Your First Office: Do You Even Need One?

How to choose the right starting point for your practice

One of the biggest questions new NPs face when building an integrative or functional practice is whether to open a physical office right away. Some NPs feel excited about having a space of their own. Others feel overwhelmed at the thought of rent, utilities, and long-term leases before they’ve even seen their first patient.

The truth is: there’s no one right answer. There are multiple paths to a successful practice, and what’s “best” depends entirely on your services, your personality, your finances, and your long-term vision. This decision isn’t about what other NPs are doing—it’s about what actually works for you.

Below is a practical guide to help you understand your options and choose the setup that supports the way you want to work.

Option 1: A Traditional Brick-and-Mortar Office

A physical office can be a great fit if you:
• Offer hands-on treatments (pelvic care, functional exams, procedures, craniosacral, etc.)
• Prefer in-person relational energy
• Need dedicated clinical equipment
• Want a consistent professional space for patient trust and comfort

Things to consider:
• Leasing costs (rent, deposit, utilities)
• Furnishing and equipment
• Longer-term contracts
• Parking and accessibility
• Ensuring the space reflects the atmosphere you want to create

Who this works best for:
NPs who want structure, a grounded home base, or offer modalities that require physical presence.

Option 2: Starting Fully Telehealth

Telehealth has become a respected and effective way to launch a practice. It can also radically reduce your startup costs.

Telehealth can be ideal if you:
• Focus on functional medicine, coaching, chronic disease management, or counseling-style care
• Want to keep overhead low
• Prefer flexibility or travel
• Serve patients across a wider geography

What to consider:
• HIPAA-compliant platforms
• Sound/privacy in your home environment
• Clear communication around what can and cannot be done virtually
• State licensing and telehealth laws

Who this works best for:
NPs who value location freedom or whose services don’t require physical exams.

Option 3: A Hybrid Practice (The Middle Ground)

A hybrid model blends the best of both worlds: telehealth as the foundation with periodic in-person availability for specific visits or hands-on care.

Examples of hybrid setups:
• Renting a room by the hour
• Offering mostly telehealth with 1–2 in-office days per week
• Using a shared wellness center or cooperative space

Hybrid benefits:
• Lower overhead than a full office
• Flexibility as you grow
• Ability to adapt as your patient volume increases

Who this works best for:
NPs who want some in-person connection without the full commitment of a dedicated office.

Option 4: Renting Space Only When You Need It

A growing number of cities offer:
• Shared medical suites
• Wellness co-ops
• Hourly room rentals
• Part-time subleases in existing clinics

This is a great “test drive” option.

Pros:
• Extremely low overhead
• No long-term lease
• Lets you learn what you actually need before committing

Cons:
• Limited availability
• Less control over the environment
• Scheduling constraints

Who this works best for:
NPs who only occasionally need a physical space for specific types of visits.

Option 5: Starting Small Within an Existing Practice

Another overlooked option is subleasing a single room inside someone else’s established practice.

Examples include:
• A therapy office
• A chiropractic clinic
• A women’s health or pelvic health center
• A wellness collective

Why this can be helpful:
• Built-in community and referral connections
• Furnished space
• Much lower startup costs
• Supportive environment for newer clinicians

Who this works best for:
NPs who want community, structure, or support while they build their own patient base.

How to Know Which Option Is Right for You

Ask yourself:

1. What services will I actually offer?

2. How much financial risk am I comfortable with?

3. Do I prefer flexibility or routine?

4. What does my ideal workday look like?

5. How quickly do I want to grow?

6. What kind of environment helps me do my best work?

7. Does my long-term vision include in-person care, virtual work, or both?

Your answers matter more than trends or advice from other NPs.

The Bottom Line

Your first “office” does not define your entire practice. Many NPs start one way and evolve into another as their confidence, clarity, and patient load grow. What matters is that you choose a starting point that feels sustainable, aligned, and supportive of your goals right now.

There’s no wrong way to begin. Start where you are, use what you have, and build a practice that fits your life—not someone else’s.

Interested in support as you build your practice?

If you’re navigating these decisions—or unsure which option fits your vision—reach out to work with me. I’d love to help you build a practice that feels aligned, sustainable, and uniquely your own.