Passive Income Streams

Man Road Sign Active Passive  - 14320892 / Pixabay

Its critically important for the Elite Nurse Practitioner to develop a passive income stream. To truly be in the top 5-10% of nurse practitioners and to separate oneself from the herd, you must develop income streams that do not actively require your involvement! Let’s back track for a minute though… I need to explain active income as many of the newer Elite NP members might not be aware of the time for dollars concept.

When you see patients and are subsequently paid, this is called active income. For the employed nurse practitioner, if you call into work, you do not get paid. On the other hand, if you see patients, you get paid. When you are a nurse practitioner entrepreneur who owns and operates their own practice, you must see patients to generate revenue. For example, if you own an insurance accepting primary care practice, YOU have to actively see patients, bill, and get paid. If you are not in the office seeing patients, then you do not generate revenue. This is active income. Active income = exchanging time for dollars. Plain and simple…

The problem with active income is that is requires YOU to work to generate income. There is nothing wrong with this if you enjoy your work, but as time goes on, burn out eventually occurs…

You can begin to dislike patient care.

You can begin to not enjoy going to the office and seeing patients.

You begin to resent the system.

You just become burnt out…

Nurse practitioner burnout is a serious problem, and there is an entire article series about it HERE just for your information.

Active income = time for dollars and eventually = burn out.

This is not applicable to everyone, but the vast majority of people who work in healthcare begin to experience it eventually and if you are strapped with debt, then you have NO CHOICE than to continue working and seeing patients to pay the bills… This is why you should strive to become financially independent by the way. It is AWESOME.

Regardless, if you want to truly become free and build a life where you do WHAT YOU WANT, WHEN YOU WANT, then you MUST develop a passive income stream. This really is not optional.

There are two types of passive income: partially passive income and true passive income.

Partially passive income is where you must put a few hours into your business/income stream every week to maintain the income stream. My men’s health clinic is a PRIME example of a partially passive income stream:

I see patients 6-8 hours a week for initial evaluations and follow ups but the practice is open Monday through Friday for 40-45 hours. I have 2 full time medical assistants that are there and a part-time one. I also have a part-time nurse practitioner that sees patients 8 hours a week. Even though I am only there for 6-8 hours a week, the practice generates close to $50,000 a month in revenue. How? Because I only follow up with patients every 3-6 months yet they come in during the week for injections, to order refills, and to pay for services. I make money when I am not even there! It is a fantastic business model and any nurse practitioner reading this can do the same.

True passive income is where you make money and have LITTLE involvement in the income stream. You must dedicate 1-4 hours a month on the income stream to maintain it, but outside of that, you make money and have little involvement. True passive income streams are AWESOME! My second men’s health clinic is great example of a true passive income stream:

I have a nurse practitioner that sees the patients and a medical assistant/manger that runs the office. This office is 4 hours away from me. I spend very little time on it. Yes, I do see patients via telemedicine for this office but those patients are seen in the 6-8 hours I spend at my main men’s health clinic, but I am even moving away from that. My part-time nurse practitioner is seeing more and more patients there via telemedicine and I just hired a new part-time nurse practitioner to begin seeing patients there as we get busier. Am I making money here? Not really as the revenue is covering the expenses… It is a break even but I will begin to make money in the very near future. Patience = long term business success.

Other more common examples of passive income streams include:

  1. Any business that does not require your active involvement.
  2. Dividend paying investments.
  3. Rental real estate.

Every nurse practitioner should develop 1-4 passive income streams. The main reason is because it will provide you financial redundancy which leads to decreased stress which then ultimately leads to FREEDOM. But you must be willing to take risks to get there…

People who have multiple passive income streams can just get up and go travel for a month whenever they want. They KNOW they have an income stream in the background to provide them money to live off of. This is a GREAT feeling! I could stop seeing new patients at my men’s health clinic tomorrow and spend 1-2 hours a week doing telemedicine follow ups and TOTALLY SURVIVE off that income stream alone. Hell, I was still getting paid when I was on vacation in Costa Rica a few months ago from my men’s health clinic! Did I need to use PTO?! Hah, that is a foreign concept to a true entrepreneur. A true entrepreneur does what they want, WHEN they want, and does not need to ask permission to do so. It is GREAT!

If you are just getting started, try to ingrain the concept of passive income into your mind as your business grows. If you already have a practice, figure out ways to increase your income through your business that does not actively require your involvement. How is this done? Through delegating tasks and busy work to others. This could be an employed medical assistant or a virtual assistant. Does it require a specific niche? Not really…

Weight loss: allow patients to pay for their refills, monthly subscription costs, or even supplements at your practice from your receptionist when you are not there.

IV infusion: sign off on the orders for patients and have an RN do the infusion for you.

Aesthetics: do the good faith exam on initial patients and then delegate the work to an RN.

Cosmetic skin care: you can sell prescription cosmetic skin care products simply from an asynchronous telemedicine visit.

HRT: operate a subscription-based concierge model and people pay you monthly for care/prescriptions while you are not even there!

The possibilities are endless… All it takes from you is to change your mindset from thinking that you must ACTIVELY work to make money to having your business and money WORK FOR YOU.

Hell, I am investing OUTSIDE of healthcare at this point in my entrepreneurial journey. I have rental real estate that pays me a passive income with little involvement and I am actually flying out next week for a meeting with the Jersey Mike’s franchise team to obtain my final approval on opening a Jersey Mike’s sub shop in my city. I am partnering with someone who is going to manage and operate it. I will have little involvement yet sit back and make a passive income. All it takes from me is the financial investment and the willingness to take a RISK.

Friends, this is what you should be thinking about as you grow as a nurse practitioner entrepreneur:


This is what will bring you freedom and allow you to break free from modern day rat race slavery.

8 Responses

  1. Hi Justin,

    Sounds like you read Millionaire Fastlane hahaha. Anyways, I love this content. I am currently 28 yrs old, an ER RN doing some travel nursing and starting to think about ways to go down this road you’re currently on. I was wondering how much experience you had as an RN/what area of nursing before you decided to go back to NP school? I’m curious as I definitely want to become financially independent in time.

    1. Hi Steven! Thanks for the comment. You are young so if you start now, there is no question you could be financially free in 15 years time. I was an RN for 3 years in the ER/home health before I became an NP. I went to NP school part-time while I worked full-time as an RN for a few years.

      1. Thanks for the reply mate. I really appreciate the feedback, I’m definitely looking into things I could do in the mean time that would make solid passive income- A blog being one of them. Very tough in Nursing as every niche is saturated though. But this is solid advice, you’ve got a new subscriber.

        1. You are welcome… Yes, most things are saturated in healthcare. You just have to figure out a way to separate yourself from the herd!

  2. I am finding it very difficult to set something like this up in my off time during the evenings while concurrently working full time, do you know of a consulting service to help facilitate this process?

      1. The issues I’ve been having are the accessibility and communicating with vendors on my off hours. Pharmacy links, EMR, web design and other applications. My goal is to operate a virtual boutique practice for adult clients along with the option of passive purchase options ex: care package – subscription, supplements- education etc. Any advice is greatly appreciated!

        1. Only advise I have is to communicate with them via email if you cannot contact them during working hours.

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