Greetings. This is just an hour of the elite nurse practitioner. Welcome to the Elite Nurse Practitioner Show podcast dedicated to nurse practitioner entrepreneurism and achieving financial freedom. Where I talk directly with nurse practitioners who need help. Listen up. Our market is saturated. Jobs can be scarce. We are underpaid. We are undervalued. We are taken advantage of by the sharks within the health care system. Frankly, screw that. Sick of it. Is time for a change. Listen, I'm here to help make that happen. We are powerful. We can forge a path. We are in control of our career and ultimately our financial and personal well-being. You do not need to submit to health care administrators and your doctor overlords. You don't have to take a measly salary. You do not have to work 50 to 60 hours a week. There is a different way, and I'm here to show you that path. This podcast is raw and unfiltered. I have not talked to the nurse practitioners in this podcast, prior to an email exchange to schedule the episode. What you're about to listen to is a consultation session between a nurse practitioner and myself. It is real. It is unscripted. It is unplanned. And I have no idea what we're going to talk about. Anything and everything can happen during our conversation. The nurse practitioners in these episodes are struggling with an issue in their professional or financial life, and they have reached out to me for help. My goal is to help nurse practitioner with actionable advice that will enhance and improve their professional business and financial life. My other goal is to hopefully help my nurse practitioner, sisters and brothers build a more productive, powerful and free life. So I hope that content and information within these podcast episodes does just that. All right, onto the episode. 

Hello everyone. Today we'll be talking to Jennifer, who is a psychiatric nurse practitioner. Currently, she is working at an outpatient clinic full time but is wanting to start her own cash based practice. She's looking to start an integrative psychiatric practice where she will provide mental health services in addition to some other niche services, such as weight loss and hormone replacement therapy to treat underlying mental health disorders, needing assistance with how to set up a subscription membership plan, how to get the business off the ground, and what is important to focus on during the start up process. Hey, Jennifer, how are you? I'm doing well. How are you? I'm doing good. Thanks for hopping on here. So let's jump in. So tell us a little about yourself, how you got a psychiatric nurse practitioner forward, what kind of things you've been doing? Yes, I've been a psych NP now for three years, primarily in outpatient psychiatry. So more general psychiatry at that did a little bit of inpatient when I was first coming out. I did private practice for one of the docs here in the Dallas Fort Worth area, did even some of the subscription base for a startup company, but it didn't last. So now I'm just in one of the major hospital systems here in the Dallas area in the outpatient clinic. Gotcha. Okay. You want to tell us what about your position? I mean, is it just just basic outpatient care to get paid? Well, can you work with that? So, yeah, they it is basic. I will say this, it's very flexible. It is state owned, so it's very flexible. I do have autonomy, a great relationship with my collaborating physician. So it is Texas. Restrictive state. More general psychiatry. General patients so than usual depression, anxiety, and bipolar. More acute because it is state. So for an outpatient, it's still pretty acute for these patients. And it is it is pretty, you know, relaxed and flexible. Like I have adequate admin time, but the pay isn't up to par, if that makes sense. Definitely. But yeah. Yeah, yeah. That seems to be the case for most nurse practitioners, unfortunately. Yeah. Okay. But, I mean, you're making a living, though. Oh, yeah. Absolutely. Yeah. How about you? Just curious. I am 30. I'm 30. No, not there. 32. So I'm also pregnant. So I've mentioned to you. So my brain on. On ten. Yeah. Yeah. Okay. So you're 32 years old, so you're pretty young. This is a this is a great time to start a business know. Yeah, yeah, yeah. I think, you know, mid thirties is really the most optimal time for, you know, for someone to start a business, especially a nurse practitioner because you know, you've lived life, you've got some wisdom behind you, you know, you've got some skills now and that sort of thing. I mean, we can start a business at any time, but, you know, the thirties seem to be a really good age for that. You still have that energy still, you know, you're still motivated and everything. So. Yeah. Okay. So you're pregnant. When are you do? Come next week. Monday, to be exact. Next week. Okay. All right. So you got about three or four days. Yes, absolutely. And I'm utilizing my maternity leave really just to focus on this, to be quite honest, like, yes, I'll be there, baby, baby, you there with me? But Mommy's got to make some moves. Sure. Yeah. Yeah. Well, I mean, they mostly just sleep and sleep, eat and hope the first month anyway, right? Yeah. Okay. Okay, cool. Deal. So you're wanting to get this up and running now, I'm assuming by about three months for now. Absolutely. Yeah, about three or four months. Okay. Okay. Yeah. We were recording this August 20, 2023, so hopefully you'll be up and running before before the year ends. Yes. Yeah. Okay, cool. Deal. All right. So what are you wanting to do? So I want to honestly continue to do really a holistic approach. That's really my thing because psychiatry, I mean, it really does have a bad rep. As NPs, we really are prescribers. Sometimes they don't even call for sure. You could just prescribe it because it's all we do and that's how we generate money for whatever the organization we work for. But my always approach is just to leaf more so conservatively. If you don't need the med, we don't need the Med. Let's get down to the nitty gritty. There's some core, is there some therapy, supplementation, sleep. So I really want to really hone in on more holistic offer meds, of course, diet, exercise. Let's just look at your lifestyle. So that's really if I was to have a niche is holistic psychiatry and kind of go from there to more of a integrative psych practice. Yes, most definitely. Yeah. Yeah. Okay. So doing some, I hope, replacement therapy, some weight loss, maybe some functional medicine based kind of absolute things. Yeah. Yeah. Okay. Not just med management. You're going to try to figure out the underlying issue of the mental health problem. Yes. That and actually bring the person back to the whole. Yeah. Versus just pushing and depressants for the rest of their life. Yeah. Yeah. No, I'm all about that. Okay, cool. Deal. So what things have you done so far? Where you at? So really finally just keeping came up with a name the other day. So now that I have the name, with Texas. We have to register with PPOC. So trying to get that off the ground, I'm coming across. What do I do now with the address? Because now with the whole COVID and restrictions being lifted, I don't know if the DEA even allows virtual addresses anymore and in trying to find an office space, because I would prefer to be virtual, but it looks like I'm going to have to probably sublease the office space just so I can do like a Google listing. So that's where I'm at. Yeah. You know, I really feel like hybrid practices are probably one of the better models. You know, telemedicine only works. Okay, don't get me wrong, it does. You know, brick and mortar only works, too. But I mean, I really feel like the hybrid practice is probably the best model. You know, having a physical location, there's multiple benefits to it. You know, like you said, having that Google business listing is I mean, it just so important. I mean, you know, think to yourself here, there's always going to be patients looking for you, right? And if you don't have a Google business listing, it's it's hard for people to find you, you know, like it'd be like back in the day, you know, 30 years ago or whatever, not being in the phone book and having a business like how to help people find you that. Yeah, right. So it's the same thing is today. It's I mean, you could have SEO on your website, you could do all of this stuff and hope that people find you just do a Google search. But Google prioritizes the local businesses and therefore the Google business listings in the local area will come up first in washing out worst. Okay. Okay. So, you know, that's yeah, it's just it makes your business a little easier, you know, it puts it on a little bit of an easy mode for people to find you. And so, yeah, so think to yourself here, consider your Google business listing. You know, you consider your physical location just part of your marketing budget. That's how I can award it for people who are on the fence about it. Okay. Okay. You don't need anything crazy here, especially for a little psych practice. I mean, you get away with a couple of hundred square feet, you know, like you don't need much, like a couple offices, like, like a little reception area and an office in a bathroom. What else do you need, really? You know. Yeah. If even that. If even that, you know, like you don't even. Right. This could be such a simple thing, right? So you'll keep that in mind. I know that you said you're in the Dallas area and I know some commercial real estate stuff is probably a little expensive in that area. But I mean, I'm sure like buying something. So would you because I know listening to your other podcast you've been a big. Proponent of small towns and me being in Dallas does obviously so many patients. Would you advise me maybe getting a, you know, a space in like a small town outside of Dallas and kind of target that area? Yeah, I would. I mean, it depends on I guess it depends a bit on your competition, too. There's a lot of NPs out here. Everyone has a private practice these days. But Dallas is big Texas. That in general is big. So. Right, right, right. I know. I drove across it just last month. To me, forever is a big state. It's like it's completely different, like the east side of Texas versus the west side of Texas. Night and day. Night and day. Yeah, it's crazy anyways, though, you know, I guess it just depends on the competition for integrative psych practice. You know, if there's not a whole lot of competition, there isn't. Okay, then you might do well, just staying in Dallas or maybe just being in a suburb of it. Okay. Okay. And I would just make sure to name your practice whatever integrated mental health or integrative psych practice or something. Make sure you put that name in it because patients are looking for that who are interested in that. You know, I mean, some people just want their Xanax in there and their Zoloft or whatever. Right. But a lot of patients would like to have a little bit more of a holistic approach. And so, you know, especially cash based one. So. So I would definitely make sure that your name includes integrated mental health or functional, you know, functional medicine, you know, mental health something and, you know, a play on words with that to make sure that people can easily find you for that. Okay. So bad that in the actual name. Okay I would well at least put it in your Google business listing. Okay. Okay, whatever. Whatever. Integrated mental health. Okay. Okay. That your punch line could be something like, you know, not just treating you with a medication, you know, treating you as, you know, fighting the root cause, you know holistic approach, blah, blah, blah, stuff like that. Okay, perfect. Yeah. But yeah, that's what I would do. But make sure you do some, you know, they should do some research here, you know, see what your competition's like in the area and definitely go somewhere where there isn't as much competition and definitely go somewhere that might have a little bit more disposable income. So I wouldn't pick up, you know, a poor area. I would pick more of a, you know, up and coming kind of suburb in the Dallas area. You know, 30 minutes to an hour from you. I mean, you know, it's not really that big of a deal to drive. I only be there a few days a week anyways. Okay. Okay. So you're saying for the Google listing, get like a sublease somewhere in like more of a fluid town or area? I would. Yeah. Okay. This is cash based, you know. Yep. Yeah, yeah. I'm quite a bit about that. Yeah. We have quite a bit of them here. Yeah. So yeah, that's kind of what I would do. Okay. Perfect. Yeah, I think I do increase your chances of success. What's your. What's your startup budget like? Luckily, we save more than we spend. So ideally, I'd like not to exceed 5000 starting off. But, hey, at the end of the day, it's an investment. So I'll go up to as far as I need. But ideally if I can cut, get everything started off and running with 5000 or less would be ideal. Yeah. Yeah. That's going to be on the lower end of the budget. Yeah. I mean I think between five and $10,000 is probably realistic. I was thinking it would probably hit upwards of ten. Yeah, I probably would. But the frugal me wants to keep it low. But I mean, you you can, you know, I mean I mean, think about okay, think about it, right? Like the LLC and you know, this is just basic stuff. So you only cost you a couple of hundred bucks. Yeah. You know, a nice website will cost you between one and $2,000. Yeah. Don't buy crap one. Like, get someone who knows what they're doing. So, you know, a good quality website, a couple thousand bucks. Then you figure, you know, furnishing a small space like we need here, the chair, the desk, you know, little furniture would like you could buy all the stuff used on Facebook marketplace. Yeah. It doesn't have to be fancy. Okay. Thousand bucks, 1500 dollars. You know, not much. You know, in we're approach $5,000 right now. You can see. Oh yeah. So yeah yeah. You a little bit of marketing budget a couple thousand bucks there you know the the lease the rent apply be a couple thousand dollars to you know the down deposit first month security deposit blah blah blah. So yeah, you're going to be approaching closer to $10,000 if you want to do it. Right. Okay. So and I'm guessing those co-working spaces wouldn't work because you really can't listed on a Google. I did. I did some research. You can't list them because your name is not listed at the business, I guess, right? Correct. Exactly. It's one address. Okay. That makes sense. Yeah. And for something like this, you don't really need to be on a main road like you don't need to be spending thousands of dollars a month on some retail location. You know, I mean, something in a little shared medical office park or something or you know, I don't think that you need to spend a whole lot of money on, you know, on a space. Okay. Yeah. You know, I think $1,000 a month, max, is how, you know, this is what I would spend $1,000 a month for, a couple of hundred square feet. That better be in a good location. Yeah, yeah, yeah. So just keep that in mind, too. So, yeah, so I would say go on this route with a little bit more realize like realistic expectations, probably close to 10,000. Okay. You know, five years ago, $5,000 was a little bit more realistic. But with inflation. Exactly. Everything is so much more expensive now and so, you know, start at budget, probably close to $10,000 is more realistic. Like you said, it's an investment. And so, you know, you're not gonna you're not gonna get a better return on your money. No, I don't think so. No, you just you trust me, you're not going to do. Absolutely not. Yeah, it's you. Yeah. Now you turn 10,000 to 100,000 pretty quick, so stock market's not going to give you that kind of returns is not quite honestly, has not yet put money into stocks now that we're waiting to kind of turn around. Yeah. Yeah, I hear that. I mean, even today, you the last couple of days as my portfolio's plunged a couple of percentage points, I'm like, yeah. So, you know, tens of thousands of dollars just gone, magic just disappeared. You know, where you could break even at this point? Yeah. Oh, yeah. You buy, you bought closer to the top then. Yeah, yeah. We, we, we put a lot into stocks. A lot. So I'm like, well, well, whoa, wait, that. Yeah, well, it's just. It's time in the market. You got to give it time, you know? Yeah, it'll, it'll bounce back. It might just take a couple of years, but yeah. If you sell when you're down then that's when you realize the loss, right? Oh yeah, yeah. If you don't sell, you're lost anything. It's just a number on a screen. It mean anything right now. Yeah, but they use that. It's a psychological thing, you know? They want to scare us out. I'm in for the long run. There you go. There you go. There you go. Okay, cool. Okay. So do you have any questions about the start up process here? So you did mention, you know, get it in a fluent area, really put the name integrative into integrative print and enough of a niche. Is that already separating me that it would draw my target audience, the target clients or should I. Even further down, speak to, you know, young professional women and burn out like I'm trying to say that alone should do the jobs. No, I think I think integrative alone should be fine. I mean, yeah, I don't know if you have to put a specific demographic in the name that's going to be more or less for your marketing. Okay. Yeah. So basically, if you in let's say you make a Facebook or Google ad or whatever, you know, you narrow down the demographics who are seeing the ad. That's when you would put a little bit more that target demographic information in there. But yeah, I would worry too much about that. I think that I think from a marketing standpoint, I wouldn't spend a whole lot of money advertising this thing because you're you know, when you advertise something like this, you're sending it out to cold leads. Basically, you're just sending it out to the world. So you don't know who's seeing it and that they're interested in this or not, you know? So I if I was you, I think I would focus more of my money and more of my time on making it as easy as possible for people to find you. Okay. Okay. So not really the marketing. So not necessarily like Facebook ads or even Google ads. It's just really just the Google listing, just your Google listing and making sure that you have a lot of content on your website. Okay. Yes, exactly. Just write one article a week and only to be 500 to 1,000 words doesn't have to be anything crazy. Okay. Okay. Just talk about, you know, how treating, you know, your obesity, you know, maybe doing some weight loss medications, how it improves your, you know, your depression or your anxiety, how various hormone deficiencies can cause these symptoms. Hyperthyroidism, for example, whatever. You know, talk about the integrative stuff that you do. Okay. Yeah. Yeah. Just by 500 to 1,000 words. I mean, I spend hours on this. Just something real quick is going to be crazy to, you know, even have a nursing professor editing this, looking over it and stuff like this. Is you okay? Yes, that's right. And publish that shouldn't be done because I believe Google Rewards the more you're active on your website and 100% SEOs like you should be able to be more searchable. Absolutely. Oh, yeah, yeah. And focus on like lots of reviews on your Google business listing. I mean, I talk about this all the time on the podcast. It's just it's that important. So, yeah, yeah. So I would focus more on that. I wouldn't spend a whole lot of money advertising this. I would maybe put a little bit of money do a Google search ad. That's about it. Okay. Google. Okay. Yeah. So someone top SEO search searching for mental health clinic near me or psychiatrist near me or, you know, whatever, you know, whatever keywords you think people will be using. Yeah. You make sure you pop up based on that keyword search. Okay. Yeah. Okay. So you do. So Google search. I was hoping so I was hoping with this new integrative thing and and such is the new wave that it would kind of help out bloom and kind of go from there, but perfect, I guess. Yeah. Go ahead. Yeah. Before jumping into anything. Are you doing this part time? Are you going to continue to work? My plan is to still work, so my plans get everything going. Hopefully, who knows? But by the time I get some start off maternity leave, I would have even seen at least one patient because I primarily just want to do cash and I don't want to touch insurance, so that should help get things going faster. Even if I saw one patient before coming back to work, I'd be happy. Okay. So definitely keep your job and continue to work and just do this very part time. And just let it. Let it. Let it just grow, okay? Don't quit your job and jump into this without having, you know, a significant patient base and some money coming in. Oh, yeah. My husband won't feel too happy about that either. Yeah. Yeah. I mean, it's a lot of work, you know, it sucks sometimes, you know? It does working full time and then starting a business and having a kid. Like it's exhausting. But I mean, you know, it'll pay off. This was easy. Everyone would be doing it. Yeah, we do need some levels of barriers somewhere in nursing because it's a floodgate right now.  Just kidding. And it gets worse every year. Every year, every year. How Texas has got to be one of the worst states. Oh, yeah, absolutely. Everybody in their mother like every day I'll have so like, oh, I want to become a NP and so I can be and they have no nothing knowledge pertaining to strike so it's just like are you going to least try to get a little bit experience shadow somebody. Right, right, right, yeah, yeah, yeah. There's just some like Texas, Tennessee, Florida. I know those. Oh, yeah. Bad states for just saturation. Oh, yeah, absolutely. Yeah. Now, I mean, all it's going to get worse. Still. I don't think it's going to get better any time soon. You know, this whole, you know, kind of going off a tangent here, but this whole shortage of providers and all this telling is mostly I mean, a lot of it's propaganda. I don't I don't think there's a shortage and I don't think that there's plenty out here. I mean, I get in my LinkedIn inbox all alone. There's so many people going to school and they're like, Hey, can you preset so-and-so and these different NP precepting agencies? I'm like, There's definitely not a shortage of everyone's going back to school. No, there's not a shortage at all. Like, where are these people really getting statistics from at all? The real world. Take a look around. Like, you know, a lot of NP jobs. They're getting dozens, dozens of applicants for one job. Yeah. You know, it's now that it is what it is. Start your business that way. I worry about it. Yeah. And get ahead of the curve. That's what I'm working at. Exactly. I feel like the NP's who started who started a business the last few years and over the next few years will definitely be an advantage. I think ten years from now, 15 years from now, it's going to be really hard to break in. Well, hopefully by then I would have been when I retired. Have that fire lifestyle. Somebody be on my own yacht on the beach somewhere. Yeah, I was a pretty, you know, a yacht. I mean, you're talking rented out, right? Yeah, I just read it. Yeah. Yeah, we're going to read it for the day, right? Yeah. Yeah. Yachts or you. That's eight figure kind of net worth stuff. You know, a girl can dream, right? Right, right, right. Yeah. Yeah. I think in the next five years, you save your money, you really try to grow this thing. I think in the next five years, you could be semi-retired, you know, not completely on your percent, but I think you'd definitely be working a lot less than you do now and probably make more money. Yeah, that's the goal. I mean, ideally, I just dream when I hear people say, Oh, I only see ten patients a week. 15 a whole week. Not even a day. A week. Well, still bringing in substantial income. Yeah, that. That's a desire. It's great. I think I saw six patients this week. Oh, my goodness. What's it like that? It's like six patients. The guy was it. You know, it's nice to get there. Yeah, that's that's the goal, honestly. But it's it. I think it's more achievable, at least for me, if I were to do the cash. So how would one really set up the subscription plan? Because, you know, for example, not to name any names, but some of these big time pill mill telehealth companies that are under the DEAs radar they do the subscription deal in. It's pretty that's pretty a lot, you know, for patients and that's just for medication management in therapy. So I'm kind of wanting to see how to do the pricing and how to kind of get it where I'm not shooting too low, but obviously I'm not pricing myself out either. Okay. Did you just may I ask you a quick did you did you read the article I published like a week or two ago about building a subscription plan? I did read it. I did. Where it's just like include everything. So they don't feel like you're nickel and diming them. Yeah, yeah, yeah, yeah. Exactly. So, you know, follow those steps. Let me ask you if you took any of our courses. No, but I have it in a cart because my C, I was going to pay for it and I found out that our job will, you know reimburse CME. So I was like, perfect. So I got a card that's free then, you know, I'm like, you're good for something. Right, right, right, right. That's one of the reasons why I wanted to make sure we got CE accredited so you can get reimbursed for it, you know. Yeah. Okay. Well, anyways, though, okay, so we take you we talked a little bit about the courses too, so it'll help kind of guide you through this process. But in terms of building a subscription plan and membership plan, yes, I feel like that is probably the best value for patients. And so in that plan, you know, for an integrative psych practice, I think the plan should include as much as possible. Okay. Now, you know, some of these med you'll be prescribing something Zoloft, for example or whatever. Yeah, I would dispense that as you just call it in Walgreens or whatever. Right. But but in terms of the integrative component of it, so the integrative component should include hormones, should include the weight loss medication, it should include the vitamins. You should include the intervention that you're prescribing. Okay. Yeah, but if you're going to be doing just basic mental health management for people who are, you know, just med management or whatever, little therapy, etc., I would say keep it at a fairly reasonable monthly rate. $80 to $100 a month. Something like that. And they can see you on a monthly basis if they need to or every three months, whatever you feel comfortable with. And then if you're doing, you know, let's just say, for example, you're doing weight loss on someone. You know, you're confident their depression or anxiety is related to their obesity, which, you know, probably is the less you say you're going to start them semaglutide and it's costing you 150 bucks. So, you know, you charge a patient $3 a month. That includes semaglutide. Includes the desserts. Right. Okay. Yeah. So how are people getting is this still a good time? I am contracting with a compounding pharmacy and they're giving it to me like I have like a relationship with them or patients are just going to go pick it up on their own. I've kind of her different things yeah as you to combat pharmacy try you to contact pharmacy very much you can yeah okay yeah kind of build a relationship of one and that's true to go out and just start ordering in. Exactly. Okay. Yeah, that's what they need. Medication. I mean, most pharmacies aren't going to issue psych meds. Yeah. But all the integrative stuff, you know, hormones and etc., they should, they should provide that for you. So during this whole startup phase of the next couple of months, you're in need to create accounts which in combating pharmacies and set all that up. I would highly advise taking our site course site practice startup course. Yes, that's in that one. And then you have, I think you even have like the HRT Semaglutide that I wanted to take. Yeah, we had a weight loss course. I think the site course will help you. Really, which is the structure of the business, because we also talk about the integrative psych practices in that course, not just insurance based mental health. Oh, perfect. Okay. So yeah, so we'll actually walk you through a little bit of is the combating pharmacies and all this kind of stuff. Okay. It makes it pretty comprehensive course one of our one of our better ones. Be honest with you. So I think you'll enjoy that. Yeah, I think that's what you do. You do the combating pharmacies, you just set up the membership programs based off of what they're charging you. You want to mark this up, you know, you want to double check basically if you can. So if let's just say, for example, you're prescribing some wine mentoring for weight loss, you're going to cost you 40 bucks a month, maybe something like that from a compounding pharmacy. So I would charge that patient $120 a month, and that would include the Med and plus the visits. Okay. But what I would do if I was you, I would have based membership programs for weight loss, HRT, you know, comprehensive integrative psych med management have like these baseline memberships. And Iu would add you got all a card menu sort of thing. That's what I was wondering, because I didn't know if I could integrate like fee for service. And then like some people just were like, Hey, I just want some therapy, my meds or just one my meds. But some people want maybe are in a whole elaborate experience with a full subscription. So maybe for two years or something like that. I would avoid nixing, you know, fee for service and having memberships. I would avoid, you know, having people have I have the option of paying you pick you dollars for a visit. Okay. Okay. One or the other. Okay. Okay. Yeah. You start mixing that together. It's just it complicates your books, complicate your payment processors. It makes it confusing for the patients. And most people will just go with the fee for service cause they think that's going to be the better value. In reality, it's really not. Okay. Okay. Would you have like an initial for everybody regardless? They all have that higher initial consultation, let's say faster third price like 400. After that, they just pick whichever service they want to do. Yeah, exactly. So like, let's just say just hypothetical here. Let's just say your base membership is 80 bucks a month. That includes basic med management and, you know, concierge care, you know, one visit a month or something, you know, up to one, you know, one visit a month. But we follow up every three months. So, you know, whatever you normally do, just a base, one like that. Okay, great. So they come in, you know, you do an integrated approach to their you know, to their health. You know, you realize, okay, you're £100 overweight now you start do some therapy with them. Do you feel like this contributes to your anxiety? You feel like this contributes to depression, etc.? And then, okay, let's, let's try to get you to lose some weight because I feel like if you lost £80, you probably are able to get off all these depressants and stuff. Okay, so let's do Semaglutide for you as an example that costs you. Like I said, let's just say 150 bucks. So then you would just add it to that membership? I would charge 200, 250 for it because you're already getting the base $80 a month, for example. Right? So, like, be thinking about that. Like, you want to be making at a minimum, at least $100 profit per patient per month if possible. Okay. Okay. So then you just mark up the med like the semaglutide. Okay. Well, let's prescribe Semaglutide for you. You know, they're still paying the base membership. That includes the visits. Right? So now you just add the medication to it, and that would be an additional monthly charge where you would add the Fed to you, you add the control or you add the testosterone, or you would add whatever, and just do what numbers make sense to you from your profit standpoint. Like you had to look at this quantitatively, you can't you can't just make up a bunch of numbers. And I always sound good. Like you have to, you know, you have to think about this logically. Like, how much is your time worth an hour? Yeah. Okay. What are you worth? I'm worth a couple of hundred bucks an hour. I'm probably worth more than that now. Like, that's that's how I feel. Like I look at my net worth, I look at how much I make. Like, I don't need to entertain any more unless it's, you know, couple hundred, your son, your child's like, yeah. Like I would never, ever work as a nurse practitioner again for someone. They couldn't pay me enough to justify it. No. Right. Okay. You're paying me $2 an hour. Yeah, right. No one's ever pay, you know that they a nurse practitioner of that, right? So what is your time worth? That's what you need to make sure that you're making that at a minimum. So you got to be thinking to yourself, how well am I going to be seen this patient for how often I'm going to be seeing this patient for? How much does that end up being an hour for the time invested, seeing that patient, does that make sense? Yeah, absolutely. Yeah. You feel good about what? Your price of that? Exactly right. So at my mental clinic, for example, like most of my patients, after a couple of visits, I don't need to see them every six months You know, I just every six months, I don't even see them very often anymore. Okay. So in a one year period as an example, they in a one year period, I see my patients, let's just say for the initial consultation, let's just say it was just let's just call an hour. The first follow up, 15 minutes. Second follow up, 10 minutes. Third follow up. It's like 5 minutes usually. Yeah. This your blood work, I think was great. Any side effects now? Great grandkids and those talking six months they'll do any talk to you about. Awesome. Do they have a recurring payment even within that six months span or do they pay every month? Okay. Okay. So they're paying us 140 bucks a month. You know, just example for the base, like 140 bucks. And so I've spent in one year on average, I've spent maybe 2 hours with the patient, maybe three tops. And we charge 140 bucks a month in margins in everything. We make a profit of about 100 bucks. So the patient, you know, we generate a profit off each patient of let's just call that 1200 dollars for the year. 12 months. You follow me? Yeah, right. Okay. And I've seen them for, you know, let's say let's just say 3 hours. Okay. We make 1200 bucks for 3 hours. I'm worth $400 an hour. Yeah. As you should. Right. Does it make sense? Yeah, absolutely. So think about it that way. And unfortunately, you're not going to really know that until you just get started. And you start doing it. You start you know, you start getting your little, you know, your workflow. You have to buy like I can't tell you what to charge people. I think you just feel the energy, you know, the confidence, you know how your comfort level is, where you're just like, this is the price. It is what it is. It's either you pay or not. You keep it moving and keep it moving. And you listen to your patients. Yeah, they'll get you. Yeah, man. Hey, I'm in 80. I'm charging a little too much. You know, drop the price a little bit. I couldn't tell you how many times I've had to re-adjust my prices for every single business I have. Okay. So, yeah, you just. You got to experiment with it, take 6 to 12 months to kind of figure it out, and then you figure out that sweet spot. There you go. Okay. Okay. Perfect. Yeah. So with doing cash, because right now my MPI is with the hospital system. So they're using that with, you know, patients that are I'm credentialed with insurance. Does this mean I need to go get like a NPI too? So that way I can use that with the patients or that's where I'm kind of sticky because I know it's like technically can't take cash from patients that they have insurance with your NPI associated and credentialed with insurance. That's where I was like, How do you work around that? It doesn't. So. Cash based practice. You're not getting a group NPI for your LLC for your business. Okay you're just operating out of your personal and I got personal NPI. Yeah. Is, is, is, is credentialed with insurance through the group NPI of the of the company that you're working for. Okay. That credentialing doesn't just transfer over to a your own business. You're not you you are not credential with insurance through your other business. Therefore, you do not need to accept insurance. Okay. Makes a difference. The only exception is Medicare. Okay. Yeah. Medicare patients. Technically, you're not supposed to charge them cash for covered services, but integrated mental health isn't going to be a covered service, so I wouldn't really worry about it. And to be honest with you, I just wouldn't worry too much about it. Because how many Medicare patients do you really think you're going to be calling you? Very few. It drives me nuts. How many NPR just hyper focus on this whole Medicare crap with with a cash based practice. Don't worry about it. There's not going to be that many Medicare patients coming through your door. So don't stress out about it. It's not that big of a deal. Absolutely. Yeah. They call to say we don't. We just we don't. We can't see. You can leave it there. Okay. Okay. Yeah. So metal. Yeah. Nothing to worry about. Okay. That's. Yeah. That gives me a lot of clarity in that. Yeah. That. Any other questions? Um, I think. I mean, really, we church based on it? Um. Yeah, I'm really shocked. Well, I'm glad that. I'm glad you found that beneficial. I think that. I mean, you got a great idea. Somebody's got a good head on your shoulders. You know, you got a little bit of money to spend on this. You know, you're going to be working still somebody. You got a husband making some money to somebody. Yeah. Really? I like it. Sounds like you're in a really good spot to do this. Like, you know, you're 32, you're still pretty young. You know, you got some money in the bank, you got some time like this is honestly a really good recipe for success. Oh, I receive it like I'm ready to go because, um, so I do have another business and I know I listen to your podcast and some of your articles, you're like, get some non-medical.S o I'm at a point where it's like minimum, it's almost like events or a thousand just for a couple of start ups. So I'm trying to get my hands into everything. We're doing real estate, we're doing Nasdaq life insurance. So just whatever make my money work for me is essentially where we're at. Good for you. That's that. That's what's up. You're diversifying your income streams and that's. Yeah, that's very, very wise. I mean, I've I've done that for years and I continue to diversify outside of medicine, to be perfectly honest with you. I'm not opening up another practice. I'm not going to be. I'm just not. I would rather open up a wine bar. Yeah, there's a market for it. Yeah. Which I, which I am doing. I'm opening up a wine bar and the charcuterie board kind of place. There isn't one in my city, and I think it would kill it, and I think it would just be downright fun, you know, in this. Yeah. Like, I will be behind that bar. I will be a bartender there a couple weeks. It'll be fun pouring like wine flights and making these little fun cheese boards and stuff, like. Yeah, it'll be fun. You know, it's really a premium for that just experience. Right, exactly. People will pay you tip money, you get to sit there with people in a non serious manner. That's not medicine. You're not stressed and you know, no regulation outside of just people under the age of 21. That's it, you know. So yeah. Anyways, not good for you I'd say. Continue to do that. Perfect. I'm excited. I'm so excited to get, get the ground running to go. Well listen, I know you listen to podcasts before, so like in the episode with you asking me, asking me a personal question, anything that you may be curious about, have you any curiosities or a question you want to ask me? So do you plan with now what your minutes practice. Are you at a point where you're just like, Hey, whoever has the highest dollar, I'll, I'll sell? Or you're just like, Hey, I'm going to continue this. Or now that you've said you're going to do the bar, but would you sell the men's practice? Absolutely, I wouldn't. I so like it. Would that be an aspiration for you to like build practices or build businesses with the aspect of sell, which I've always heard that's what most business owners should do, put in the position where people can just buy it from you. Yeah. So yeah, I've talked about this before in a few other podcast. I don't talk about it much but but yeah, we are developing right, right now. I know this is August 20, 23 when we recorded this, but we're I'm developing a how to scale a practice course, like how to build $1,000,000 practice course. And, you know, one of the points well, the goal for the courses is to teach you how to build a practice that you can sell. Okay. Yeah. How to build a business that you could sell. Yes, that. So there's you know, there's two goals as a business owner, right? Goal number one is to build a business that you enjoy. So you are self-employed, right? Yeah. And you know, you have a business that you're running, you're making good money, you're working for yourself, right? Like that's goal number one. That's going to be more or less of your first business or two. Right? Okay. Goal number two. And this is where the goal this is like where I'm at now. I'm not going to even start a business. But what I'm going to start a business for goal number two, just right from the get go is to build a business that you can end up selling and buy. And to do that, you have to build a business that works for you. You don't work in the business. That's one of the most critical aspects of it. So if you build a business back to where you can walk away from it and the person who bought it from you can just take it from you and just continue businesses, okay. And you walk away. Most nurse practitioners listening to this who have their own practice there are. Like a one man, one woman show. If they leave, they don't make money. They don't see patients. Right. You can't sell a business like that. No one's going to buy a business. No one's going to buy a headache. Right. Who wants to buy a light building? They want to buy something that's making money right from the get go. So you got to create a business that works for you and that. And you do that by automation, having lots of systems in places or in place and by having employees having other people work for you. Know, I have four nurse practitioners on in practice that see patients for me. I haven't seen a new patient in months. Hmm. Yeah, I just. I just have my established patient base, my follow ups, and I'm going to continue seeing them until they basically just slowly fizzle out and fall off. I mean, you know, there's always a turnaround. There just always is. You know, people who come and go, I just welcome do a practice, you know what I mean? So, yeah, I just get to kind of maintain my patient base right now. And yeah, so, like, I have a business that works for me now. It's like, really, you know, so I can get away with C patients for 2 to 4 hours a week now. Right. And so, yeah, if someone came up to me and was like, you know, we'll give you enough for X net income tomorrow, I'll write you a check. I'd be like, Let's do it. Well, why wouldn't I? That's the goal. That's honestly the dream. Yeah, you can get there. You. You're 32 years old. Okay, so you're 32. I think I was 33 when I first started my first practice, I was like 33, I believe. Or was that. Yeah, I was 33. Yeah. So listen, you're working at that some time. Got the time. That gives me some hope there. Make that your goal though. Yeah. Yeah. Definitely don't establish and resell. Yeah. Yeah. Don't be afraid of hiring another nurse practitioner in the next year as as volume picks up. Okay. Yeah. And on average, if I were to play my cards right, because that's just who I am. How likely would it take to maybe not just to have a full practice, but a substantial income of working six plus on a regular each month or something? Is it really the sweet spot? Like six months, 6 to 9 months. That's within a day. Yeah, it's. Yeah, you know, I can't really answer that. I mean, I've known some NPs who have started a practice before and, you know, $100,000 a month, you know, with 3 to 6 months of opening. And then I know others who've been open for two years that are barely making a profit. You know, it's it's one of those things that right place, right time, right service, you know, some of it, some of it's just luck and it's. Yeah. And stability at your control. Yeah. But you'll never know until you actually do it. That's the thing. That's the thing. That's a gamble. All the business, you can do as much research and you can do all that stuff. And at the end of the day, it's just you just kind of just do it, see what happens. Yeah, just. I'd rather just do it. Have regrets and not do it at all. Yeah, but in six months, you should be making a profit. Okay. If you are not, you really need to step back and be like, okay, what's going on? Absolutely. Yeah. And if you're not you shoot me an email or hop on to the podcast, I'll gladly I will do so. In the meantime, if there's any others you can think of, let me know. Because I know I think I honestly think those two courses are really all you need right now. I think that if you're going to pick one course, do the psych course, of course, like I think I'm going to buy more better than that right now. Okay. Then you can start doing models, clinical courses, the weight loss stuff. Yeah. Okay, perfect. Cool. Awesome. Well, listen, this is a pleasure talking to you, and I wish you the best of luck. Keep you updated. Thank you so much. I appreciate your time. I hope everyone enjoyed the episode with Jennifer. It was a great episode. I mean, she really has a solid plan in place. She is at the right time in her life to start a business. I think that's one of the big messages of this episode, is that you have to be at the right place, starting a business when your life is hectic, when it's unorganized, when you're in financial distress. It's probably not a good idea to start a business at that point. You know, you've got to get your life situated and organized. So a good place to start a business is basically, you know, the place that Jennifer's in right now. She has a good job. Her spouse has a job. They live below their means. They have saved their money. They're dressing their money. You know, age is one of those things that's kind of out of your control. But if you are in your mid thirties, that's you. That's a really good time to start a business. Does it mean, you know, you can't do it because really your fifties, you certainly can, but I think your mid thirties with those sweet spots. But yeah, she has all of these things going for her. So like right now is a very, very good time to start a business. Granted, she's pregnant, she's having her kid in a week, but outside of that, I think she's in a really solid place. So step back and think to yourself, you know, is right now a good time in my life to start a business or to put the energy and time and the money into growing my current business? Okay. Don't do it in the middle of, you know, a divorce or in the middle of a bankruptcy or, you know, in a bad situation. It's probably not a good idea. You don't need that extra stress in your life. So keep that in mind as you start your practice and you build your practice. What I would do is have some ideas later. Thanks. Thank you for listening to the show. Quick legal disclaimer The content of this podcast has been for informational and entertainment purposes only and should not be used as legal, financial, medical, regulatory or practice specific advice. For information pertaining to your specific legal, financial, medical, or practice specific needs, please be sure to consult with your lawyer, CPA, medical director and or your state's practice laws and the most up to date clinical guidelines. As always, do your due diligence when it comes to any information found online in podcast content. 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