Can A Nurse Practitioner Have Their Own Practice?

Can you open your own practice as a nurse practitioner? Should you? Whether you're preparing to take your first steps in the nursing profession or you're already qualified as an NP, you may be wondering what your options and limitations are and whether or not you can one day open your own practice.

The answer will ultimately depend on where you live, but there are a few other considerations, as well.

Can A Nurse Practitioner Have Their Own Practice?

Whether a nurse practitioner (NP) can practice autonomously or not will depend on their location. Some states allow NPs to operate with reduced/restricted autonomy while others provide full practice authority (FPA), giving them the right to practice independently and without physician oversight.

Full Practice Authority

With full practice authority, NPs are granted complete autonomy and can provide a range of diagnostic and treatment services.

NPs can evaluate patients, arrange diagnostic tests, create treatment plans, and prescribe medications.

Reduced Practice Autonomy

NPs with reduced practice autonomy cannot provide all levels of patient care independently and must work under physician supervision.

Restricted Practice Autonomy

NPs can't open their own practices as they are very limited with regard to the work they can perform. They must practice under the direction of a physician or other medical supervisor.

In What States Can A Nurse Practitioner Have Their Own Practice?

The laws concerning nurse practitioner (NP) autonomy are constantly evolving, so be sure to check with your state nursing board before making your decision.

As things stand, you can practice independently in the following states:

• Alaska : All NPs have FPA in Alaska. As a result, they can open their own practice and perform duties such as analyzing tests, diagnosing patients, and more. They may also apply for the right to prescribe controlled substances.
• Arizona : Nurses licensed via the Arizona Board of Nursing can apply via the Controlled Substance Prescription Monitoring Program (CSPMP) to prescribe controlled substances. They must also register with the Drug Enforcement Agency (DEA).
• Colorado : FPA is granted following over 1,000 hours of practice and physician oversight.
• Connecticut : Physician oversight is required for at least 3 years before FPA is granted.
• Delaware : FPA has been available to NPs in Delaware since 2021.
• District of Columbia: FPA is available to nurses with a graduate degree, RN license, and NP certification.
• Hawaii : Although there are very few NPs in Hawaii, they do have FPA.
• Idaho : FPA is granted to NPs who complete at least 30 hours of continuing education.
• Iowa : NPs have full practice authority in the Hawkeye State.
• Maine : Maine grants NPs full practice authority, allowing them to diagnose, test, and prescribe medications.
• Maryland : Once they have registered with the Prescription Drug Monitoring Program (PDMP), NPs are able to prescribe medications and practice independently in Maryland.
• Massachusetts : NPs with at least 2 years of relevant and supervised experience can practice independently.
• Minnesota : NPs are able to practice without a supervising physician and can prescribe controlled substances.
• Montana : FPA is granted after the NP completes courses in disease management and pharmacology.
• Nebraska : NPs must first complete 30 hours of pharmacology before they are given full practice authority.
• Nevada : Controlled substances can only be prescribed after the NP registers with the DEA, but other than that, they can open their own independent practices.
• New Hampshire : NPs are able to open private practices and prescribe controlled substances.
• North Dakota : FPA is offered following the completion of a pharmacology course and registering with the Prescription Drug Monitoring Program.
• Oregon : Full prescriptive authority is available in the Beaver State.
• Rhode Island: Full prescriptive authority is granted after the completion of a Uniform Controlled Substances Act Registration.
• South Dakota : FPA was granted here back in 2017.
• Vermont : Full prescriptive authority is only granted following at least 1,600 hours working under physician oversight.
• Washington : NPs in Washington state have the right to diagnose and treat patients independently. They can also prescribe medications.
• Wyoming : NPs don't need to work with a collaborating physician and can benefit from some of the most lenient laws in the US.

Why is Full Practice Authority Important for Nurse Practitioners?

Many qualified doctors are turning their backs on primary care and focusing on more lucrative specialties. In combination with the current nursing shortages and the issues created by the pandemic, this has left a huge gap in the healthcare sector and it's one that can be filled by nurse practitioners.

Allowing NPs to act as primary care providers benefits both the patient and the healthcare provider.

Steps To Opening Your Own Practice

If you reside in a state that grants nurse practitioners full practice authority, you may want to consider opening your own practice. It's not an easy, quick, or cheap process, but it can be a very lucrative and rewarding one.

Take a look at the steps below for more information.

Step One: Consider Where You Should Open Your Own Practice

Opening your own practice takes a lot of time and dedication. You need to be passionate about the work that you do and committed to making it work, as it's not going to be an easy ride.

Creating your own private practice is not just about being your own boss and making your own rules. It's a business like any other, and that means you'll be working long hours and dealing with everything from hiring and firing to advertising, bookkeeping, and networking.

You'll need to think about locations, staff, business insurance, marketing costs, and a host of other things that simply aren't relevant when you're working for someone else.

Success won't happen quickly, either. It's something that you need to work at and something that could take years to prosper. If you're not prepared to stay for the ride and you're just looking for an easy life, creating your own nursing practice is probably not the right call.

Step Two: Create a Business Plan

Every business idea needs a business plan, and a private practice is no different. If you live in a state that requires you to work under a supervising physician, make sure you have them on board at this stage. You should also work with an attorney who can help you deal with all the red tape surrounding tax and practice guidelines.

Consider the location, the requirements, and the potential issues. All of these things need to be considered and planned well in advance to make your life easier further down the line.

Step Three: Find Your Location

Where will your business be located?

Are you going to operate out of your home or do you need to rent a location? If it's the latter, consider the cost and convenience. If it's the former, think about how realistic it is to operate a business around your family and personal life.

Consider waiting areas, equipment, and cleanliness. It also needs to be warm and comfortable to ensure that patients are relaxed and at ease.

Step Four: Hire Staff

You don't need to hire a huge team right off the bat. Most medical practices start small and then hire additional staff as needed. You may determine that you can survive without any staff in the early stages, but as you grow your business, you'll need to grow your team as well.

Step Five: Attract Patients

Advertising is a key factor in any business and patient care is no exception.

Create a website and establish a social media presence. If you're not a great writer or communicator, hire someone else to manage these profiles for you.

Look into Facebook Ads and Google Ads, as well as banner ads, targeted ads, and offline advertisements.

Conclusion

It's important to remember that while you're taking a larger cut as the business owner, you also have many different expenses to consider, including legal bills, equipment, staff, rent, utilities, advertising, and more. Your earnings are not as stable, either.