Lessons Learned From Nurse Practitioner Independent Practice

A Conversation With a Nurse Practitioner Entrepreneur

Joyce A. Hahn, PhD, RN, NEA-BC, FNAP; Wesley Cook, APRN, FNP-BC, CPSN


Nurs Econ. 2018;36(1):18-22. 

In This Article

Opportunity and the Social Contract

Joyce Hahn (JH): What led you to establish District Primary Care, LLC, as an independent nurse practitioner?

Wesley Cook (WC): I went to NP school with the intention of starting my own shop. I have always been an outlier in nursing, and I have always found employment terribly constraining. Originally, I envisioned morphing my nurse-led aesthetics consulting practice into an NP-led medical spa. Washington, DC, a frontrunner of full practice authority regulation, provides a tremendous opportunity for enterprising NPs, so it seemed a natural fit. As I waded deeper into the practice of diagnostics and therapeutics, I found elements of clinical practice that were lacking in my generalist-RN career, the very elements that took me out of bedside nursing and led me to innovate an aesthetics practice as a generalist RN: the authority to act from specialized knowledge, the opportunity to be a revenue-producer, and, most importantly, the opportunity to confront a finite problem of knowledge in an empirical way. Once I had a taste of diagnostic reasoning, I knew my original practice vision had to change. So, I developed a business that would allow me to practice diagnostically and maintain the more profitable procedural practice of aesthetics. As a business owner, I had the freedom to maintain both, so I did.