American Academy of Nurse Entrepreneurs

What are APNs really worth?!: What goes on behind closed doors

Ever wonder how much revenue you generate for your practice? If you’re not sure, do the back of the envelope math (Carolyn Buppert provides a formula in Ch. 10 of her textbook Nurse Practitioner’s Business Practice and Legal Guide):

(# of patients seen/day) x (avg reimbursement/visit) x (days worked per year) x (avg collection rate) = Total Revenue

  • Assumptions:
    • 6 weeks time off
    • Avg reimbursement $70/visit
    • Avg collection rate 90%

What if I told you the average APN generates approximately $400k annually for their practice.  Does your salary reflect this? Do you get a share of the profit? You don’t? Why not? Your physician colleagues do. Why don’t you get a seat at the table too? Perhaps your employer wanted to include you in profit-sharing, but said they couldn’t because it’s “illegal”.

The dirty truth is that APN’s operate at a historical disadvantage when negotiating compensation with physician employers. It’s commonplace for a physician employer to retain around 40-50% of revenue generated by an APN which can mean >$200k to the physician.

This model no longer makes sense for the modern NP-Physician dynamic. Today APN’s essentially work independently, and when required by state law, within the formalities of a collaborative agreement. The legal standards of collaborative agreements allow doctors to have their cake and eat it too. It gives the facade that the APN “needs” the physician (thus “justifying” the physician retaining a disproportionate share of the profits), while removing any legal liability from the physician’s practice.

Oh, and one more fun, antiquated legal loophole physicians exploit – in some states, a NP cannot legally own or share profit interests in a PA, PC or PLLC. That’s right, corporate law actually makes it illegal for you, as an APN to share in the profits of a PA, PC, or PLLC owned by a physician. The corporate laws defining medical practice business ownership were created decades ago and are illogical in today’s landscape.

APNs nationwide have fought and won battles to expand scope of practice and reduce arduous physician supervision standards that can impact APN’s earning potential.

This feudal corporate practice structure essentially keeps NPs in serfdom. Yes, you have “independence” but as long as you work for a doctor’s office you cannot share in the REAL value – owning a portion of the company’s profits.

Are you going to leave all of that hard earned money on the table, or are you going to ditch the overlord and become a Nurse Owner?

Curious as to how much revenue you’re generating for your practice? Enter your email below and download our FREE APN Revenue Calculator. Discover what you’re really contributing to your clinic and see if it matches your what you’re taking home. Check it out!


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