"You can get past the dead end. You can break through the ceiling. I did and so have countless others."
In this episode, Justin sits down with Felicia, a nurse practitioner currently working in urgent care who is preparing to launch a wound care and foot care clinic. Together, they walk through key decisions around choosing a service area, office setup, and navigating cash versus insurance based models.
The conversation also explores the long term opportunities that come with practice ownership, including creating more flexibility, building financial independence, and leveraging specialized clinical experience into a growing business.
Overall, this episode offers a practical and encouraging look at how nurse practitioners can turn their experience into a focused and sustainable practice of their own
00:00:02:12 – 00:00:24:07
Unknown
Greetings. This is just an hour for nurse practitioner. Welcome to the Elite Nurse Practitioner Show podcast dedicated to nurse practitioner entrepreneurism and achieving financial freedom, where I talk directly with nurse practitioners who need help. Listen up. Our market is saturated. Jobs can be scarce. We are underpaid. We are undervalued. We are taken advantage of by the sharks within the healthcare system.
00:00:24:07 – 00:00:47:14
Unknown
And frankly, screw that. Sick of it. It’s time for a change. And listen, I’m here to help make that happen. We are powerful. We can forge a path. We are in control of our career and ultimately our financial and personal well-being. You do not need to submit to healthcare ministry and your doctor who you don’t have to take the easily salary.
00:00:47:16 – 00:01:08:22
Unknown
You do not have to work 50 to 60 hours a week. There is a different way. I’m here to show you that path. This podcast is written for. I have not talked to the nurse practitioners of this podcast prior to the call. Outside of an email exchange to schedule the episode. What you’re about to listen to is a consultation session between the nurse practitioner and myself.
00:01:09:03 – 00:01:31:00
Unknown
It is real. Is it scripted? It is unplanned. I have no idea what we’re going to talk about. Anything and everything can happen. During our conversation, the nurse practitioner. These episodes are struggling with an issue in their professional or financial life. They have reached out to me for help. My goal is to help the nurse practitioner with actionable advice that will enhance their professional, business and financial life.
00:01:31:01 – 00:01:51:20
Unknown
My other goal is to hopefully help my nurse practitioner, sisters and brothers build a more productive, powerful and free life. So I hope the content information within these podcast episodes does just that. All right. To the upset. Hey everyone. Today we’ll be talking to Felicia, who is a nurse practitioner. Currently, she is working full time in an urgent care.
00:01:51:22 – 00:02:11:05
Unknown
She is wanting to start a wound in foot care clinic, but she is needing help with some office based choices determining service area and cash versus insurance based considerations. Hey, Felicia, how are you? Good. How are you? I’m good. Thanks for coming on here. So tell us a little about yourself on the nurse practitioner four. And what, what you’ve been up to.
00:02:11:07 – 00:02:40:20
Unknown
Right. So I’ve been a nurse for 13 years. Primarily home health, hospice care. I graduated with my FNP last August, and, am working urgent care at the moment and loving every minute of it. I’ve gotta say. Yay! Yeah. It’s great. Yeah. Yeah, I worked there, I don’t know, ten, 12 years or something like that. And urgent care.
00:02:40:20 – 00:03:03:12
Unknown
I don’t know how they last so long. I don’t know if I’m going to make it a year. Yeah. It sucks. It’s. It is such a grind. It is such a hustle. You know, you think you’re going to be treated all this cool stuff, and it’s just mostly bullshit, you know? I mean, yeah, it kind of really makes you realize how much of, Henry pussy’s are really out there in the world.
00:03:03:14 – 00:03:20:05
Unknown
Oh, yeah. I’ve had a sinus congestion for a day. I need a steroid. Yeah. Steroids, antibiotics. I had a guy come in one time. Just a completely random story here about urgent care. And then we’ll go on about, you know, your issue. But, I remember I had a guy. I was just like, this was just a light bulb moment for me.
00:03:20:06 – 00:03:37:15
Unknown
I was just like, what the hell’s wrong with people, my lord? I mean, I understood how people could wipe their own ass and, like, so this guy comes in and he tick, tick, bite is the complete chief complaint. I’m like, okay, you know, you have a ball up bull’s eye lesion or something, you need some doxy, you know, whatever.
00:03:37:15 – 00:04:01:19
Unknown
Fine. So I go in the room and he’s like, the ticks still on me. Can you please remove it? I’m like, you can’t remove tick. Like really? Like, okay. Okay. Man. Jesus. Like. Oh, okay. So he pulls up his suit, so he pulls it the sleeve of his leg, and I look at it and I’m like, dude, that’s a scab.
00:04:01:21 – 00:04:29:17
Unknown
That’s not a tick. Are are you sure? I am 1,000% sure, sir. That is a scab. Well, can I still have an antibiotic for tick bite? Sure. Here you go. Get the hell out of here, my lord. I’ve got similar, similar things. Yeah, yeah. It’s just. It’s just ridiculous. Yeah. But anyways. Okay, cool. So you’re wanting to start your own, wound care food care clinic?
00:04:29:18 – 00:04:50:00
Unknown
Yeah. I’m kind of trying to go back to what I’ve. I’ve done that my whole nursing career. I love wound care. And I want to just kind of get back into that, and get away from the urgent care setting. Yeah. Yeah. Okay, so you did wound care foot care as a as an orphan where you do, like in home health and things like that.
00:04:50:01 – 00:05:18:02
Unknown
Yeah. Yeah, yeah. Okay. So. Okay. Where are you in the process? Are you just just now getting started? I’m just now getting started. I haven’t done my LLC or anything yet. I’ve kind of, I’ve thought for maybe four months on this and have not done anything. I’m just stuck in that. What? What what’s the best route?
00:05:18:02 – 00:05:39:07
Unknown
What’s the rail that I need to go that would help me the most? And then I just think too much on it. I feel like. And just don’t do it. So I just need to get get that little push. Yeah. Have you taken any of our courses or anything to give you, like, the steps? Yeah, I’ve, I’ve done the mobile, lane foot care.
00:05:39:07 – 00:06:05:13
Unknown
I’ve also done the mobile practice. Okay as well. Okay. Okay. So you, you have the steps on how to do you. Yes. Take action and do it. Yes. Exactly. Yeah. Okay. Well, what’s preventing you, you think? Why are you kind of stuck in this analysis paralysis? I don’t know, I go back and forth. I’m trying to decide if I want to do my clinic here in my office.
00:06:05:13 – 00:06:34:13
Unknown
I have a home office. So I’ve thought, well, maybe I could get a UPS, mailbox, to use for my LLC and then do my Google business listing from home. But do it like a service business area. But then I’ve also thought, well, maybe I should just get a, room, and rent, and then maybe have people come to that room so I can see more people in a day.
00:06:34:15 – 00:07:04:14
Unknown
I don’t know. I get stuck on the, I guess, how I want to go about it. Yeah. All right. Well, so using let’s talk about first let’s talk about the office kind of choice first. Okay. First things first. You need to get your LLC. Okay? You just need to do that basic stuff. All right? You know, spend one day just knocking out that simple business infrastructure stuff that’s just outlining the cause.
00:07:04:14 – 00:07:21:14
Unknown
Usually it’s like the first, first ten slides of the business section of the course. It talks about what you need to do right. So get your LLC, go get a bank account, get an EMR. Like just get the basic stuff done out of the way, okay? It really shouldn’t only take you a day or two to get all I had done.
00:07:21:16 – 00:07:47:21
Unknown
All right? So just knock all that out and then the office space thing. So if you want to start mobile, mobile works you’re going to accept insurance I’m assuming. Right. Yeah. Yeah. Okay. This is probably going to be a lot of Medicaid and Medicaid, Medicare, some private insurance I’m sure will be thrown in the mix. Right?
00:07:47:23 – 00:08:11:15
Unknown
Yeah. So, so you need to start getting credentialed sooner than later, right? It’s going to take you 3 to 6 months before you can even step foot in someone’s house. And actually, Bill. Right. So you need to get credentialed today, okay. Like that’s that’s what you just need to knock it out. So get your LLC, get your iron.
00:08:11:17 – 00:08:45:14
Unknown
Get a group NPI number okay. For that for that LLC. And then you can just apply for one of those online through the NPI, whatever that website is. NP yes. Or what where that site is. So go to that site, get your group and get yourself a group NPI for your LLC. Okay. And then you need to get credentialed and you need to do that, like as soon as you possibly can just attach it to your home office, whatever comes to use your home address.
00:08:45:16 – 00:09:06:06
Unknown
Just if they question it, you just say, I have a home office and I’m going to be doing mobile care. Like, this is just my office is my base of operations. This is where I do billing. This is where I, you know, store the wound care supplies, etc. it’s in a home office and I go out and I, you know, and I see patients and then just get credentialed.
00:09:06:11 – 00:09:23:15
Unknown
All right. If you need to expand that credentialing into home or in, in office visits, then, you know, at the time of credentialing, you could probably go ahead and get credential for that as well. You just say, you know, I do have a set up in my home office to where I could where I could do it here.
00:09:23:17 – 00:09:43:03
Unknown
That doesn’t necessarily have to be 100% the truth. You have the capacity to do it, but you’re not going to do it because you’re planning on maybe getting an office space, you know, a little bit down the road. So you can’t do that in, you know, in office. Okay. But the whole point of this is that you need to get credentialed because you can’t do a damn thing to your credential.
00:09:43:05 – 00:10:04:14
Unknown
All right. So, so I would highly advise that you you start there, right? Just use your home office. Hell with it. It doesn’t matter. Who cares if you’re. It doesn’t matter if you’re home address is attached to your credentialing application. Who cares? Doesn’t it doesn’t make a difference. Your LLC, you know, if you want to, you can attach it to your home address for the time being.
00:10:04:14 – 00:10:29:13
Unknown
You can change that later. All right. No one’s going to look this up. You know, it’s not really a privacy issue right now. I wouldn’t worry about it. Okay? A wound care clinic. You know, if you use your Google business listing and you attach your home address to that Google business listing thing, you know your home address is out there as a business now, it’s a wound care clinic.
00:10:29:15 – 00:10:58:00
Unknown
I don’t think I would be terribly concerned about an invasion of your privacy because it’s I mean, it’s a wound care clinic. Like, you know, I wouldn’t have a medical cannabis clinic outside of my house, you know? Yeah. Like, you know what I mean? But a wound care clinic. I mean, you’re Medicare patients. You know, most your patients may be older, but probably going to be fine.
00:10:58:00 – 00:11:20:02
Unknown
I doubt anyone with some nefarious intentions are going to be looking up wound care clinics on Google and going to those office locations to rob you or defraud you. I don’t I don’t think it’s a big deal. All right. So you probably just get away with using your home address for right now to save you some money and just keep going, okay?
00:11:20:02 – 00:11:35:17
Unknown
I don’t want you to get hung up on this because of because of an address, okay? It’s not that big of a deal right now. So I just say just go for it. Use your home address. Whatever. Okay. But you got to get credentialed, and you got to get that, like, you got to get your INR, get your group NPI number.
00:11:35:17 – 00:11:55:11
Unknown
You get that stuff. And then talk to a medical credentialing medical billing company okay. Do not do this yourself, okay? It is it’s time consuming. It’s a pain in the ass. You’re probably going to forget to check a box on the application, and it’ll be sent back to you. And the clocks reset. I mean, it can be just about anything.
00:11:55:11 – 00:12:16:08
Unknown
Okay, so I would just hire a professional to do it for you. That’s going to be one of your biggest upfront expenses here is just paying for that. Yeah. So I mean you’re going to spend a few thousand dollars on getting on getting credentialed. So it’s just a necessary expense. But, have you looked at any medical billing, credentialing companies or anything?
00:12:16:10 – 00:12:37:23
Unknown
I actually know of, provider. She has given me her and the two credentials that she uses, that she recommends. So I’ll use one of them. There you go. Okay. So just contact them and just get started. They will tell you what they need. Okay? So if you are missing something, they will tell you what you know what you need.
00:12:38:00 – 00:12:52:19
Unknown
So if you forget to get that group NPI, they’re gonna be like, you need to get a group NPI. Please just go get it real quick. I mean, it takes 15 minutes, okay? And it takes no time. It’s just an online thing. You fill out a form, you click on it, you have your NPI, like, so same with your ID number for your LLC.
00:12:52:19 – 00:13:16:18
Unknown
It takes five minutes. Okay. So so just go ahead and get started with all that. I think that’s step number one for you is to just get credentialed, get the general infrastructure of your business done. Okay. If they are going to be doing the billing for you so you don’t have to deal with it. You know, I wouldn’t pay more than 5%, seven tops.
00:13:16:20 – 00:13:40:18
Unknown
Okay. Usually if they’re going to be doing the billing for you, they’ll probably have an EMR recommendation for you that they like, for the billing aspects of it, for wound care. Medic. I mean, I’m sure just any kind of EMR is probably sufficient for you. I mean, you know, like, want an EMR where you can draw pictures on, you know, certain pieces of anatomy or whatever, like.
00:13:40:18 – 00:14:04:17
Unknown
Yeah. You mean you could do that? You. So I’m sure, I mean, sure, I’m sure there are some EMR is out there that you used before, but, so. Yeah. So that’s kind of where, that’s where I’d start. Any questions with any of that? Do you think it would definitely be beneficial to have someone have a baler for the clinic instead of trying to do it myself?
00:14:04:19 – 00:14:26:02
Unknown
Yeah, yeah, I would, it’s just it’s it’s a headache. You know, chances are you’re probably going to continue to work at the urgent care, right? Yeah. You know, should give that up, right? No. Not yet. You mean. Yeah. You will be able to in time, but not yet. You’ll be working urgent care. You’re gonna be doing this wound care on the side.
00:14:26:02 – 00:14:58:10
Unknown
You’re going to be busy. You work 312 at the urgent care, I’m assuming. No. My, my schedule is a hot mess. I work, one week. I work like a Tuesday, Friday, Saturday, Sunday, like 38 hours. And then the next week I work a normal three twelves. So it’s it’s broken up a little, but I, will have two days a week that I can work on my business.
00:14:58:12 – 00:15:19:17
Unknown
Well, those two days a week be fairly predictable in terms of patient care. They will be. They’re not the same days every week, but they are. Every other week would be the same, same days. My schedule doesn’t change or row like it just has one week. I work these days. The next week I work the opposite days of okay, so okay, so it is predictable.
00:15:19:20 – 00:15:43:00
Unknown
So yeah, so it’s predictable. Yeah. You’ll be able to schedule patients on those days. Yes, yes okay. Okay. So yeah. So you’ll be doing it two days a week. I mean that’s plenty of time probably for, you know, for, for a while. So, but yeah. And here’s the medical billing question, though I would say that, do you really want to spend your time learning how to do all that right now?
00:15:43:02 – 00:16:08:13
Unknown
I don’t want no. No. Probably not. And if if it would, if it’s easier for them to just do it, then that makes sense. I just haven’t really thought much about who’s going to be billing at this point, I guess. Yeah. My advice would be to just hire someone to do it for you. Okay? Okay.
00:16:08:13 – 00:16:22:06
Unknown
That way they submit the claim, they’re keeping an eye on it. They’re doing all that kind of stuff. All you gotta do is chart. It’s like the code. Move on of life. You know what I mean? Yeah, well, you let them do all that back end crap, you know what I mean? So that’s what I do recommend that you do.
00:16:22:06 – 00:16:50:21
Unknown
I just hire someone to do it for you. Keep an eye on that, though. Like, keep an eye on it. Make sure that they’re actually doing their job. Make sure that they’re actually billing, which they’re actually chasing claims and stuff. I’ve heard way too many horror stories from employees over the over the years who hire a medical biller for their, for their practice that accepts insurance and the medical biller doesn’t necessarily, you know, screw them over, but they just don’t do a good job.
00:16:51:00 – 00:17:11:08
Unknown
You know, they submit claims and not checking to see if they’re being paid. They’re not sending audit requests in. They’re just they’re not doing a good job. And I’ve heard some stories from people where I’m like, where they’re just like, I’m literally out $75,000 in billings from last year, and I can’t do anything about it because it’s Biller just sucked, you know?
00:17:11:08 – 00:17:30:07
Unknown
So so get a referral from someone who’s using someone and make sure that they’re actually pretty good. And, you know, so that he might maybe my piece of advice for you and yeah, like I said, you pay him five, 7% or something. So go ahead and get all that set up, okay. Because we, you just have a waiting game right now just waiting to get credentialed.
00:17:30:07 – 00:17:56:12
Unknown
There’s not really a whole lot you can do between now and then. So, yeah, I mean, it’s gonna take you three months to get credentialed, probably okay. With Medicare and stuff like that. So for the three months, what do you do? I mean, you know, you spend that three months getting all your supplies and getting everything organized and getting familiar with the EMR, building your templates in the EMR.
00:17:56:14 – 00:18:17:20
Unknown
I mean, you could spend that time being productive. So that way when day one comes where you can see a patient boom, these go all also there’s stuff done. You have accounts with medical suppliers. You have your templates charting templates done. You have all these things done and ready to go. And it’s just you’re just really just sitting there waiting to pull the trigger basically.
00:18:17:20 – 00:18:42:11
Unknown
You know what I mean? So yeah. Do you have any questions there in terms of that general startup process there? You know, okay, I think the the modules really helped on them. Yep yep yep. Just just just follow those those pieces of advice, follow the advice in the marketing sections as well. You know, I mean create a Google business listing.
00:18:42:12 – 00:19:03:02
Unknown
You do not need to create an ad for a business like this. You know, waste of money. Okay. You don’t. People are going to be looking for this if they need it, but most of these people are going to be referred from their insurance company. So you’ll just get referrals from the insurance in general to send you patients, and then you’re going to get referrals from outside sources.
00:19:03:02 – 00:19:27:13
Unknown
And so that is where you’re going to probably need to try to spend some time on getting some of those referral sources dialed in. So during that three month period of time where you’re waiting to get credentialed, that is kind of what you can do. You can spend your time going out there and talking to primary care offices, nursing homes or assisted living facilities and etc., etc., etc..
00:19:27:15 – 00:19:55:04
Unknown
Okay, you got to get those referral sources. You got to get patients. Yeah. Yeah. I feel like, I already have one. Primary care provider that she’s already been making a list for me, especially for foot care. And then, pretty well, I mean, like, really the home health I think I’ve got because I’ve just worked at some long.
00:19:55:04 – 00:20:19:16
Unknown
I’ve got some good connections there. Nursing homes are going to be difficult probably. But that’s going to be the biggest money for me. So I’ve got to be able to get it. And then some of those, why is it going to be difficult? I just I, I don’t I feel like it will be just because they’re nursing homes and you know, how they’re all their legalities and everything in it.
00:20:19:16 – 00:20:40:22
Unknown
I don’t know, I feel like it’ll be more difficult than the home health. Like I feel like I already got the home health referrals. I’ve got good connections with a lot of those people. And I guess that’s what I’m stuck on is like, they’ll be easier than the nursing home just because I know them so well. Sure, I mean, you always go after low hanging fruit first, right?
00:20:40:22 – 00:20:51:19
Unknown
So, I think, you know, nursing homes are going to be your big, big money generator. So you are you have to do is you got to figure out who the director of nursing is at that nursing home.
00:20:51:21 – 00:21:15:11
Unknown
Make an appointment. Go in there, talk to them. You know what I mean? Yeah. Be like, I’ll do my own billing. I’ll do all that kind of stuff. I just want to come in and treat your patients, that kind of thing. And. Yeah, you know, you never know. You might go into one of those nursing homes, and the director of nursing is like, you know, thank God you came here because our wound care person that was coming in is leaving next month.
00:21:15:12 – 00:21:40:11
Unknown
Yeah. They’re moving like, you never know. You’re I mean, you’re. Yeah. So you have to just get out there and just try to just get out there and make some and make some relationships. That’s kind of how that’s how that that’s how you got to grow is thing. Okay. If you just sat back and did nothing. Okay. Let’s just say as an example, let’s say hypothetically, you decided I’m not going to work at all.
00:21:40:13 – 00:22:04:12
Unknown
I’m not going to, go out and try to get referrals. I just had my Google business listing. I was gonna wait for insurance, send me. People say you just did that and just wait for people to call. Say they did that. I bet you after a year you’d probably be kind of busy. You know, kind of like, you know, be making a few extra bucks basically.
00:22:04:14 – 00:22:21:01
Unknown
Right? You get a couple years, you get established, people start finding out about you, etc. and then, you know, after 2 or 3 years, you probably would be actually pretty busy. That’s if you probably you did absolutely nothing. So it really just depends on what your time frame is. Do you want this to get busy quick or not?
00:22:21:03 – 00:22:37:04
Unknown
If you want to get busy quick, you got to get out there and go out there. But to work and do it, if you want to just take your time with it, then just get it open, get it started and just kind of take your time. Which honestly might not be a bad idea for the first couple months.
00:22:37:06 – 00:22:58:15
Unknown
Get your feet wet, understand the billing, understand the processes, work out any kind of issues before you get busy. So for the first month or two, maybe just use some of that low hanging fruit referral that you have. But your Google business listing out there wait for maybe insurance companies to refer people over to you and yeah, you could just do that for the first few months until you kind of get comfortable.
00:22:58:15 – 00:23:30:14
Unknown
And then once you get comfortable, that’s when you basically tell yourself, okay, I’m really busy now, and then you go out and then that’s when you really hustle through. Yeah. So any questions about patient acquisition? I do have some, some questions about like service areas. My county is kind of like in the center. And then, the surrounding five counties are kind of just around my county.
00:23:30:14 – 00:23:53:06
Unknown
So each place is around 20, 25 minutes away. I know like all these counties, the home health service. So I kind of want to service all of them. But then at the same time, I’m thinking if I get one referral to like just one patient in one area and then I’m having to spend all that drive time, is it worth it?
00:23:53:08 – 00:24:10:14
Unknown
I guess it is. If for even just one referral? Or should I ask them like, no, I need maybe 2 or 3 in the farther, more rural areas?
00:24:10:16 – 00:24:22:02
Unknown
I have no clue with in this in it with a mobile wound care kind of a thing. I have no clue of Medicare insurance. Reimburse you for mileage. I doubt they do.
00:24:22:04 – 00:24:40:11
Unknown
All right, I hope everyone’s enjoying the episode so far. I just wanted to take a quick break to thank everyone listening, and also give a big thank you to all of my social media followers and email subscribers. If you haven’t done so yet, please subscribe to our email list at WWE, WW, np.com and make sure to follow us on Facebook, Instagram and LinkedIn.
00:24:40:13 – 00:25:05:05
Unknown
Email subscribers will receive updates on new weekly podcast episodes, multiple weekly articles, we publish, new courses and everything else related to helping succeed. Remember, all elite nurse practitioner courses are designed to help you build in each practice, increase your financial strength, and to break free from the rat race. If I can break free and other countless nurse practitioners can break free and so can you.
00:25:05:06 – 00:25:27:06
Unknown
Additionally, please share this podcast with your other nurse practitioner sessions. And for those out there, the more NPS that venture out on their own, a stronger our profession will become. Now let’s get back to the episode. They don’t. But, I should be able to, put my mileage on my taxes later. Well, I mean, look at it.
00:25:27:08 – 00:25:55:14
Unknown
Yeah. I mean, you’ll be a good deduction there. Yeah, yeah. And the wear and tear on your vehicle and stuff. That’s not really income generation. That’s just now reduced your taxable build your taxable income. Okay. So then, you know, it just depends on how much you know, what are you being reimbursed like, is it worth it is is is driving 45 minutes to change someone’s wound back out or something.
00:25:55:15 – 00:26:14:18
Unknown
You know, are you going to be doing some debridement. Are you going to be doing some different things that can, you know, increase the bill, you know, is it worth it to you is going to just change someone’s oh, hell, I don’t know, pal. A needle cyst removal wound or whatever that takes you 15 minutes. And it’s just a simple wound thing.
00:26:14:18 – 00:26:45:09
Unknown
Like, is that really worth your time? You know? Yeah. Well, that’s going to be up to you. You know, I think that the larger service area is definitely going to be good for you in terms of just patient, you know, patient acquisition, especially during the first year or so where every dollar counts, you know, everyone who starts a business, everyone who starts a practice specifically, anyone who starts a practice the first year, you do whatever you have to to make some money.
00:26:45:11 – 00:27:06:02
Unknown
Yeah. Like you see patients that aren’t really aligned with your niche. As an example, like my mental health clinic, I do some medical cannabis evaluations out of it. I’d see some primary care. I did random shit because I just needed every single dollar I could possibly get. Now, obviously we don’t, you know, I don’t bother with those kind of visits.
00:27:06:02 – 00:27:40:14
Unknown
Right? So in your, you know, in your situation, your service area, like take what you can get for a little while because you need you need to start patting a business account so you have some ammunition for expansion and growing and building a nest egg building an emergency fund so you can when you duck with the urgent care, you have a nice chunk of change set aside to float you through any kind of difficult times.
00:27:40:16 – 00:28:05:16
Unknown
Right. So that’s kind of your goal with this is for the first years did not really don’t really pay yourself okay. Invest that money. Like save that money so you can eventually exit the urgent care setting okay. You don’t want to just dive in and just start, you know? Hey, Greg, we made $5,000 this month and wound care.
00:28:05:18 – 00:28:30:21
Unknown
Let’s go. You know, let’s go down to Florida for for a week and, you know, just shit. Like, that’s not what you want to do with that money. You need to need a bite the bullet and accept the fact that you’re probably not going to pay yourself much, if anything, for the first year or two, because you want that money to to build up so you can invest back into the business for it to grow later.
00:28:30:23 – 00:28:53:00
Unknown
And you see, you can also pad your personal financial health so you can pad it up so you can quit that urgent care job right. It’s like what I did, really the true nail in the coffin for me, that was like, dude, it’s time to quit. It’s it’s time to quit. You don’t need this anymore. For me, it was pay my house off.
00:28:53:02 – 00:29:19:09
Unknown
I paid my house off. That’s when I was like, screw this job. I don’t need this anymore. Why the hell am I here? And that’s where. And that’s where I quit. Okay? I aggressively paid down, paid off my mortgage with all the money I was making through my businesses. Like, aggressively every like 20, $30,000 a month I would throw at my mortgage.
00:29:19:11 – 00:29:37:20
Unknown
You’d do that for a year. Your mortgage is paid off like your mortgage is paid off. Okay. So that’s what I did. And then that was nail. That was the nail in the coffin for me to quit my urgent care job. Because why why am I wasting my time with this? So for you, it could be something similar.
00:29:37:22 – 00:29:56:11
Unknown
Pay some debts off with the money that you’re accumulating it through the wound care business. Pay some debts off, put some money to the side. And then when you get into a healthier position financially, you can look and say, you know what this urgent care salary. Now, I don’t really need this anymore because I paid off some debts.
00:29:56:11 – 00:30:13:18
Unknown
I have, you know, I paid off some bills. I’m making this much in the wound care place now. I don’t need this anymore. This is just eating my time up. And honestly, it’s preventing me from growing the wound care business. Because now I can’t take new patients because I don’t have the time right to get to that point.
00:30:13:19 – 00:30:44:02
Unknown
You to that point, you’re throwing business away so you can keep making, you know, you make this urgent care money, right? That’s just dumb. So, you know. Yeah, that would be my advice for you, Yeah. So, yeah. Your service area. Then take what you can get, okay? Take what you can get, because you could probably get to a point where you could hire friends to be doing a lot of the busy work for you.
00:30:44:04 – 00:31:04:05
Unknown
Right. You go you do the initial assessment, you check on them every 3 or 4 weeks, do some debridement, do whatever. You know, only your provider can do. But the brain goes out there on a weekly basis or every three days or wherever, just as wound dressings, that sort of a thing they’re billing, you’re making a profit and you’re paying them, you know, 30 bucks an hour or whatever.
00:31:04:07 – 00:31:26:05
Unknown
Okay, that’s how you going to grow this into a business that really has the potential of generating some significant money. Like, that’s the kind of business that makes you wealthy, not just you going out to do Metal Gear. That doesn’t make you wealthy. That’s just a job. You giving yourself a job. Okay. Groups like that, what you want.
00:31:26:07 – 00:31:46:23
Unknown
Fine. That’s fine. What are people but okay with that? But you want to build a business that works for you. That’s what you need to be thinking about long term. So if you have six counties total, right. That’s a very large service area. And as you get busier again, you can begin hiring help to see patients for you.
00:31:47:01 – 00:32:05:19
Unknown
You do that multiple times and before you know it, you have a very large wounded foot care clinic that has, you know, you may need another nurse practitioner or a couple of friends or something. And before you know it, your business is sitting there making your $500,000 a year and you’re not really having to do much other than just overseeing it.
00:32:05:21 – 00:32:30:13
Unknown
Okay. Yeah. So think that way. If you want to be an entrepreneur. Yeah, I think that way if you’re just content being self-employed, then, okay, there’s nothing wrong with that. You work four days a week, probably make $250,000 a year, be your own boss and that’s it. Like that’s fine. Do a lot of employees do that? And it’s not whatever, but what you want to do?
00:32:30:13 – 00:33:00:19
Unknown
Find something wrong with that. So I’ve been working for someone now so. Okay. Any other questions about service area or patient acquisition? No, not about the service area. I do have a question. So I’ve thought about adding a little bit of cash base the PCP I have that, she’s really want to refer some foot care to me or patients that, like, insurance isn’t going to pay for.
00:33:00:19 – 00:33:28:04
Unknown
So they may be diabetic, but they don’t have all the things. They don’t have peripheral artery disease, or they don’t have, you know, neuropathy, amputation, anything like that. So I’ve thought about add in like a cash base model to that. And then offering maybe some other things to go along with it, like pressure mapping or I don’t know, red light therapy.
00:33:28:04 – 00:34:02:19
Unknown
I don’t know different things. I don’t know, given my, key. Like there’s going to be older population that’s going to be probably more, I mean, they’re living on a, fixed income probably. I don’t know how worth that it is going to be. Well, yeah. I mean, most people on a fixed income on, you know, who are completely rely on Medicare, you know, who make, you know, $1,800 a month in Social Security.
00:34:03:01 – 00:34:26:01
Unknown
You know, I mean, these people aren’t they don’t have anything to spend where they live on a very, very tight budget. And that’s kind of their life. Right? Or so what happens when you don’t save and invest money, unfortunately. And that’s the case for the majority of people. The average person retires with A41K balance and about $200,000. Think shit going to do nothing for you, right?
00:34:26:03 – 00:34:57:06
Unknown
They rely completely on Social Security. So that’s the majority of your patients. Yeah. So a cash based option is probably not going to hit very well. Now there are always people who have money okay. There are always going to be retirees out there who do have money okay. They did it right. Therefore one KS $2 million. You know, they saved a lot of money, their house paid off, etc. they have money and they know how they spend it on because they’re old and they can’t do anything.
00:34:57:08 – 00:35:21:00
Unknown
So they will spend it on whatever it is to make them feel better. Okay. So so yes, it can work. I would just not expect it to be any kind of significant revenue source for your business. It is more of just an accessory add on service that is going to be targeted. Unfortunately, two more of the, you know, wealthier people.
00:35:21:00 – 00:35:45:06
Unknown
It’s just that’s life, you know, might not be fair, but it is what it is. So so yeah, you could do that. I mean, why not give it a try? You know, my and red light devices by, you know, I don’t know whatever, whatever that is PRP or regenerative medicine stuff. You know, there’s all kinds of other things, I suppose, that you could use for this.
00:35:45:06 – 00:36:17:04
Unknown
Peptides. You know, giving someone, BPC 157 or a growth hormone peptide or something like that probably would help facilitate, you know, wound healing. Yeah. So, so, yeah, give it a try. Listen, on your website, you know, and when you go out to do the initial evaluation on patients, you will know who has money and who does it, because I did home health for a couple of years to as an RA, because I got sick and tired of the e.R.
00:36:17:07 – 00:36:35:11
Unknown
Like I got kind of sick and tired of that after a while. So I was like, I want something that’s laid back. I can make my own schedule. I go to nap school. So I worked home health for about two years when I was going to NB school. Great job. Isn’t like they anyones listening to this. Being a home health R.N. is a great job.
00:36:35:13 – 00:36:50:22
Unknown
It’s your own schedule. You kind of just get like they don’t care when you see the patients as long as they’re seen right? Like you get paid, you get paid production. So if you work your ass off, you can see a lot of people and get paid for it like it’s a and it teaches you how to be independent, you know?
00:36:51:00 – 00:37:13:22
Unknown
So, but you know, just as I do when you’re a home health when I was in home health, when you pull up someone’s house, you know, if they have money and you know, if they don’t. So when you do the initial migration, you can you can probably sense the room here and determine, okay, maybe this is someone I could sell them on these things, you know what I mean?
00:37:14:00 – 00:37:33:16
Unknown
And, you know, basically no, no, no, don’t try to be sleazy about it, but you just hand them a, you know, a pamphlet or a brochure or something and be like, just at why I do provide these alternative methods that insurance does not cover. But I’ve seen great results with you can list some peptides, red light, whatever it is that you want to integrate into your practice for it.
00:37:33:18 – 00:37:52:05
Unknown
They take it, they take it, they don’t, they don’t whatever, you know. But you go into a single wide trailer where the floor is saturated with dog piss and they’re sitting there on the couch like, I would not give them that brochure. Yeah, I’m not going to go well. Right. Yeah, I’m sure you can. You see those houses as a home health nurse?
00:37:52:05 – 00:38:18:00
Unknown
I’m sure a lot, unfortunately. Yeah. Yeah, I have to. It’s just you. How do you live? I don’t understand someone looks like that, but whatever. Yeah. So that’s how I would approach that. Okay. And listen, on your website. Do you know why not? But that’s how I would approach it. I would be have to be one of those things where someone is probably not going to be deliberately looking for that service, that cash based service.
00:38:18:00 – 00:38:38:07
Unknown
They’re going to be looking for it. You just sell it to them. When you go in for the initial evaluation, you can still bill you can still bill Medicaid for the general wound care. But Medicare does not cover these other services. So you don’t have to worry about the whole, you know, am I charging cash for a service, Medicare covers, etc.?
00:38:38:07 – 00:39:12:10
Unknown
You know, like you don’t have to worry about that because Medicare doesn’t cover BPC 157. They’re just not going to and they probably never will. Right? So yeah, well any questions there. No, no I think that’s that’s good. And that makes sense. Yeah. Yeah. My last question is, so, obviously I do have to work, full time in urgent care.
00:39:12:12 – 00:39:45:18
Unknown
When do, either transition to prison, like, is it after I’ve been working to, like, full two days a week in my business for several months, or, like, I don’t want to miss my opportunity on growing my business because I’m working full time. Right. That is a hard decision. And it is a hard thing to, I guess, develop a rule for.
00:39:45:20 – 00:40:24:13
Unknown
Okay, that is probably one of the hardest decisions most nurse practitioner business owners and honestly, just really any business owner will make. When do I leave my full time job to focus 20% of my business, right. It’s a stressful decision because you’re giving up. You’re giving up the security of this job and the benefits and the predictable check to something that is not predictable, that doesn’t have benefits, but has the potential of paying you a hell of a lot more money than that job ever will.
00:40:24:15 – 00:40:53:08
Unknown
Right? So there’s some pros and cons here, right? So, to make that decision, I feel like the way I kind of put it is, is that if your business is generating enough money to comfortably cover your living expenses, but you’re losing a little frugally. Okay, so frugal living expenses. Now we’re not going to go on vacation for six months.
00:40:53:10 – 00:41:10:19
Unknown
I’m not going to buy a new car. I’m not going to buy a new TV. We’re kind of just live very frugally, you know what I mean? For the next six months, if the if, if your business is generating that kind of money that allows you to do that, then it’s probably a worthwhile decision to consider leaving your job.
00:41:10:21 – 00:41:35:01
Unknown
And that way you can then focus on your business, because I’ll tell you what will happen is that once you give up your business, I mean, why don’t you give up the job that you’re working in game. Once you give that up, you realize for the first time in your life how much energy and time you were giving away for that job.
00:41:35:03 – 00:42:00:18
Unknown
And once you quit, you now have all this extra energy and this extra time to now focus on your business and honestly focus on your family and stuff right? So it is it’s it’s a great feeling once it happens. And so when that happens, then you’ll be able to focus on your business and put the time and energy into your business where it will grow.
00:42:00:20 – 00:42:17:04
Unknown
So when you quit, I bet you in 2 or 3 months you won’t have to live frugally anymore. You can go back to living the way you were living before, because now you put the time and energy in your business that you didn’t have before. Now you have the capacity to see more patience. Now you have the capacity to work on the business versus just in it.
00:42:17:06 – 00:42:35:07
Unknown
And you’d be really surprised what could happen. I’ve never heard from someone ever before, like I’ve never heard from someone who quit their job and focused on their business, and their business declined. And like, like like it declined or failed. I’ve never heard that before. I’ve only heard from people who quit their job and focus on their business.
00:42:35:07 – 00:42:56:02
Unknown
Their business grows. That’s all I’ve ever heard and I’ve never heard anyone say they regretted quitting their job. Never heard that before. One thing I hear is that I regret not quitting my job earlier. That’s what I hear. Unknown. So? So that’s just kind of a rule of thumb, okay? If it’s paying enough for you to live frugally for, you know, frugally, then cool.
00:42:56:02 – 00:43:22:12
Unknown
Go with it all right. And this is the reason why you should have this. The reason why you should build some sort of a nest egg for yourself. An emergency fund. You know, you can build six months of living expenses and keep that in the bank. Then if for some reason the business did decline, if it did decrease, you still have that buffer there for you to get, you know, to weather you through a slow month or something.
00:43:22:14 – 00:43:48:21
Unknown
Okay. Yeah. Another way, another thing that you could do as well is you can get to the point where you’re like, you know, okay, my business is generating enough for me to live frugally, but I don’t want to live frugally. I just want another day or two to focus on my business. So in that regard, and this is what I did when in that regard, you drop down from full time to part time or just PRM.
00:43:48:23 – 00:44:06:16
Unknown
Okay. So what I was doing by the time I almost by the time I quit the urgent care, I was working one day a week, I was working on Mondays. That was it. I didn’t work any other day. Just Mondays, I’d say I work. I work the busiest day of the week because I’m still getting paid production. I work the busiest day of the week, but I’m going to do one day a week.
00:44:06:16 – 00:44:24:00
Unknown
It’s all I’m going to do. And they’re like, okay, so I did one 12 hour shift on a Monday and that’s all I did. I did that for about a year before I finally just, you know, before I quit. So. So you could do that as well for a buffer. Yeah. I thought of doing that. Of course, where I work, you would.
00:44:24:00 – 00:44:48:11
Unknown
I would have to give a three months notice. So I have to still kind of plan it at the right time. If I want to go in, I’ll have to plan it to where I can go in in three months. Right? Yeah. There just, you know how it is. Like they like to control everything. So, I’ve tried to decide, like, when is going to be the right time to do that.
00:44:48:12 – 00:45:10:02
Unknown
Because I don’t want to be. I don’t care forever. No, that’s Burnout City. You can’t do that. You can’t predict when that time is going to be. Okay. You have no clue. It could be. Let’s just say you be in credentialing today. You get a credential three months from now, okay? It’ll take you another three months to start getting some decent business.
00:45:10:02 – 00:45:29:00
Unknown
Okay. So let’s just say as an example, let’s just say six months from now, right? You actually could be in a position where you’re like, you know what? This this business has gotten a lot better than I expected. I’m going to give these people three months. That could happen. Okay. It could be a year from now. Yes. You have no idea.
00:45:29:00 – 00:45:45:18
Unknown
You will know when the time comes, but you just don’t know when that time is. All right. Yeah. So you will know. You trust me. You’ll know. You’ll know when patients are calling you the term. And you have to turn them away because you don’t have any more days. Or you will know when you’re like, shit, I don’t want to give up this business.
00:45:45:20 – 00:45:49:22
Unknown
I’m going to start seeing patients on Saturdays.
00:45:50:00 – 00:46:05:18
Unknown
It’s a short term sacrifice for a couple months to see you get that business or you know what I mean? I had to do that. A lot of people had to do that. A lot of people had done that work evenings that work evenings, work weekends don’t want to give away business, you know, so you just have to do that for a little while, bite the bullet.
00:46:05:18 – 00:46:25:15
Unknown
But the good news is that only lasts for a few months. You know, maybe six tops. So? So you’ll know when you’re starting to do that and you’re busy and you’re like, Holy shit, this thing is making, you know, maybe $10,000 a month. Like, I’m actually making some decent money now, and I’m having to work weekends now. I’m having to like, this sucks, but that’s the time you like.
00:46:25:15 – 00:46:42:22
Unknown
You know what? I put my three months in, I’ll just work one day a week. And that one day week, it’s going to be enough for you to probably, you know, pay half your bills or whatever, right? Yeah. Yeah, yeah. So trust me, it’s a good feeling. Know when you quit that urgent care?
00:46:43:00 – 00:47:02:20
Unknown
I’m ready. I wish it was already here, but, you know. Yeah. Just patiently waiting right now. Patiently waiting. It’s a good day when you quit, I’ll tell you like I remember. I know I’ve told this story before, but I know I’ll just tell it again. On my last day of the urgent care. Do you have you have you heard this story before?
00:47:03:02 – 00:47:20:21
Unknown
I don’t think so. Another podcast or anything. Okay. All right. So. So the last day, the urgent care job I was working at. Okay. So I had a lead in my men’s health care clinic, my medical cannabis clinic. Like, I didn’t need the urgent care income anymore. I don’t even know why the hell is even still doing it.
00:47:20:23 – 00:47:41:10
Unknown
Like, I really don’t. I don’t know why I was still there. And so, so anyway, so I went into my manager’s office and I was like, I’m giving you my 30 day notice. And she was like, well, you had to give us. I think it was like six months or something at six month notice to quit, I think, I think it was it was 3 or 6 months.
00:47:41:12 – 00:48:04:12
Unknown
And, I was like, well, I’m giving you 30 days. She was like, well, you you’ll be un hirable with Hospital Corporation of America for the rest of your life. Okay? I don’t give a shit what care. I don’t plan on ever coming back. So I really don’t care about money if I’m un hirable nationwide through HCA, whatever.
00:48:04:14 – 00:48:28:04
Unknown
So they’re my 30 days, and, it’s the last day, right? The very, very last day. This was like at the end of February. I think it was kind of a slower day. I don’t know, the flu must have ended or something, but like it was kind of a it was a slower day. And I remember looking at the clock that we worked 8 to 8 and we were looking at the clock and being like, where are you?
00:48:28:04 – 00:48:45:08
Unknown
Get the hell out of here. I’m so sick of this. It’s like 5:00 came around and I was like, you know what? I’m done. I’m done. I don’t I don’t want to finish these last three hours. I don’t have it in me. So like, I walk up to the front desk and I was like, closes doors. They’re like, what?
00:48:45:08 – 00:49:04:20
Unknown
I was like, closes doors, lock them up, I’m leaving. And they were like, well, we would want a provider here. I was like, don’t worry about it. I’ll take the fall. Guys, you can’t work if there’s not a provider here, right? They’re like, yeah, well, like, so close the doors, lock them up. I’m taking everyone in the brewery to go.
00:49:04:22 – 00:49:23:19
Unknown
So I just closed the doors. I just closed the doors at 5:00 to everyone over this brewery that was like, you know, five mile down the street or something like that. We all just drank beer. And, you know, I bought everyone dinner or whatever. And, yeah. So I guess someone called the corporate office or someone I don’t know.
00:49:23:19 – 00:49:44:13
Unknown
I don’t know if a patient showed up and it was closed or whatever. And, so I guess they, you know, they call corporate, they call the hospital or something, and then like the regional, the director of outpatient services or something like call me on the phone and was like, Justin, we closed at eight. I was like, okay, well, today was my last day.
00:49:44:13 – 00:50:03:10
Unknown
I don’t care. We closed at eight. I was like, okay. She was like, so we’re gonna have to make, you know, probably have to hold your bonus for this quarter. I was like, you can keep the $700. I just hung up the phone. So, Yeah, it was a fantastic feeling by one of the best days of my life.
00:50:03:10 – 00:50:08:16
Unknown
So hopefully you’ll experience something like that. Yes, I hope so.
00:50:08:18 – 00:50:27:03
Unknown
So, yeah. Just keep. You got it. I’m an insurance based wound care. Foot care clinic has the potential of making some decent money, so I feel like you can really turn this into something that’s very profitable. And, you know, you can pivot from it to, you know, maybe you want to integrate a little primary care into it or something later on.
00:50:27:03 – 00:50:52:20
Unknown
I mean, there’s so many different options you can do. So, so anyways, you have any any other questions? No, I think that was it. Okay. So, like to end the episode with you asking me a question, you have a question for me, like a personal question or a curiosity? Yeah. Did, did you always know you was going to, like, be an entrepreneur, or did you just kind of get tired of the healthcare system and decide to like, say, fuck it?
00:50:52:20 – 00:51:20:16
Unknown
And I’m done? Okay. Honestly, no, not really. I, I mean, I didn’t go into B-School knowing I was going to open up my own practice. It really never crossed my mind to be honest with you. I mean, I’ve always had an entrepreneurial spirit, you know, I’ve always done some little side things and stuff, but I never went into it thinking I was going to start my own practice and so what happened was it was some time and I think it was like 2015 or 2016 or something.
00:51:20:18 – 00:51:38:06
Unknown
I had a, a friend who was an MD and, he worked in the E.R. he was in E.R., doc he was older guy I think it was like mid 50s, early 60s or something. And, we would go fly fishing together. We go float down the river in East Tennessee and, so we go. We go float.
00:51:38:08 – 00:51:54:04
Unknown
Float, fly, fish or whatever. And he owned a lot of he owned a lot of clinics. And he was the one who sparked the idea in my mind about opening up a practice because he was telling you how much money he was making in these practices that he owned. And I’m like, why do you work in the E.R.?
00:51:54:06 – 00:52:11:10
Unknown
And he was just like, I don’t know, I have nothing else to do. I’m like, okay. So he sparked the idea in my mind. And so at that point, a year later, I said, when I started my first practice, so he kind of sparked the idea for me. And then I caught the bug. I just never was going to go back.
00:52:11:10 – 00:52:37:01
Unknown
Like, Felicia, when you when you start your business. Okay. And the first month or two when you see the amount of money that you made, Freeman of hours you put into it, you will catch that bug. You will never go back. You’re just you just won’t because you’ll finally realize what it’s like to actually get paid what you’re worth and actually get paid what you produce.
00:52:37:03 – 00:52:52:19
Unknown
So for the first time in your life, you will see this and you’ll just be like, like the curtain is just raised, you know, from, you know, from your eyes. It’s just it’s just rays. You can finally see the light and you’ll just be like, I’m never I’m never gonna go back to that ever again. I’m gonna. I’m gonna focus on this.
00:52:52:21 – 00:53:12:22
Unknown
That’s what happened to me. I remember the first, you know, first month or two of my business. I remember just looking at the bank account, just being like, man, whoa. I’ve made a lot of money for how much hours I put into this. Like, this is insane to me. You know, I think the first day I ever did medical cannabis evaluations, that was really my first business where I was actually making some good money.
00:53:13:00 – 00:53:30:22
Unknown
I’ll do the medical cannabis evaluations. And I remember the. I remember the first day I did it, I went to, I went to a 420 event. So there was this 420 festival or something. Right. And so someone was like, do you set up a tent there? Do you medical cannabis evaluations, like you can make a lot of money.
00:53:30:22 – 00:53:51:15
Unknown
I was like, really? He was there. Like, yeah, I was like, all right, fuck it, I’ll do it. So I rented a tent at this for 20 festivals on April 20th, and it was just bunch of like dispensaries were had tents, people were selling CBD and all this kind of stuff, you know, Rastafarian and tie dye shirts and just shit like that.
00:53:51:17 – 00:54:10:12
Unknown
And I had this tent. I just put a little sign that said medical cannabis valuations. And like, I’m not joking you. In six hours I made $3,000 cash and I was just like, whoa, I’m never picking up an extra shift in the air or the urgent care ever again in my entire life. So like, that’s how it hit me.
00:54:10:12 – 00:54:29:15
Unknown
So, so I hope that’ll happen to you. You know, you go out, work eight hours, you’ll be like, damn, I made $2,000 named Billings. Like, I hope that happens for you. Probably will. Yes. Yeah, that’s what I’m hoping for. Yeah. No, I think it will. Okay. Cool. Any other questions? Nope. That’s it. Cool. All right, I appreciate you.
00:54:29:16 – 00:54:48:20
Unknown
I want to do a follow up. Let me know. Okay? Okay. Thank you. Take care. Bye. Thank you for listening to the show. The legal disclaimer the content of this podcast is meant for informational and entertainment purposes only, and should not be used as legal, financial, medical, regulatory, or practice. Specific advice for information pertaining to your specific legal, financial, medical, or practice specific needs.
00:54:48:20 – 00:55:06:10
Unknown
Please be sure to consult with your lawyer, CPA, medical director, and or your state’s practice laws and the most up to date clinical guidelines. As always, do your due diligence when it comes to any other information found online in podcast. The content in this podcast is copyrighted by Galaxie Medical Southwest 2023, and it cannot be duplicated, rebroadcast it, or reproduced without our written permission.
