Malpractice Insurance, Telehealth, and the Nurse-Entrepreneur

Malpractice Insurance, Telehealth, and the Nurse-Entrepreneur

All nurses should invest in malpractice insurance, but for nurse entrepreneurs who want to operate their own practice, malpractice coverage is essential. If you are planning to venture out on your own and create a healthcare business, you need to protect yourself from potential claims by selecting the right insurance carrier based on the type of practice model you intend to deliver.

Finding insurance companies that recognize standard brick-and-mortar practice options is not hard, but if you want to incorporate the growing field of telehealth into your practice, you should take a close look at the options offered by different malpractice insurance carriers. While each company adopts the same state guidelines (e.g. nurses located in MA cannot provide telehealth services to a patient in FL unless first seeing them for an in-person visit) coverage can vary on the ratio of allowable in-person to telehealth visits. If you already have a malpractice carrier and are thinking about including telehealth within your practice, be sure to assess your plans in this area, consult with your current carrier, and shop around, as coverage varies considerably.

If you’re not yet insured and are just starting to make your business plan, here’s what you can expect regarding coverage: if you are a self-employed individual registered nurse who a) doesn’t work in a correctional facility, b) doesn’t provide cosmetic or medical aesthetics procedures, and c) has not been subject to a medical malpractice claim or disciplinary board action within the last 5 years, your coverage should come to around $250 per year. Such a policy should cover $1 million per incident and $3 million in aggregate. If you are providing a walk-in clinic-type experience where you are seeing most patients in-person, providing services like physicals, blood pressure monitoring, wellness checks, wound care, suture removal, etc. this type of standard coverage ought to fit your needs. However, if you are interested in expanding into telemedicine, keep in mind that many carriers place a limitation on in-person to telehealth visits of 75:25, where three-quarters of your patient visits need to be in-person.

If you intend to provide telehealth services that might include consultations, outpatient visits, nutrition therapy, smoking cessation services, alcohol misuse screening, depression screening, advanced care programs, and annual wellness visits, your malpractice insurance is going to be higher than it would be for an all bricks-and-mortar practice or a practice with limited telehealth options. For a telehealth-focused practice, you can expect your insurance to cost approximately $400 per year. This insurance ought to cover $1 million per incident and $6 million in aggregate coverage. Thus, for that additional $150 per year, your insurer should provide for $3 million of additional aggregate liability, and impose no limitations regarding the ratio of in-person to telehealth visits that are required for an individual policy.

If you are just starting to plot out the parameters of your business, now is the time to decide whether telehealth is a good fit for yourself and your prospective patients. With no end in sight to the nursing shortage and our aging population, telemedicine is no longer just for rural districts; it’s an expanding field no matter where you work and live. For many, the flexibility it offers is highly attractive as telemedicine allows you to work from home and other sites outside a conventional brick-and-mortar office. If you expect to work with patients remotely, estimate what proportion of your practice you want to devote to telehealth, what your expected ratio of in-person-to-virtual visits will be, and start making inquiries among malpractice insurers.

Rob Goodall, MBA is managing director of AlyxHealth. A 20-year financial services industry veteran, Rob is the head of sales and principal financial modeling strategist at AlyxHealth. He provides guidance on fiscal analyses, strategic partnerships, product design, development, and launch. Within this role, he also provides a cost savings analysis to expand profitability and revenue growth for clients and the firm.

More information on AlyxHealth can be found on their website, www.alyxhealth.com. Click here to join the AlyxHealth Community.

How I Became a Nurse Entrepreneur

How I Became a Nurse Entrepreneur

I have always had an interest in owning my own business but what could I do independently as a nurse? Without having a clue as to where to start, I conducted a general search, and found a book about starting a nursing agency. Thinking to myself, “I could do that!” I bought the book, but when I started reading, I realized the information was very generic. There were no specific “how-to” details; instead, it provided a very basic outline.

After finishing the book, I realized there was no blueprint for me to follow to start my own business. I would have to start down the path of becoming a nurse entrepreneur completely in the dark and form my agency on my own.

My Journey to Becoming a Nurse Entrepreneur

I first determined what expenses I would incur, made a budget, and then a business plan. At first, I felt lost in this process as my professional experience was strictly in the nursing world where I would care for patients without involvement on the business side of healthcare. I tried to seek help from friends who had gone through this process in different industries, but it became abundantly clear that my situation was unique. They were able to offer little support because starting an independent nurse-led business was a relatively novel concept. Undeterred, I persisted and found my way. I decided upon a name for my agency and determined the type of legal entity my company would be, went to the state office and registered my new business!

At this point I knew it was time to begin marketing activities. I had brochures and business cards made and mailed to prospective facilities. I asked my nursing colleagues to refer their friends who wanted to have per diem opportunities. I continued the process by building a website, figured out payroll processing, and just kept trying to move forward.

The whole experience of starting a business took me approximately one year, dedicating a lot of research, time and expenses. There were some bumps along the way, but resiliency was key to my progress. Shaping my company is still an ongoing process, with lessons learned almost daily, but after eight years of continued success I feel that every year gets better and better and the lessons learned are teaching opportunities to improve!

I want to share my story to help other nurses realize they too can become nurse entrepreneurs. Nurses should feel empowered to conquer their fears and begin down the path to becoming independent business owners. Navigating the process was not easy for me because I had no business experience and no idea where to start. Providing nurses with the tools they need and guiding them through the process of building and running a business, is a huge gap in the industry today. I was thrilled when I was introduced to the team and concepts being developed at AlyxHealth. Dedicated to helping nurses thrive, AlyxHealth would have provided me with the tools I did not have at my disposal back when I started my own nurse-led business.

Why would a nurse want to start a business? 

Nurses today work harder than ever, many times in understaffed and unsafe situations to care for their patients. With more new nurses leaving the profession than ever due to these situations, this has to stop! I want to be sure that all patients are taken care of by a nurse—now, and in the future—and if the number of job vacancies keeps rising, we will have no one left to care for our sick and injured!

When talking with prospective nurse entrepreneurs who have expressed interest in starting their own businesses, I hear the same common concerns including: 

  • lack of confidence in themselves; nurses are great at caring for people but are often intimidated by the financial aspect of healthcare.
  • lack of support (financial and emotional) and not knowing who to ask for help.
  • lack of expertise and fear of the unknown.

What kind of a business can a Registered Nurse run independently?

  1. Patient coaching (for example, a Critical Care Nurse can teach heart health techniques for patients that are post-heart attack)
  2. Diabetic management – Education
  3. Wound care
  4. Foot Care – Assessment
  5. Private Duty Nursing Care – patient advocate, patient administration, wellness check
  6. Dementia Care Therapy for private patients or facility educators

What kind of a business can an Advanced Practice Registered Nurse run?

In 23 US states, an APRN can practice INDEPENDENTLY from a physician (with more and more states changing their guidelines).

Walk-In Clinic concept practices, such as:

  1. School/work/camp physicals
  2. Rashes
  3. Cuts/wound care
  4. Suturing
  5. Cough and Cold symptoms
  6. Medication management
  7. General practitioner care

More Specialized APRN degrees can also include practices in:

  • Psychiatric
  • Family
  • Geriatric
  • General Practice
  • Midwife

The more RNs and APRNs providing care in the communities, the better the care will be!

About the Author

Karen O’Donnell is a Registered Nurse and the owner of Caring Nurses Staffing Agency LLC. More recently, Karen has taken on the role of Senior Director of Clinical Solutions and Practitioner Success at First Matrix Health, the creator of the AlyxHealth platform. AlyxHealth allows nurses to personalize their services and fees, set their own business hours, and choose where to deliver care. More information can be found on their website, www.alyxhealth.com.

5 Characteristics A Nurse Entrepreneur Should Have

5 Characteristics A Nurse Entrepreneur Should Have

Have you noticed that nurse practitioners are becoming more common in this country?

We are providing patients with essential medical services. We, as nurse practitioners, are able to offer diagnostic and treatment services for a wide range of illnesses. While many nurse practitioners might be happy at an office that is run by someone else, there are some who consider becoming an entrepreneur.

Starting your own nurse practitioner practice can be lucrative and gives you an opportunity to help those patients in need, but you should understand what you are getting into. I personally have been providing patients with care at my clinic for many years and the knowledge I have acquired is invaluable. If you are considering becoming a nurse entrepreneur, be sure to learn more about the top characteristics that others in the industry possess. This way, you can do a more thorough analysis of yourself.

1. The Ability To Be In Control

In one scientific publication, it was found that one of the most important traits for a nurse entrepreneur is the ability to be and remain in control over any type of situation. When you become an entrepreneur and start your own nurse practice, you need to be in charge of various aspects all at once. You need to be a leader and have the ability to recognize situations that may spiral out of control quickly – and then take charge to avoid such problems. For me, the ability to act fast and be in control at all times is critical to the success of my practice.

2. The Ability To Analyze A Situation And Know When It’s Okay To Take A Risk

Another critical characteristic lies in your ability to take risks at the right times. There are many risks that have to be taken to succeed in the business world. Understanding how these risks will play out and when it is appropriate to take such a risk is critical. I often find myself taking risks, but only when I am able to understand how my decisions might play out.

3. A Need For Achievement

You should have a desire for achievement. Once you have established your new office, you need to recognize the fact that there is always room to grow. You should know how to set goals – both short term and long-term goals. You should also know how to continue striving toward those goals, ultimately ensuring a consistency in achievements reached.

4. Innovation

Innovation – the ability to adapt to new things – is a characteristic that is now more critical than ever before in a nurse practitioner. You should be able to adapt to the latest technological advancements that have been made. Plus, you need to be able to accept new changes in the industry and ensure you always have the latest treatments for patients. 

5. Ambiguity Tolerance

Finally, ambiguity tolerance is another characteristic that you definitely need. As a nurse practitioner, there will be times where the result of something you strived for turns out as a disappointment. You should be able to bounce back and avoid thinking negatively about such events.

Conclusion

As a nurse entrepreneur, I have a lot of responsibilities. Understanding what it takes is important. I believe that the characteristics outlined in this post are crucial to nurse practitioners who are looking to take the entrepreneurial route.  

Creating Your Own Business With Your Nursing Degree

Creating Your Own Business With Your Nursing Degree

You started out on your journey through nursing school starry eyed, young, and idealist; ready to save the world and make it a healthier place. You put in hours upon hours of studying, memorizing, and working hard on your clinicals, and finally you stand at your graduation, proudly accepting your well-deserved diploma; about to embark on your dream career path as an RN clad in your new nursing scrubs.

Yet, in real life it’s not always easy to keep that spring in your step and joy in your daily routine as a nurse working in a hospital or facility. The hours are long and the work is often grueling, making this not the ideal work situation for everyone. 

There are those who are competent and caring, yet feel stagnated and restricted in their nursing position. Others worked on the floor for years, and feel like they are ready for a change, yet still want to stay within the same line of work. They seek a job that allows for more flexibility in terms of schedule, or dare I say, they dream of someday being their own boss. If you thought being a registered nurse means you are stuck working under others at a facility, then think again, because this amazing possibility of being your own boss does actually exist!

There are several ways you can create a lucrative and fulfilling career, while still pursuing the dreams of your youth and utilizing your qualities and talents that make you the idealistic, young (at heart), and extremely caring nurse. One way to achieve this is by becoming a nurse entrepreneur and starting your own business. In your role as a nurse entrepreneur you can be self-employed, all while doing the work that you love — it’s a win-win!

What work can be done as a nurse entrepreneur?

There are several career options in the world of nursing entrepreneurship. Choose one that fits your needs, personality, and personal preference, and start enjoying your independence today.

If you are unsure which direction you want to take with your new entrepreneurship, have no fear! Changes are always difficult, but the benefits that you will enjoy once everything is in place will far outweigh any hardship you had to deal with initially.

It may be a good idea to keep your current position and cut your hours if possible, while devoting the other hours to starting your own business. This will make the change less overwhelming, and will enable you to still generate income and benefits from your part time position to tide you over until your own business is all set up and running. This will also allow you to slowly figure out what will work best for you in a more relaxed manner, as opposed to feeling pressured to figure everything out quickly as you start your new life as an independent nurse

It’s also good to do some self-exploration and ask yourself which parts of your current position you enjoy most, or are passionate about. This will give you an idea which direction you would like to take with your business and what area you want to focus on. You may go through many ideas before you hit the one that feels right to you, but don’t worry, that is totally normal.

Here are a few nurse self-employment ideas based on skills and areas of focus:

Nurse Coach

If you enjoy working one on one with patients by promoting wellness and helping those suffering from chronic diseases live their life to the fullest, then becoming a certified nurse coach might be the perfect job for you. A nurse coach focuses on promoting wellness by creating customized care plans for patients with chronic conditions or health related issues. They can also open wellness clinics or become holistic nurses. A holistic nurse is a licensed nurse who focuses on the mind, body, and spirit connection to promote wellness and good health.

Nurse Consultant

If you are good at analyzing situations, identifying problems, and coming up with solutions to resolve the issues, then a nurse consultant may be your calling. You can work independently and get contracted jobs with hospitals, health care facilities, or even insurance companies to help with internal audits in identifying billing fraud and other compliance issues.

Or you can also focus on a specific niche such as legal work and become a legal nurse consultant. A legal nurse consultant provides invaluable expertise and works together with a legal team in assisting the attorney with understanding medical terms, reading through medical records, and deciphering the medical jargon in medical-legal cases. A legal nurse is needed in medical malpractice cases, as well as personal injury lawsuits. They do not practice law, but fulfill a unique role in the legal process, assisting in bringing about a positive outcome of the case in favor of the client.

Nurse Educators

Are you someone that enjoys educating others in health and nursing information? Then becoming a nurse educator might the perfect job choice for you. There are several ways you can fulfill this important role. You can become a teacher or trainer who formally teaches in nursing school or a speaker who presents at educational seminars and presentations. Another option in the field of nursing education is becoming a nurse writer. If you enjoy putting pen to paper then this is a great option. There is always a demand for high quality nursing and health related articles written by registered nurses, and the pay can be quite good as well. 

So, for all those nurses out there who feel stifled at their current job, there is hope for a brighter future by starting your own business. Do your research, put your feelers out, and see where you find yourself comfortable and enjoy the freedom of becoming a nurse entrepreneur, all while living the dreams of your youth.

3 Flexible Nurse Entrepreneur Business Ideas

3 Flexible Nurse Entrepreneur Business Ideas

Many nurses find that they experience burnout in the profession and want to create an opportunity to work for themselves without the stress and wear-and-tear that they get from working in the hospital setting. Most importantly though, they want more flexibility and control of their work. Here are 3 flexible nurse entrepreneur business ideas to get you thinking about your next nursing opportunity. After all, a nursing practice can take many forms.

What will yours be?

1. Nurse Health Coach

Nurse health coaches have the ability to actualize their patient’s health care goals outside of the hospital setting by helping them develop the healthiest version of themselves. By teaching patients how to take optimal care of themselves, the nurse health coach empowers them for life.

Nurse health coaches work with patients to provide guidance and resources to assist their patients in living a more healthy and balanced lifestyle. In terms of nursing experience, nurse health coaches generally have many years of direct patient care in the hospital setting and have the desire to have a more immediate and positive health impact on their patient’s lives.

Many nurse health coaches are entrepreneurs who work in private practice, although some hospitals and doctor’s offices hire nurse health coaches as well. According to some surveys, nurse coaches can earn similar or even more income than they do working in hospitals.

Nurse health coaches help their patients by working with them in the following ways:

  • Understanding patient’s unique health care dynamics
  • Assessing patients’ readiness for change
  • Identifying client opportunities and issues for improved health
  • Identifying and setting goals to achieve optimal health
  • Encouraging and empowering patients to reach their goals

Perks to becoming a nurse health coach:

Nurse health coaches generally have more autonomy in this role than they do in other nursing careers. While nurse health coaches must work very hard to be successful, the career offers flexibility with setting one’s own schedule, work atmosphere, and patients.

2. Legal Nurse Consultant

A legal nurse consultant (LNC) is an RN expert for legal cases involving medical incidents and issues. LNCs are extremely valuable because they bring clinical expertise and medical experience to attorneys in the litigation process.

LNCs clinically analyze and evaluate facts and testimony related to the delivery of nursing and other health care services and outcomes. They also analyze and review the nature and cause of injuries in legal cases.

Legal nurse consultants’ responsibilities vary depending on the employer and often include:

  • Attending medical reviews by independent medical examiners
  • Testifying in court as an expert witness
  • Reviewing cases to identify strengths and weaknesses
  • Preparing chronologies or timelines for medical records
  • Working with lawyers to plan health care litigation
  • Drafting legal documents in medical cases under the guidance of an attorney
  • Educating attorneys and paralegals about health care issues

Perks to becoming a legal nurse consultant:

This option makes for a great nurse entrepreneurial business idea because LNCs have the ability to combine their clinical expertise and medical experience with the law. As business owners, LNCs can work as much or as little as they want and have complete control over what they accomplish.  In addition, LNCs can often choose which clients they work with and types of cases they consult on.

3. Nurse Blogger/Freelance Writer

Nurse bloggers and freelance writers create and manage websites containing useful information for readers. They are generally developed based on the creator’s medical and/or personal niche.

A great benefit to becoming a nurse blogger/writer is that each post or article can be written from a completely different perspective. Nurses work in many different specialties with diverse patient populations. Therefore, each nurse has different skill sets and experiences within their career that they can draw unique information from. In other words, nurses can bring a lot of life experience into their writing.

There is a wide range of nurse bloggers on the internet writing about:  nurse mom lifestyle, nursing informatics, nurse money topics, new graduate nursing, nurse humor, nursing apparel, nursing specialties…  and the list goes on and on.

As a nurse blogger or freelance writer, you can:

  • Set your own work hours and schedule
  • Have total creative control over your content and products
  • Improve and continue to develop your writing skills each time you create a new piece
  • Become a better thinker because the writing process forces you to pause and think deeper
  • Develop strong opinions about nurse topics that matter
  • Discover thoughts and ideas about the nursing profession that you didn’t even know you had

Perks to becoming a nurse blogger or freelance writer:

Nurse bloggers and freelance writers are also entrepreneurs who manage their own businesses. Many often also have full-time positions and do their writing/website design in the evenings or weekends. There is no set schedule, therefore they can decide to work or not work whenever they want.

HEALab Provides ASU Health Students Path to Combine Healthcare and Business

HEALab Provides ASU Health Students Path to Combine Healthcare and Business

Arizona State University is helping more students pursuing health-related degrees to marry their knowledge and curriculum with entrepreneurship, in order to help them forge stronger paths in their healthcare careers. The ASU Health Entrepreneur Accelerator Lab (HEALab) program helps teach students to think up new solutions, design a business model, and apply to the ASU Venture Devils Program for further mentorship and funding.  

While their Tempe campus has hosted their business, engineering, and design schools for a long time, the health-centered colleges are based in the downtown Phoenix and West campuses. Combining the resources and strengths from these schools and ASU’s office of Entrepreneurship and Innovation creates opportunities for nursing and health students pursuing their bachelors and masters degrees, both in the classroom and in the workplace.

From Classroom to Competition to Career

Students are already showing major successes from the program, as shared by the Phoenix Business Journal. Ramona Ramadas, who has been pursuing her Masters in Healthcare Innovation through ASU’s online courses, recently competed in the Nurse-Pitch competition at the 2019 Healthcare and Management Systems Society conference and placed third. Her startup, New Trails Navigators, is an AI-driven platform designed to train incarcerated inmates, prepping to release and re-enter the workforce, to begin a career in healthcare. The mentoring and networking Ms. Ramada has been able to gain through the HEALab has helped her win three additional competitions and awards, including the Pakis Social Entrepreneurship Challenge and the Alliance for the American Dream.

In addition to being a resource for Arizona State students, the HEALab has been used by students at other schools. Back in February, students from Mayo Clinic Alix School of Medicine visited the lab and other school campuses and centers, through a week long Entrepreneurship and Innovation selective with Dr. Rick Hall, CONHI’s Senior Director of Health Innovation. These students used applied human-centered design techniques and lean startup business tools to develop application ideas.

The HEALab offers monthly guest speakers and one-on-one mentoring to all ASU community members, faculty, and students, including those from different campuses, and those taking online coursework. For more information about the HEALab, click here.

Correction, March 27, 2019: We initially reported that New Trails Navigators works with newly incarcerated inmates, instead of inmates who are preparing to release and re-enter the workforce. We have edited the article to reflect this correction.

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