The Clinical Nurse Specialist Entrepreneur: Developing a Business Plan in Ambulatory Care.

The demand for primary care services in the United States continues to outpace the existing number of family practice physicians, with Texas projected to experience one of the highest shortages. In addition to the growing and aging general population, retiring physicians leaving the workforce will have a large impact on clinician shortages in the coming decade. A small Central Texas community was facing the potential strain of this physician shortage as a family practice physician with more than 30 years of service in private practice neared retirement. Patients under the care of the retiring physician received comprehensive care with availability of in-house services including x-ray and simple procedures, an asset to a community without a local hospital or urgent care center. Chronic disease prevalence within his patient population necessitated continuity of care upon the physician's retirement. Without it, the community's access to these comprehensive primary care services would have been negatively impacted, increasing the risk of decompensated disease states. A business plan was developed to transition this physician-owned practice into a nurse-led clinic (NLC) with a clinical nurse specialist (CNS) at the helm to maintain access to high-quality, cost-effective primary care services in the community. This article will outline essential business plan components used to guide the successful transition into a NLC model (Table).