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“You can get past the dead end. You can break through the ceiling. I did and so have countless others.”

When Do You Need an Employee?

Vacancy Hiring Help Wanted Sign  - mohamed_hassan / Pixabay

I get asked quite often “when do I need to hire an employee?” or “I am so stressed-out juggling everything in my business, what do I do?” These are basically the same question asked a different way. If you are following The Elite Nurse Practitioner Model, hopefully you have or are in the process of starting a part-time niche side practice that accepts cash only. If you want to accept insurance, then so be it, just be aware of the challenges associated with it. The part-time niche side practice can be done 100% solo when you first get started. This is great because it will keep your expenses down as you will not need to hire out help. This way, you can test the waters to make sure the niche side practice idea will actually be feasible. Remember, throw the fishing line out and see what bites!

Regardless, if your practice begins to get busier and starts to turn a profit, you know you have stumbled upon something with long term potential. You can continue to work by yourself for a period of time, but there will be a point that you will need to hire help, or you will suffer from the dreaded overload paralysis.

I have been there… Trust me… You don’t want to experience it.

For this reason, you need to know when it is time to hire out help! But if you can get away with avoiding employees entirely, then do so. Employees increase the complexity of your business. You must deal with workman’s comp, employment regulations, EMPLOYMENT TAXES, drama, and other BS that comes along with having employees…

The truth of the matter though, is that if you want to SCALE your business and begin having it WORK FOR YOU and develop a passive income stream, then you will need to hire out help. If you are content with doing some concierge men’s health or weight loss visits in patients homes or via telemedicine and working solo, then more power to you, but you will reach a ceiling in your business.

So, when is it time to hire out some help?

Basically, when you are starting to pull out your hair from the stress and workload!

In other terms, it is time to hire an employee to help you if you meet ANY of the following conditions:

  1. Your part-time practice is becoming more of a full-time practice because you are spending all your time on BUSY WORK vs. INCOME GENERATING WORK.
  2. Your anxiety and stress levels have increased since starting your business to the point where it is affecting your quality of life. Remember, your quality of life should IMPROVE from your business.
  3. You are beginning to make mistakes in your practice such as forgetting about appointments, paying bills, charting, etc.… Yes, this is okay occasionally, but once you begin to forget important tasks on a regular basis, it is becoming problematic.
  4. The quality of the care you are providing is beginning to decrease because your mind is “elsewhere” during visits thinking about business related topics vs. the care at hand.
  5. You are getting to the point that you want to scale/grow your practice so it can become a passive income stream that works for you. For this to happen, you really need to offload work onto others.
  6. You begin to see your business as more of a tedious job that you are now dreading instead of loving because of the workload.

These are the top six reasons for hiring an employee. If one or more of these conditions is being met in your entrepreneurial life, you really need to consider hiring an employee.

The employee you hire can be strictly part-time at first. This person can be a standard receptionist, medical assistance, LPN, or even an RN. It all depends on what type of business you are running. You would only need an LPN/RN for an IV infusion or Ketamine Clinic in most instances so they can assist with the infusions. For the most part though, a standard medical assistant is more than sufficient for part-time help. They can check patients in, administer injections (in most states), answer phone calls, schedule appointments, etc.… Essentially, this individual will be doing all the BUSY work in your practice so you can focus on INCOME GENERATING work. That is how you make money folks.

Let me give you my personal experience with hiring an employee

My medical cannabis clinic was operated 100% by myself for the first 1.5 years. I answered the phones, scheduled appointments, and even saw the patients in my office by myself 90% of the time. If I knew it was going to be a busy day, I had a friend come help me, otherwise, I did this by myself. Was it a pain in the ass? Your damn right it was, but it allowed me to keep my expenses significantly low. What did this result in? The ability to REINVEST all of my business revenue into my Men’s Health practice, real estate, The Elite NP, and my telemedicine practice I sold. This hard work allowed me to stay DEBT FREE. Which is critical! I eventually needed to hire help as we become busier, more on this with my Men’s Health example.

When I started my Men’s Health practice, I knew that I was going to need part-time help from the get-go. I knew I couldn’t operate two practices simultaneously by myself! That would be impossible, and I would ultimately meet all of the 6 reasons I outlined earlier. So, I hired a part-time medical assistant to help me when we first opened. I only paid this guy for 20-30 hours a week for the first 2-3 months, but he was cool with that. Additionally, I made him come to my medical cannabis clinic on Friday mornings to help me with patients. You could say he was my sidekick, but the help he provided me was INVALUABLE. He is one of the predominant reasons why I was able to scale and grow both businesses. I continued answering the phone for my medical cannabis clinic though!

Fast forward over 2 years later, and I now have 3 full-time employees and a part-time NP. When I had my telemedicine practice, I had MULTIPLE part-time NPs working for me. Utilizing these employees has been absolutely pivotal to the growth of my businesses. I am now hiring another NP for my 2nd men’s health practice to help me grow it.

Remember, when you are first getting started, you can TOTALLY operate your practice on your own. A small part-time niche cash practice can easily be ran by a single NP.

Will it be stressful? Yes…

Will it be a lot of work? Yes…

Will you want to pull your hair out at times? Yes…

BUT! You will save a lot of money by doing it yourself until the practice gains enough steam to go on autopilot. Then once one of the 6 conditions outlined earlier happens, you better be posting an ad on Craigslist, FB Marketplace, or Indeed for some help! As soon as that part-time employee begins to take the workload off you, you will catch a new breath of air and begin to work ON your business vs. IN your business! That is when the real success begins to occur…

2 Responses

  1. Your weekly blogs always seem to be so timely for me! I feel.it may be getting close to time to hire some help. How do I figure out the legalities I need to navigate in order to hire a nurse, or even another NP?

    1. Most states don’t have any special requirements. If you can hire them as a 1099 contractor, do so as that will save you a tremendous amount on employment taxes. I believe you are in KY, so check out 1099/contractor regulations in that state. If they are fairly liberal/open, and I suspect they are, then just hire the LPN as a contractor to come assist you from time to time. If you are hiring a W2 employee, you will need workmans comp and you will need your CPA to help set up all of that. Just talk with your CPA, they are very knowledgeable about this type of thing!

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