Name: Suellen Drake, NP
Name of Practice: Advanced Nurse Practitioner Services, LLC
Location: Northwood, N.H.
Patient Population: I see patients from age 4 to 90-plus.
Practice Niche: I am a family practice nurse practitioner and have a post-master's from a psychiatric nurse practitioner program. Many of my patients have mental health issues. I also have a subspecialty in menopause and also have a strong interest in endocrinology.
Startup Costs: I started by providing house calls with very little startup - about $5,000 (mostly for phone systems, marketing, licenses and some equipment). When I opened a primary care office, I took out a $35,000 business loan along with a $10,000 home equity loan. I keep $10,000 in the account for operating expenses and to provide an adequate safety net when the office is slow.
Year of Launch: 2002
Financing Sources: Citizens Bank was very helpful and supportive. I had gone to other institutions, but they offered me much less.
Marketing Activities: I went to primary care offices and offered house calls to their homebound older adults. I also went to schools and offered to do sports physicals. I took brochures to local businesses and put posters everywhere.
Current Staff: me, an office manager who works 3 days a week, and a medical assistant intern from a local college
Average Number of Patients a Week: more than 40, which is great since I can cover expenses with just 20 a week. I offer longer visits to patients, which limits the amount that I can see each day (about 10 to 12). I also make five to eight house calls 1 day a week.
Billing: I accept most of the insurance plans offered in the area: Anthem, Blue Cross, CIGNA, Harvard Pilgrim, Aetna, Medicare, Medicaid, HCVM and others. If I am not included on a patient's plan, the patient pays for the visit on the day of service and receives a discount of 30% to 40%.
Software and Other Office Tools: I have a completely paper-based office. I worked in family practice for more than 10 years as a medical assistant and feel comfortable with a paper system. I have developed forms with a check-off list, and I carry my appointment book with me at all times. I find that using paper forms allows for more face-to-face time with patients.
Current Financial Health of Practice: Great! After 2 lean years, I feel like my efforts are paying off. My paycheck is starting to look more like the average for the profession. I believe I will far exceed the current average salary for the area.
Future Plans: I will continue to build the practice. A massage therapist and registered dietitian provide services at the practice as needed, and I hope to contract with a counselor soon.
What I Wish I Had Known Before Starting Out: I wish I would have known how long it would take to be profitable - although maybe ignorance is bliss!