…

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

The post Personal vs. Practice Money: What’s The Connection? appeared first on Nurse Practitioners in Business.

Additionally, you must also know things that have little to do with clinical care, such as billing, marketing, staffing, compliance, basic technology, etc., none of which were part of your NP education.

But there’s another skill that, while underappreciated, deserves just as much attention…becoming smarter with your money as a business owner.

The goal is to understand your money better so you know what is happening, can ask better questions, and make more informed decisions.

So Why Does It Matter?

It matters because there is a big difference between operating a practice and building a financially successful business.

Some practice owners are in business to pay the bills…

The money-smart business owner considers how the business affects their personal finances and contributes to their long-term financial security.

And this is what we want to explore more closely in this series…

Money-Smart Doesn’t Mean Knowing Everything

Many people feel intimidated by financial topics…

Terms like cash flow, revenue, profit, taxes, contributions, depreciation, retirement accounts, and financial statements can be confusing and lead to avoidance behavior.

But it doesn’t have to be this way…

Because you don’t have to master the topics, only understand them enough to make informed financial decisions.

Developing money-smarts starts with asking basic questions like:

• How much money is coming into my practice?
• How much does it cost per month to operate it?
• How much money do I personally need each month?
• How much should stay in the business?
• Am I setting aside enough for taxes?
• Am I saving enough for my retirement?

Don’t have the answer to every question?

That’s ok…

Developing awareness and becoming money-smart starts with recognizing which questions to ask… the next step is knowing how to find the answers.

Your Two Financial Lives

Once you become a practice owner, you’re responsible not only for your personal finances, but also for your business finances.

While the two are related, they are distinctly separate.

Your personal finances include things like:

• household expenses
• rent or mortgage
• personal debt
• emergency savings
• insurance (car, health, life, etc.)
• retirement savings
• investments
• long-term financial goals
• and more

Your business financial life includes:

• practice revenue
• operating expenses
• payroll
• taxes
• debt
• owner compensation
• business reserves
• equipment purchases
• and more

From an accounting, operational, and legal standpoint, the best practice is to keep your two financial lives separate even though they are connected.

Ultimately, one reason for owning a successful business is for it to support you financially.

However, if you don’t know how much money you need in your personal life, it becomes much harder to determine how much revenue your practice needs to generate.

Revenue Is Not the Same as Personal Wealth

While it’s exciting to generate more revenue in your practice, it’s easy to forget that more money doesn’t mean it’s available for personal consumption.

Even if your practice collects $20,000, $40,000, or more in a month, that revenue may need to cover rent, payroll, insurance, supplies, billing costs, marketing, taxes, debt payments, and other expenses.

And even if money is left over after expenses are paid, it may be earmarked for other things.

A portion may need to stay in the practice as a financial cushion, to buy new equipment, pay next month’s tax bill, or go toward hiring expenses.

That’s why a practice can appear super successful even though the owner may still stress about money.

Give Your Money a Job

One of the simplest ways to become smarter with your money and deploy it with intention is to stop viewing it as one large pool.

Think of different dollars having different jobs.

Money that belongs to your practice must:

• keep the practice running
• pay owner and employees on time
• pay taxes
• build an emergency reserve
• repay debt
• keep enough in reserve for future expenses

Your personal money needs to:

• cover all household expenses
• pay down debt
• fund retirement
• build investments
• contribute to savings and an emergency fund

The goal is to become more deliberate about what your money is supposed to accomplish, but without a plan, it’s easy to spend whatever is available.

Personal Finances Influence Business Decisions

Even though personal and business finances are separate, personal finances often shape how a practice operates.

Let’s assume that your household expenses are high, and your savings are dwindling.

Consequently, you may have to take more money out of the practice than is reasonable.

Alternatively, you may feel pressure to grow too quickly, add services the practice can’t deliver consistently, hire too many employees, or increase patient volume before the practice is financially ready.

Compare that to the practice owner who has saved several months of personal expenses and has lower household obligations.

That owner probably has far more flexibility: they can leave money in the practice for longer, make slower hiring decisions, or wait for a marketing strategy to produce results before abandoning it.

While your personal financial situation alone doesn’t eliminate business risk, it does give you choices.

Is Your Practice Your Entire Financial Future?

This is not a trick question…

Almost all business owners invest and reinvest heavily in their businesses, especially during the startup and growth years.

And that makes sense.

But over time, you also need to build financial security outside your business, your practice.

That may mean building up:

• retirement accounts
• personal savings
• investment accounts
• real estate holdings
• other business opportunities
• and other financial assets

While your practice may become one of your most valuable assets, ideally it shouldn’t be your only one.

Building wealth outside the practice gives you greater financial flexibility and reduces dependence on the practice’s continued success, its future value, or its eventual sale.

And we’ll explore these ideas later in this series.

For now, though, the important principle to remember is this:

Your practice should contribute to your financial future, but not be your entire financial future.

Start With Awareness

To increase your level of awareness, start by asking yourself a few simple questions…

• Do I know my monthly household expenses?
• Do I know what my monthly practice expenses are?
• What are my emergency savings?
• What are the financial reserves of my practice?
• Am I consistently setting aside money for taxes?
• Am I saving for retirement?
• Am I building financial assets outside my practice?
• Do I have clear financial goals for myself and my practice?

Consider your answers as feedback on where your financial education needs to start…

Becoming a Stronger Business Owner

Running your practice as best as you can is important, no doubt.

However, owning a practice involves more than keeping the doors open, seeing patients, managing employees, and paying the bills.

It also means learning how to manage best the money your practice generates, including:

• understanding how to protect the practice
• compensating yourself appropriately
• preparing for unexpected expenses
• saving for your and your employees’ retirement
• building up your investments

None of these skills develop overnight; you acquire them one concept and one decision at a time.

And that’s the intention behind the “Get Money-Smart About Your Practice” article series.

My goal is to start with the basics and gradually explore personal finances, business finances, saving, investing, retirement planning, and employee financial benefits.

Because ultimately, it’s not simply about building a successful practice, but about building a practice that contributes to your long-term financial success and security.

Tell us what you think… leave your comment below!

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

The post Get Money-Smart About Your Practice appeared first on Nurse Practitioners in Business.

What is new, however, is the frequency with which it occurs. You may have experienced workplace violence firsthand as an NP business owner, or as an employee in a prior job.

Violence does not always come from an outside third party, but may also come from within the office, like from an aggressive patient or a disgruntled employee.

Workplace violence is not limited to physical attack, but includes threats, intimidation, harassment, verbal abuse, stalking, and other behavior that makes you or your employees feel threatened and unsafe.

While workplace violence in healthcare is more common in larger settings like hospitals, ERs, or social service agencies, smaller medical practices are no stranger to it.

How Serious Is the Problem?

The numbers are concerning… 

According to the U.S. Bureau of Labor Statistics, healthcare and social assistance experienced 57,610 workplace-violence cases during 2021 – 2022 that were serious enough to require days away from work, job restriction, or job transfer.

This number represents nearly 73% of all such workplace violence cases across private industry, whereby women experience workplace violence more than three times as often as men.

Violence in the workplace appears to be increasing; data show an increase of 30% between 2011 and 2021/2022.

A survey by National Nurses United (NNU) also shows an increase in workplace violence…

NNU surveyed 1,267 registered nurses and found that 84.8% had experienced at least one form of workplace violence during the previous year, and 36.4% said violence on their unit had increased.

According to the CDC, more than double the number of health workers reported harassment at work in 2022 than in 2018.

Implications for Smaller Practices

While a smaller practice may not face the same risks as an emergency department, psychiatric facility, or large hospital, it still has vulnerabilities.

• There may be only one or two employees at the front desk.
• Staff may work alone early in the morning or late in the afternoon or early evening.
• There may be only minimal physical separation between the receptionist and an angry patient.
• And unlike large organizations, small practices don’t have security officers they can call on…

Which makes prevention especially important…

OSHA has issued guidelines for preventing workplace violence…

The agency identified several factors that may increase healthcare workplace violence, including long waits, understaffing, working alone, unrestricted public access, poor facility design, inadequate training, and insufficient security.

While some things are difficult to change in a small practice, others are easier to implement.

Here are 7 Things to Help Reduce Violence in the Office.

1. Create a workplace violence policy.
   Make it clear that verbal threats, intimidation, harassment, and physical violence toward staff will not be tolerated. Outline what will happen if the policy is violated, such as termination from the practice, referral to law enforcement, etc. Include a copy of the policy with your intake package, and have patients sign it.
   
2. Walk through your office looking for vulnerabilities.
   As you walk through your clinic, ask yourself…How can staff deal with an aggressive patient in the exam room? Can someone easily get behind the front desk? Are exterior doors securely locked and well controlled? Are the parking area and entrances well lit? If you find a vulnerability, see whether you can adjust the workflow or usage for safety. Often, even small layout changes and adjustments can make a big difference.
   
3. Give staff a way to call for help.
   You might use a security camera in public areas, like a hallway or waiting area, to give staff early warning of danger. You could install a panic button at the front desk and in exam rooms, use a wireless alert system, use an internal messaging system, or rely on an established code word that alerts other employees to a problem. There needs to be a way to alert others to potential danger.
   
4. Train employees in de-escalation.
   You and your staff must know how to recognize escalating problem behavior. Make it a priority for everyone to understand how to maintain distance, avoid unnecessarily escalating an argument, and know when the priority changes from calming someone down to getting away and calling for help, like 911.
   
5. Pay attention to predictable triggers.
   Try to keep predictable triggers to a minimum whenever possible.
   Unexplained long wait times, payment and billing disputes, medication requests, and unhappy family members can all lead to conflict that can easily get out of hand.
   Have clear and easy-to-understand policies in place, and enforce them…
   While they will not eliminate every problem, they can keep unnecessary confrontations to a minimum.
   I’ve experienced firsthand how an unpaid bill and strong demands for medication refill can result in disagreements and quickly escalate into a threatening situation.
   
6. Document every incident, even if nobody is hurt.
   Even though everyone is busy, it’s important to document every incident…
   A threat overlooked today may become important when the patient shows the same behavior at the next visit.
   Make sure that all staff report incidents and review them together as a team.
   Determine what exactly happened. What were the warning signs?
   What could have been done differently? What should be done differently next time?
   
7. Have an emergency plan in place before you need one.
   If a situation escalates to an emergency, who will call 911?
   Where should staff and other patients go? What should employees do: evacuate or shelter in place?
   What happens if an aggressive patient refuses to leave?
   It’s best to have these conversations in advance. Decisions like these are much easier to make when everyone is calm and not under pressure.

Safety Considerations are Part of Your NP Practice

Even though OSHA does not have a specific federal workplace-violence standard, employers remain subject to OSHA’s General Duty Clause.

If you have any employees, you must provide a workplace free from recognized hazards likely to cause death or serious physical harm… who wouldn’t want to do this?

OSHA recommends that healthcare organizations establish workplace-violence prevention programs appropriate to the organization’s size and complexity. Depending on your state, you may have additional requirements.

As a practice owner, you spend considerable time thinking about HIPAA, cybersecurity, OSHA, malpractice risk, and protecting patient information.

Keeping yourself, your employees, and your patients safe deserves a place on that list, too.

Let’s hope you will never experience a serious violent incident; however, if you do, you and your staff will be prepared and know what to do.

Have you experienced violence in the workplace? What happeded and how did you handle it? What changes. if any, did you make in your clinic as a result? Please share your experience so we all can learn from it…

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

The post Protect Your NP Practice Against Workplace Violence appeared first on Nurse Practitioners in Business.

“How can I get patients into my clinic fast?”

We understand, because most practice owners have been there at one time…

You invested time, money, and energy into opening your doors… and now you need patients, and you need them fast!

And while there are many ways to market your practice, including a website, social media, paid advertising, email marketing, and more, none of those necessarily produces patients fast.

If you want to create momentum quickly, one of the best things you can do may seem old-fashioned, but it’s free, and surprisingly simple:

Get Out Of The Office And Get In Front Of People

For a new local healthcare practice, getting in front of people can often accomplish what online marketing cannot do nearly as quickly.

It lets people know who you are, what you do, and that you are available to see patients.

A common mistake new practice owners make is assuming that opening the doors will somehow bring in patients.

But it doesn’t work that way.

Don’t wait for people to discover you. Be proactive and let the people in your community know about you and your office.

You may have a beautiful office, an excellent website, a Google Business Profile, and years of clinical experience.

But none of that helps if people in your community don’t know you exist.

When you are new, your first marketing job is not necessarily to persuade someone to choose you.

It is simply to make people aware that you are there and open for business.

And that means introducing yourself to the community instead of waiting for the community to find you.

Start With Other Providers

One of the easiest places to begin is with other healthcare offices in your area.

Think about the physicians, specialists, therapists, pharmacists, chiropractors, urgent care centers, home health agencies, and other healthcare professionals who regularly encounter patients who may need services they cannot provide.

Some have long wait times, some may not accept certain insurance, and some don’t accept new patients at all.

Visit their offices and introduce yourself. Explain what your practice does, who you serve, and how patients can reach you.

You don’t need an elaborate presentation or a polished sales pitch. In fact, a simple conversation may be much more effective.

You can say something like:

“I recently opened a practice nearby. I want to introduce myself and let you know we’re accepting new patients. My office provides the following services  _______.

If you have patients you can’t accommodate, or who need the services we provide, we’d be happy to see them.”

Leave behind a business card, brochure, referral information, or simple one-page description of your services.

The goal is not to pressure anyone for referrals, but to make sure they know your office exists.

Get in Front of Your Local Emergency Department

Depending on your specialty, another place to introduce yourself may be the local hospital or emergency department.

Emergency departments often see patients who need follow-up. Others need a primary care provider. Some have difficulty finding someone who can see them promptly.

So, if your practice can meet those needs, let the ER or hospital know.

Find out who handles discharge planning, case management, social work, community referrals, or provider resource lists.

Again, introduce yourself and your practice and explain:

“We are accepting new patients, and if you have people who need appropriate outpatient follow-up and are having difficulty finding a provider, we would be happy to be considered as a resource.”

Again, you are not asking anyone to guarantee referrals. You are simply making them aware of another option.

You are making yourself known as an available option.

Talk to Local Organizations

While this option is not as fast as the ones above, you should consider it. Healthcare happens in communities, not just medical offices.

Think about where the people you want to serve already meet.

Depending on your practice, that might include:

• Senior centers
• Churches and faith communities
• Schools
• Daycare centers
• Gyms and fitness centers
• Community organizations
• Employers
• Retirement communities
• Chambers of commerce
• Support groups
• Local nonprofit organizations

Introduce yourself to the people running those organizations and get in front of their members. Offer to speak to them about a health topic that fits your expertise and is of interest to them.

Participate in community health events. Attend local business gatherings. Volunteer to participate in community programs.

This gives you broad exposure and lets you become a familiar healthcare professional in the community.

And familiarity matters when someone later needs care.

Consider participating in community events regularly; it’s a great way to get in front of people, provide useful information, and build your practice at the same time.

Tell People Who You Can Help

When introducing your practice, don’t just say:

“I just opened a new clinic.”

That doesn’t tell people anything.

Instead, help them understand who you are, what you do, and who they should think of when they hear your name.

Instead of giving bare-bones, useless information, you could say:

• “We’re accepting adults who need a new primary care provider.”
• “We work with women going through menopause who are looking for ongoing support.”
• “We’re happy to see patients who are having difficulty getting a timely appointment elsewhere.”
• “We provide psychiatric medication management for adults.”

The clearer you are about the patients you serve, the easier it becomes for someone to recognize and make a referral.

People can’t refer the right patients to you if they don’t understand what your practice actually does.

A Low-Tech Marketing Strategy

New practice owners sometimes believe marketing has to begin with complicated strategies. But that’s rarely the case.

Social media, search rankings, funnels, advertising campaigns, and content marketing all have a place in building a practice.

But when your schedule is empty, and you need patients now, your fastest marketing strategy involves nothing more sophisticated than comfortable shoes, a stack of business cards, and some friendly conversations.

Here’s What To Do Next…

• Use AI to make a list of 20 or 30 organizations and healthcare offices in your community.
• Then start introducing yourself.
• Do a few every week.
• Follow up periodically.

Build relationships instead of making a single visit and disappearing.

Over time, people will begin to recognize your name and understand what you do.

And when someone says, “Do you know anyone I could see for this…?” your practice has a much better chance of being remembered.

And Finally, Don’t Confuse Fast With Instant

There is one important caveat.

Getting in front of people may be one of the fastest ways to build awareness for your new practice, but that doesn’t mean patients will immediately start filling your schedule.

Relationships, referrals, and trust take time… especially in the beginning.

Don’t hide behind your computer waiting for your marketing to work; go where your people are!

So when someone asks, “How do I get patients fast?”, our answer stays the same…

Get out there, introduce yourself, and talk to people.

Scroll down a bit and tell us what you think – leave a comment…

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

The post Need Patients Fast? Get in Front of People! appeared first on Nurse Practitioners in Business.

While this shift is immediate, your mindset takes longer to catch up.

Frequently, NPs who become owners think of it as clinical practice with greater independence.

Now they can:

• make their own decisions
• choose how they care for patients
• and create an environment in line with their values

Clinical aspects are important, but they’re only part of the picture.

Opening a practice comes with additional responsibilities, including the financial, operational, and strategic health of the business.

While you become the legal owner in a single day, with the stroke of a pen, learning to think and act like one is a gradual transition.

Clinical Autonomy Is Not the Same as Practice Ownership

Wanting greater clinical autonomy is why many NPs consider starting a practice.

They want more control over patient care, scheduling, services, and the overall patient experience.

But clinical autonomy and practice ownership are not the same.

• Clinical autonomy gives you greater control over how you practice.
• Practice ownership gives you the responsibility for creating and maintaining the business in which that care occurs.

As a practice owner, you must think about pricing, expenses, cash flow, marketing, patient acquisition, policies, technology, vendors, compliance, staffing, and long-term planning.

You must decide which services to offer, how to deliver them, what they cost, and whether the practice can provide them sustainably.

While you may be comfortable making independent clinical decisions, you may feel unsure about making business decisions.

That’s normal, and to be expected.

And it doesn’t reflect badly on you, nor does it indicate a lack of ability. All it reflects is a lack of training and experience in an area that’s new to you.

Clinical experience prepares you to care for patients, but it doesn’t automatically prepare you to run a business.

Why the Transition Feels Uncomfortable

As an NP, you’ve spent years developing your clinical knowledge and skills.

However, moving into new territory, like practice ownership, can make you feel like a beginner again.

Initially, your new responsibilities will feel unfamiliar and uncomfortable.

Negotiating contracts, evaluating vendors, understanding financial statements, setting fees, marketing your practice, enforcing policies, and making impactful decisions… takes adjustment and a shift in mindset.

While the discomfort can cause some NPs to question whether they’re cut out for owning a practice, it usually just means they are learning new skills and getting used to their new role.

Just as you had to develop your clinical skills through learning and experience, you will, in due time, develop your business skills in much the same way.

You Must See the Whole Picture

As a clinician, you’re trained to focus on the patient in front of you.

As a practice owner, however, you must continue to focus on the patient while also considering how each decision affects the practice as a whole.

Here’s what I mean…

• Waiving a fee may help one patient, but repeatedly making exceptions will weaken the practice’s payment policies and hurt the bottom line.
• Offering extended availability may be convenient for patients, but it may leave you exhausted and frustrated over time.
• Adding a new service may sound promising, but more activity doesn’t necessarily produce more income for the practice.

As the owner, you must consider patients, finances, operations, compliance, staff, and personal capacity… all at the same time.

Owning a practice as a clinician requires a broader perspective and makes for responsible ownership.

Because if the practice struggles financially, becomes difficult to operate, or depends entirely on the owner’s personal sacrifice, it will be unable to serve anyone in the long run.

But when you protect your practice, you also protect the services it provides to the community.

Still Acting Like an Employee?

Starting your own practice will not erase habits shaped by years of employment.

As an employee, you worked with systems created by someone else.

Someone else determined pricing, established policies, negotiated contracts, maintained technology, dealt with finances, and planned for the organization’s future.

But once you become the owner, those responsibilities do not disappear. They transfer…  and become yours.

Sometimes, new practice owners continue to focus almost exclusively on clinical work. It’s where they feel at home; it’s where they feel most competent.

And all too often…

• Administrative tasks are treated as inconvenient interruptions.
• Financial reports are avoided.
• Marketing is postponed.
• Policies, if they exist,  are handled inconsistently.
• Planning is pushed aside by whatever feels most urgent at the moment.

But the practice cannot manage itself while the owner concentrates only on patient care.

If the practice owner is unwilling to pay attention to cash flow, pricing, marketing, workflow, or expenses, someone else has to step into that role.

You don’t have to do everything yourself, but you must ensure that the important work gets done.

Accepting Two Professional Roles

Becoming a practice owner does not require you to abandon your identity as a clinician; it means expanding it.

You now have two legitimate, distinct, and necessary roles.

• As the clinician, you protect the quality and integrity of patient care.
• As the business owner, you protect the viability and direction of the practice.

Sometimes, these roles may seem to be in direct conflict…

For example…

• You may feel uncomfortable discussing money with patients
• Enforcing cancellation or financial policies
• “Firing” a patient from your practice
• Limiting after-hours access
• Discontinuing a service patients appreciate but the practice cannot afford to provide

However, being mindful of revenue, expenses, policies, efficiency, and profitability does not diminish your commitment to patients.

Your practice must stay financially and operationally healthy to stay in business and provide care to the community.

Your clinical mission and business objectives don’t have to be opposing forces.

Remember, it’s the business that makes the mission possible!

Growing Into the Owner Role

The transition to your new role begins when you accept that business knowledge is necessary and must be learned, just as clinical knowledge was.

It begins…

• When you start setting aside time to work on the practice, not only in it.
• When you start reviewing financial and operational information regularly.
• When you create workflows and systems rather than handling everything as a unique event.
• When you take a proactive stance to deal with problems instead of ignoring them.

Don’t shy away from getting professional help when specialized expertise is needed, while recognizing that the final responsibility for the practice remains with you.

At times you will have to make decisions without having all the answers.  Some decisions will work; others will need to be revised.

A poor result does not automatically mean you are a poor decision-maker; oftentimes, you’ll gain insights that help you make the next decision.

Over time, you’ll notice that now you’re anticipating problems instead of reacting to them.

You’ll start asking how a decision will affect the entire practice and become more comfortable reviewing the numbers, enforcing policies, changing ineffective systems, and seeking help before a problem becomes a crisis.

These are signs that you’re developing as a practice and business owner.

In Summary…

Practice Owner… is a role you grow into.

Starting a practice gives you the title of practice owner, but becoming confident in your new role takes time.

There’s no need to stop thinking like a clinician. After all, your clinical expertise and experience are essential to your business.

What is required is expanding your perspective and developing the skills required to operate a business.

Your practice and patients need an outstanding clinician, while your business needs an engaged and capable business owner.

When you learn to care for your business with the same intention you bring to your patients, your business becomes better and stronger.

We want to hear from you; tell us what you think, leave your comment below…

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

The post Starting Your NP Practice Changes More Than… appeared first on Nurse Practitioners in Business.