5 Essential Tips for Nurse Practitioners Opening Their Own Practice

With the demand for health care and qualified nurse practitioners rising, many with an NP license can be wondering if opening their own practice or clinic is right for them.  To help you get a better idea of how to do it right, we have collected a list of five tips to help when starting out on your own.

1. Know the law Each state is different and so too are the requirements for nurse practitioners that want to open their own practice.  For example, some states require that an NP work along side a licensed physician, open a limited liability company, or other.  Be sure and check with your state board first before venturing out on your own to ensure that it is even legal for you to open your own practice.

2. License up Even if your state allows nurse practitioners to have their own practice, it is still vital to have all your licensing documents in order. There can also be certifications, codes, and other standards that the state will want you to have.  Know what they are before you open to ensure that it is worth the effort to you.  The county and city you practice in may also have their own standards for nurse practitioners.

3. Go special  If you do live in a state that allows nurse practitioners to have their own practice, consider a specialty.  Even if it is pediatrics, sports medicine, or whatever your NP training is in, letting the public know that you specialize in this type of care can help your practice stand out.

4. Insurance  Most patients will pay for health services with some kind of insurance from Medicaid to private PPO’s.  Before you open your practice, it is essential to know which plans you will accept, what they pay for, what the rate of compensation is, and all pertinent details before opening.  Again, the state, city, or county may require you to accept insurance plans of their choosing.

5. Malpractice  Insurance isn’t just for patients.  All health care practitioners need some form of malpractice insurance to cover them in case the worst happens.  Knowing what the rates are, what they cover, and how it works is also an essential step to opening your own practice.

Bonus!  There’s more to opening your own NP practice than in the above.  If you are still curious about pursuing the path to owning your own practice or even just to get some leadership tips, there are many useful resources out there.  One of the best is Nurse Practitioner Business Owner which helps nurse practitioners who want to take the next step in their career.

Ally Wagner is studying to become a nurse and also contributes to Nurse Practitioner Programs which helps those studying to become nurse practitioners.

Paula Deen–This Lady Has Your Back

I love Paula Deen. Poor thing has been through the ringer this week, especially in the comments section on places like CNN. She “came out” and told everybody she has Type 2 Diabetes and people used this as an opportunity to rail at her about her liberal use of butter and smiles.

I love that she uses butter.

I love that she smiles.

If she were French we would ask her which red wine complemented our favorite casserole.

I love that she has worked hard and has made a living for herself—when years ago she was home bound due to a phobia that kept her from leaving the house.

I like it when people are resourceful, overcome obstacles and are successful. She could have died a poor single mom with no money for a tombstone. If she had, people could have yelled at her about that too.

Get a grip.

If you don’t want cocaine don’t do it. If you don’t want red hair—don’t go to the hairdresser and pay for it to be dyed red. If you don’t want to eat butter don’t eat it.

Never mind that Type 2 Diabetes for some is more complicated than an over indulgence of butter.

The part of public health that has always amazed me is that in many ways it gains its legitimacy on the premise that people are stupid and must be told exactly what to do and how to do it. And that no one else should be allowed to present a differing message than the prevailing public health message of the time. It’s just too distracting from their good messages.

  • We have praised the disruption in health care that brings power to the patients, consumers and advocates.
  • We want electronic medical records.
  • We want to be able to see our health records without permission.
  • We want accurate nutrition labels so that we can make adult decisions about what to buy and eat.
  • We want patient centered medical homes so that the care is about us medical system.
  • We don’t want closed managed care systems because we want the liberty to choose our providers and make educated decisions about how and where to seek care on our own.

But as I listened to the shrieking about Paula—I realized that people want those things AND to be told what to do.

Let me tell you a story.

I had the good fortune to be a nursing student and then go on to work at the same urban-ish hospital for 5 years. In that time I got to know certain “frequent flyer” patients and their families very well. One of the more infamous patients, I’ll call her Willie Rae, was admitted to the hospital because after she ate two sheet cakes-went into a little diabetic coma—on top of her heating pad (because she had hurt her back earlier) and got a 3rd degree burn. As I’m getting her settled in on the floor and asking her all the admission questions…I have to ask “Why did you eat TWO sheet cakes?”

“Girl, cause they were on sale at Kroger!” says Willie Rae.

They had been on sale. When I saw the sale sign earlier in the week I had wondered who needed to buy two sheet cakes at one time. It may have been graduation season. I don’t remember. We were in Ohio. This picture was taken just a few weeks ago in Ohio. We love to eat sweets and get a good bargain.

Anyway, Willie Rae and I had a good talk. At the end of the conversation I tried to work on behavior modification. To make a long story short—we started negotiating about future eating habits and it ends in Willie Rae agreeing to eat ONE sheet cake at a time instead of TWO.

This was a success. Truly.

Change is hard.

Change takes time and I think we set people up to fail if we don’t give people the tools or remind them of the skills they already have to be successful change agents in their own lives.

When we get all judgmental or create expectations that are so out of line with where people truly are everybody loses.

I’d much rather people cook using Paula Deen’s recipes than go to KFC every day. That means they are going to the grocery store and cooking. Halleluiah!

Her diagnosis is a mixed blessing.

She is planning on making versions of her favorite recipes with a light touch. Paula has the ears and trust of people that most public health interventions just don’t reach.

They might even trust her to use one stick of butter instead of two.

3 Must Use Resources For Starting A Health Based Social Enterprise

Breaking News: School Doesn’t Teach You Everything

Problem: You just spent $$$ on your degree and you still don’t know how to do what you went to school for.

Solution: Build Your Own MPH/MPP/MWD/MBA (Master of Public Health, Master of Public Policy, Master of World Domination and Master of Business Administration)

This is easy for me to say because I have some of those degrees anyway. But honestly—when I finished my programs, there were still skills that I needed in order to get to where I wanted to go in life that just didn’t fit into the school experience.

If you are still wondering:

  • How do I get my nonprofit/social enterprise to become sustainable?
  • What are the legal frameworks for setting up a social enterprise?
  • How do I build traction behind my great social enterprise/nonprofit idea?

Here are 3 resources to get the practical skills you need whether working in the US or abroad:

NESsT

NESsT develops sustainable social enterprises that solve critical social problems in emerging market countries.

They have created what looks to be about 157 FREE PUBLICATIONS for the studious Smurfs among you to take advantage of on Issu (a digital publishing platform).

These are serious (but short) documents that range from a legal series geared specifically for social enterprises -to- tested methods that can help you distribute your products to reach your intended market.

Risky Business: The Impacts of Merging Markets and Mission uses analyses of 45 social enterprise cases from 15 countries to examine impact in terms of financial performance, mission/values, organizational culture, relations with stakeholders, etc.

http://www.nesst.org/publications/

Unite For Sight

Unite For Sight is a nonprofit organization committed to excellence in global health. These people throw a real conference. No time to sit and do nothing. Unite For Sight’s Global Health conference is truly jam packed with SO MANY GOOD options that you’ll wish you could split yourself into pieces to attend all the sessions. Go to the conference this April. Register by December 31st for the cheapest rate http://www.uniteforsight.org/conference/

Now that you’re registered for the time of your life, go bone up on your missing skills at the online Global Health University. Enrollment in the Certificate in Global Health is available to any student or professional who is interested in global health. Global Health University helps to effect widespread innovative change in global health through comprehensive training workshops, Global Health Certificate Programs, fellowship and internship opportunities in the U.S. and abroad, social enterprise consulting, and online courses.The total cost to enroll in the Global Health Certificate Program is $65.

Cheaper than grad school—right?

http://www.uniteforsight.org/global-health-university/

Partners In Health (PIH)

These are the leaders in providing preferential health options for the poor across the globe. If you don’t know them check them out.

The best made a Program Management Guide so you HAVE to read it. I just downloaded it last night in a zip file and it rocks!

This 14-unit program offers a structured approach to starting a program, revamping an existing one, or expanding a site based on PIH’s experiences in the field. Program managers can use this guide to anticipate and find creative solutions to common challenges that PIH and other similar organizations have confronted in resource-poor settings.

Table of Contents:
Unit 1 Learning about the local context
Unit 2 Understanding legal matters
Unit 3 Building site infrastructure
Unit 4 Managing a procurement system
Unit 5 Strengthening human resources
Unit 6 Improving programs through training
Unit 7 Improving outcomes with community health workers
Unit 8 Establishing a financial system
Unit 9 Creating a development strategy
Unit 10 Working with partners
Unit 11 Addressing the social determinants of health through a program on social and economic rights (POSER)
Unit 12 Using monitoring and evaluation for action
Unit 13 Conducting research
Unit 14 Maximizing impact through advocacy

Are you still whining about how you don’t’ know where to go for help to get your project off the ground?

World AIDS Day-5 Things You Can Do In the U.S.

Today is World AIDS Day and there are many very eloquent statements about the history and trajectory of this disease.

As innovators in health I challenge you to up your game–particularly in the US.

You can watch my Call to Action with Housing Works here

joy-twesigye

In the United States, public and private sector investments in research, advocacy and education have yielded noticeable progress in HIV/AIDS prevention and treatment since the 1980s. Yet even with this progress, in 2008 the Centers for Disease Control and Prevention (CDC) published the latest estimate of new HIV infections in the United States for 2006– which were roughly 40 percent higher than previously estimated, indicating that the HIV epidemic is worse than previously known.  Furthermore, HIV/AIDS remains a serious problem in the US—particularly among racial, ethnic and sexual minority communities (Centers for Disease Control and Prevention, 2009). Continue reading

Health and Education Innovation Meet to Improve Dementia Treatment

Primary care often gets all the buzz when it comes to innovative services but Dr. Peter Whitehouse shows them up by providing dementia treatment in his K-8 charter school, The Intergenerational School. Provide research data that supports intergenerational learning to improve mild to moderate dementia-check. Next up–he’s starting a school based health center.

Don’t miss out on the deep dive where we cover:

Continue reading

How Do You Get Your Start in Global Health?

People get into global health a variety of ways. I especially admire Dr. Paul Nanda’s entry into global health because he discovered his passion in the middle of his family medicine residency. For those of you who don’t know too much about medical training—it is not very flexible. This is a story of someone who made a decision, became the first family practice resident at The Ohio State University to do an international rotation and then went on to found and head the Global Health Education Department for Family Medicine at the same institution.

Watch the interviews on my Vimeo Channel: http://vimeo.com/channels/pitchforksoptional

In TWO jam packed interviews we cover:

Continue reading

How can you make food policy accessible? A: Start with a casserole!

A HUGE thank you goes out to everyone who came to the first Charm City Casserole Cook-Off! Not only were the entries stupendous–but we had wonderful judges (Monyka Berrocosa, Linda Rittleman, Ms.Dorothy Peace and Ms. Juanita Garrison) and photography provided by Sulakshana Bhattacharya. Becky Kuk gave everyone the scoop on Whitelock Community Farm and some of the participants got to walk down the street to see the Farm first hand.

Check out the pics here.

Down load the winning recipes!

Sweet Potato Casserole-Judges Pick

Holy Mole Pie-Crowd Favorite and Kid’s Choice Winner

We’ll let you know when you need to get your ovens revving for the Charm City Casserole Cook-Off so stay tuned!

Skpe Series with Pitchfork Holders

I am embarking on an exciting project which I am pretty sure you will love. Over the next few months you will be getting a chance to see what it takes to change the universe. I’m interviewing passionate change makers in health*.

These people are going to blow you away with their honesty and detailed notes on how they got to where they are today. In order to make it feasible to get all the juicy details, the interviews will be posted into two jam packed sessions. The first interview will cut to the chase– they will tell you the problem they are intending to fix, how they chose their method as the way to do it and give advice to you on how to charge into their field. The second interview is a deep dive where they will tell you what it really takes to be a game changer, how to define success and weather you’re cut out for being the lead change agent or if you should make the leaders casseroles (everyone needs to eat so there is no disgrace intended here).

These are interviews from people in global health, equine therapy, primary care, food security and everything else in between!

Stay tuned…eyes peeled….lovely things will enter your in-box next week.

* If you’re like–hey why haven’t you interviewed me? Then drop me a line info@turningpointpolicy.com and let’s see if we can make Skype magic!

Applied Food Policy-Snobs Need Not Apply

What we know:

There are food deserts in Baltimore.
People in Baltimore are not healthy.
There is a wide range of economic backgrounds in Baltimore.
People like to eat.
Change is hard.

The Solution:

Charm City Casserole Cook-Off: Eat This, Baltimore!

The solution uses highly applied public health and urban food policy approaches in order to promote community building and city revitalization. Casseroles became the frontrunner as the catalyst for change after using a wide social, structural and cultural lens to assess the opportunities that could be seized to create a turning point in people’s lives.

Casseroles are a familiar food and easy to make. They can be made with easily sourced ingredients and can be made at a variety of health and price points. Many of the current food/urban agricultural projects that are occurring across the city are focusing on food accessibility and nutrition consciousness-raising. A logical next step is to get people cooking.

Casseroles, in this paradigm, are intended to be used in a similar way as mushroom soup is used in their recipes—as glue that holds unsuspecting ingredients together. Casseroles are inherently meant to be shared and thereby are great vehicles to promote community building. Driving deeper connections in the community raises trust and can help rebuild our informal networks, which are an important influencer of health status. Casserole contests can be part of Baltimore’s economic engine. The contest can be used as an opportunity to showcase the diverse food offerings Baltimore has to offer as well as raise funds for a worthy cause like Whitelock Community Farm. For reference, the Texas State Fair made $3.6 million dollars in ONE day…the day of the fried food competition. Why wait?

There’s a $50 1st place cash prize for each category! Compete/Eat!