The activity of the liberal nurses is in continual progress. This is due to many factors.
First of all, the aging of the population favors the growth of the demand for care. As a result, nurses will have more opportunities for services, particularly for the seniors’ pathology segment.
The progress of hospitalization at home multiplies the number of missions in favor of the liberal professionals, and in particular for heavy pathologies. This factor also favors the increase of professional fees because it often concerns high value added care.
In addition, the legislator organized in 2009 a considerable transfer of acts in favor of nurses. Home nursing services also help support demand.
In the end, only the numerus clausus and the volume of retirements slow down the development of the activity of the liberal nurses.
How is the liberal nursing market organized?
Professionals are gathering more and more to meet the technical needs of certain services: palliative care, dialysis for example. The nursing sector, where demand continues to grow, can be characterized in two ways.
In general, the liberal nurses are under agreement. Their actions are therefore reimbursed by the Health Insurance. These acts are classified in 2 categories.
- Nursing medical procedures are those performed on the basis of a medical prescription. These include bites, various specimens, or dressings.
- For nursing care, no prescription is necessary.
According to the mode of exploitation: the liberal nurses gather in medical practices to pool their competences and the means, in order to rationalize their activities. These professional associations are constantly growing.
Becoming a liberal nurse: the constraints
The professional holds the State Nursing Diploma. The training lasts three and a half years and takes place in a state-approved nursing school. The law also requires an experience of at least 2 years in hospital, within six years before installation in the liberal sector.
Professionals can specialize in most areas of medicine: cardiology, oncology, etc. This specialization can be done through training, and is sanctioned by a State Diploma. The law also provides for the validation of acquired professional experience. It should be noted that 87% of professionals are women.
In addition to his skills, the Liberal nurse must be particularly attentive to his patients. The activity is very demanding from both a physical and a psychological point of view. The professional must be very meticulous and vigilant, especially in respect of hygiene standards.
The nurse who has his diploma and at least 2 years of hospital experience must register at the prefecture. For this it has a period of 2 months after installation.
If he wishes to practice at home, he must make the request to the department of construction and housing of his department. The public authorities prohibit the creation of practices in saturated regions, and offer installation aids in those which lack nurses.
To be registered, the nurse must register at the Primary Health Insurance Fund.
Several texts govern the activities of nurses. The public authorities seek to limit the increase of the health expenses, also the refundable acts are framed by a ceiling since 1993. These measures are accompanied by sanctions in case of overrun. Replacements are also closely monitored.
The rates of the acts are established by the Health Insurance. Their display is mandatory.
The sector is not risky, but it requires a rigorous follow-up of the acts, in particular because of the requirements of the Health insurance. The professional must follow quantitatively the acts performed each month. At start-up this follow-up must be weekly. He must decompose these acts between those who are reimbursed and those who are not. The ceiling of the Health Insurance is 23 000 medical acts of nurses, however the volume of acts not reimbursed is free. These constitute approximately 36% of the services provided.
The rates for all acts are fixed by the Health Insurance. Nurses do not hesitate to charge their travel expenses within the limits of the legal fees.
The heaviest burdens are those represented by social contributions.
For firms located in urban areas, rents are often high.
Even if the sector is not risky, the professional will have to take into account the fact that the reimbursed acts are more profitable than the acts that are not reimbursed. In the interest of profitability, he must therefore perform as many acts as possible. He may also specialize in a segment requiring high value-added acts.
As the investments are not very high, the risk of indebtedness is low. The necessary equity is very low. On the other hand, it is essential to set up a minimum revolving fund of around 90 days of turnover, because the medical insurance organizations always put a little time to make the refunds.
The value of a patient
As part of a recovery, the patient of a nurse can be estimated at 35% of annual fees, to correct the quality of the location, the potential for development.
Financing a Liberal Nurse: Getting a Professional Credit
In this buoyant market, the most successful professionals work in partnership in nursing practices or medical facilities.
The law prohibits pure creations in certain areas defined by the texts. A new installation is then possible only at the previous stop of the activity of another professional. Public support for installation is available for other regions.
The time to build a customer base is relatively long. It takes about 3 years to reach a satisfactory cruising speed.
In order to pool their resources, more and more professionals are integrating specific structures. For this reason, civil society means is the most used modality.
This sector does not require huge investments, but owning a vehicle is often very useful. The material must be renewed on average every 7 years.
It is also possible to finance the recovery of a patentielle.