Seasonal Differences with Patient Volume in the Nurse Practitioner Business

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Many nurse practitioner entrepreneurs become “anxious” during the first 1-3 years of opening a practice when patient volume DECREASES one month. This is the typical scenario:

You are cruising along, and each month gets better and better. You see your patient volume steadily increase and you also see the practices revenue increase. It is a fantastic feeling! Mustering the courage to take a small risk opening a practice and your hard work is FINALLY paying off. And then BAM! One month the numbers go down… Maybe the next month the numbers are down again. What is happening? You begin asking yourself questions like:

“Is my business failing now?”

“Are my patients going to another practice?”

“Did the patients not like the care I was receiving?”

Essentially, you begin to psyche yourself out!

LISTEN: Don’t stress out when volume goes down… IT HAPPENS and often times it is nothing more than a seasonal variable.

Patient volume will fluctuate month to month and season to season. Welcome to human nature and the reality of entrepreneurism. To this DAY I still psyche myself out when I see patient numbers and revenue decrease at my men’s health practices and my medical cannabis clinic. After doing this for multiple years now, I have realized that it usually comes down to the season. I have consulted with hundreds of nurse practitioners and the same phenomenon occurs with their practices as well. Therefore, this is a normal occurrence.

In general, people follow the same trends and behaviors. Most humans have a “herd” like mentality and follow the herds of what other people are doing. Because of this, human behavior can be predicted. When it comes down to operating a niche practice, you should understand this behavior when it comes to patient volume and practice revenue as it will save yourself from a considerable amount of anxiety.

So, let’s sum up seasonal differences with various practice types. Before we do this though, the definition of “major holidays” encompasses Thanksgiving, Christmas, New Years, Memorial Day, and July 4th.

  1. IV-Infusion clinics: You can typically see a small decline in patient volume before major holidays but see an upswing immediately afterwards as people will be suffering from hangovers and want to feel better. Additionally, you will see large upswings in patient volume during “illness” seasons like cough/cold season and influenza season as people will want immune boosting infusions. With COVID, you will see similar fluctuations in volume. Overall though, IV-Infusion clinics should have a fairly stable patient volume and monthly revenue.
  2. Weight loss clinics: You will typically see a decline in patient volume around the holidays as people are enjoying time with their families and spending money elsewhere. You will also see declines around school events (beginning of school, spring breaks, etc.). You will see a LARGE influx in patients at the beginning of the year for all the “New Years Resolution” folks and spikes in volume scattered throughout the year depending on certain seasons. You will see large influxes of patients during times where weddings are popular and also in the spring to get ready for that “summer body.” Overall, you should have a fairly consistent volume of patients.
  3. HRT practices: Pretty much the same as the weight loss clinic. Expect declines in patient volume around the holidays and around school events (beginning of school, spring breaks, etc.) as people are too busy with life to worry about their health. My men’s health practice ALWAYS sees a decline in patient volume in November and December, but we see a large influx of new patients in January and also before summer.
  4. Aesthetics: Like the weight loss clinic. You should have a fairly consistent patient volume throughout the year but expect declines around the holidays and an upswing at the beginning of the year.
  5. General wellness practices: Essentially expect declines around major holidays and upswings during the beginning of the year, in the spring, and around certain seasonal events such as weddings, marathons, and so forth that revolve around looking and feeling good.
  6. Primary/Specialty care: Pretty consistent around the year with small declines around the holidays.
  7. Urgent care: This one is pretty much the OPPOSITE of the wellness practices. You will get utterly SLAMMED during fall/winter and around the holidays as that is the peak of cough/cold/flu season. You will also see declines in patient volume in late spring and during the summer. Summertime is one of the slowest times of year for urgent cares. It is one of its saving graces…
  8. Opioid addiction: Pretty consistent around the year with small declines around the holidays.
  9. Coaching/Consulting: Similar to the weight loss/wellness clinic trends. It is DEFINITELY slower during the holidays as people are using their money on gifts/family time and do not have discretionary spending for coaching.

These are general trends within outpatient care that I have noted personally and from hundreds of nurse practitioners I have talked with over the past 2-3 years. There will ALWAYS be variations in terms of patient volume depending on your regional demographics and economics. For example, I know a nurse practitioner with a men’s health clinic that is absolutely KILLING it right now during the holidays, whereas my clinic has slowed down by 10-20%. Therefore, the trends I noted should not be followed 100% as it will be slightly different for everyone.

The point is to highlight that patient volumes CAN and WILL decrease depending on the time of year. On the opposite side, it CAN and WILL increase depending on the time of the year as well. So, be aware of seasonal variations on “how busy” your practice will be and take appropriate measures to ensure you are going to be okay mentally and financially (emergency funds, lowering expenses, etc.) during slower times.

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