“You can get past the dead end. You can break through the ceiling. I did and so have countless others.”

Finding Your Practices Niche

It is absolutely critical that you find a niche for your side practice. A side practice is a small business that you can focus 10 hours a week or less on. Therefore, primary care is not going to work. You need to find a service that is in demand by a specific market of individuals that are willing to pay cash. This is the type of niched service you must find! A niched practice is the perfect side business for a nurse practitioner to start.

Opening a side business that is not niched will pose issues for the aspiring nurse practitioner entrepreneur. You cannot operate a direct primary care office or an urgent care very well part-time. These types of business models do not fit well within the Elite Nurse Practitioner Model.

Starting a business that requires your full-time attention is a recipe for stress, financial tension, and potential failure. The goal should be to create a life of more freedom and financial independence when you start a business. This is easier to achieve with multiple niched side businesses. Finding that niche is absolutely critical and is the first step when starting a business.

The following is an excerpt from the upcoming release of the new book The Elite Nurse Practitioner Model. It goes over finding a niche idea for your side practice:

What type of business should you create? How do you come up with multiple ideas for multiple businesses? It can be difficult. You must figure out your niche. A business niche is a specialized service or product that targets a specific market.

Primary care is not a niche. Primary care for the LGBTQ community? Sort of. Primary care for the Hispanic male LGBTQ community? That is a niche! This is the type of practice you want to start if you follow the Elite Nurse Practitioner Model. Niche practices make great part time practices and can generate a healthy side income.

TIP: The more niched your service line is, the more you will set yourself apart. The more niched you are, the less competition you will have. How many primary care offices are competing against each other? A very large amount. It is not a niched service. How many African American male anti-aging clinics that specialize in the treatment of male pattern baldness are there? NONE. You have no competition and you have a very specific population of patients that are easy to target market toward.

So how do you find that niche? Often the niche is stumbled upon during your normal day to day work. You need to be on the constant look out for services that solve a specific problem to a specific population. Right now, at this very moment, stop reading and think about this:

What is a problem that I have encountered often in my clinical practice that affects a specific group of patients and creates a significant distress in their life?

If you can answer that question, then you have found your practice niche. That is your first side practice to start. Common niche practices among nurse practitioner operated businesses include:

  • Aesthetics
  • Hormone replacement therapy
  • Opioid addiction treatment
  • Allergy and asthma clinics
  • Stem cell injections
  • Weight loss clinics
  • Direct primary care practices

The problem with most of these is that they are not niched enough. I have a testosterone replacement clinic specifically tailored to upper-class men. That is a niche. A generic hormone replacement clinic is not a niche and could pose difficulty growing. Why? Because you are marketing it to everyone over the age of 35. Dial in that target market! Also, providers who just take a hormone pellet course and integrate it into their current practice are not starting another side business. They are simply just adding a service to an existing practice that likely offers multiple other services.

Tip: Do not be a one stop shop. I often consult with nurse practitioners asking for opinions about their medical practice website and the amount of services offered is downright confusing. I couldn’t imagine how confusing it is for the patient! It also looks unprofessional and creates a mediocre ‘jack of all trades but an expert of none’ vibe. When people go to a clinic’s website, they want to know what you do within thirty seconds. The more tabs or pages they must go through, the less likely they will be to actually convert into a patient.

When I opened my men’s health clinic there were other places in town doing testosterone replacement therapy. But they were also offering a dozen other services. I stole the market by specifically only treating men and being the expert in testosterone replacement therapy in the region. We receive regular calls from women wanting hormone replacement therapy. Could I accept these individuals as patients? Sure, it would be more money! But it takes away from my niche and would start me down a path of converting my men’s health clinic into just a run of the mill hormone replacement clinic. I would lose some of my male clientele. A man does not want to come into a clinic where he can freely talk about his sex life when the lobby is full of menopausal women. Therefore, before you decide to add a service line to your practice think long and hard about the potential consequences it could bring. Will it destroy the ambience and the niche of your practice? If so, it is not a good idea.

If you are considering one of the above practices, consider how you will set yourself apart from the competition. You need to target a specific patient population within your market. If you want to provide multiple services, you should do so to a specific population or open another practice offering that additional service to another market. You will set yourself apart and create an expert ambience to your practice when it is operated under separate business entities.

If you want to start a profitable part-time business, you must provide a niche service. I cannot stress this concept enough. You need to be creative and think outside the box. Do not do what everyone else is doing in your area, be the outlier. If you do this, the money will come. Remember, you should start this as a part-time endeavor and start it cheaply! I promise, you will make money if you provide a quality niched service, market it correctly, and give it at least 6 months.

The Elite Nurse Practitioner Model book goes over each principle of the model in detail as well as many other recommendations that will put you on the path to success as a nurse practitioner entrepreneur. I guarantee it.

33 Responses

  1. Thank you so much! After reading multiple articles from you, I found my niche and am opening a side practice next month. I am marketing, but hope I’m marking correctly. I could use some tips ASAP on that. Thank you,
    Kym Cannizzaro

    1. Hi,
      I came over your page just a few weeks ago and boy have I learned! I do want to thank you for your unselfishness and generosity toward the profession. You are actually making a difference in the professional lives of NP. I am a psych NP and did not think I could ever find a niche. You have me thinking now! Blessings to you.

        1. So glad i bumped into this blog.
          I would like to reach out for one on one consultation please.
          Thank you Justin for sharing with so many of us absolutely amazing information to freedom of seeking employment and being undervalued.

    1. Yes Candi, it will be in e-book format at first and then depending on how well it does I will launch it in print format, amazon kindle, etc…

  2. I just discovered this blog the other day and just finished reading all your articles. I’ve been wanting to get a side hustle started to really maximize my income and your blog has been very helpful. Still working on my niche, but I’ll get there. Looking forward to your book. Thanks again from WA state!

  3. I am currently trying to figure out the logistics of aesthetics. Training, how much input does collaborating physician have. I’m definitely getting burned out with what I’m doing. Have a salon willing to rent me a room with its own entrance. Now to get started!

    1. A physician should not have much input for a small aesthetics practice other than taking your money for “collaborating.” Get started, the best time to start was yesterday!

  4. Agreed. Being to “general” will limit who you see. Find a specific group of people who need a specific treatment.

  5. Love your concepts! Part of my motivation to become an NP was to become more independent financially and professionally. I’ve dreamed of a niche practice, but felt it wasn’t obtainable. Somewhere through school and novice practice, I lost that drive to excel outside the box. Reading your blog has rekindled that entrepreneurial spirit in me. I’m tired of being undervalued; its part of the medical culture. Still very insecure about the follow through here, but soaking in the information you’ve shared.

    1. Heather, you can do this! I lost that drive too. What rekindled it for me was moving to a FPA state. Once I started one clinic, it just snowballed from there. The best way to get past that insecurity is to pick and idea and just pull the trigger. You will learn along the way. Do not get analysis paralysis like so many others do!

    1. I have integrated my stem cell practice into my men’s health clinic for the time being as just a small accessory service, but otherwise yes, all my businesses have different locations.

  6. I am so jaded with practicing as an FNP for so many reasons. I am also a PMHNP. I have been thinking about starting my own business for about 3-4 years. Finding your niche seems so difficult. I understand it’s important to do a market assessment. I am definitely interested in doing a cash business. My thoughts were to integrate mind and body and target women (maybe mothers) and offer care for low-level mental health conditions (depression, anxiety, insomnia), weight and nutrition (medical weight loss and coaching), and fatigue. Is this too much? I basically want to help women improve their self-care in a way that tends to their mind and physical self.

    1. Greetings Carrie!

      Yes, finding your niche can be difficult, but what is the most important factor is determining your target market and fixing a problem in THEIR life. So, you want to target women, possibly mothers, with a variety of issues. This is way too broad. You need to be thinking of a specific market, like wealthy mothers who are interested in horse racing (TOTAL EXAMPLE) and the anxiety have in their life. You really need to do some soul searching and figure out who could use the services that you are interested in providing. General wellness services work, but it just makes it a little more difficult to target. Think to yourself about patients you have seen that you have helped and figure out what is a common finding with that group of patients.

  7. Hello Justin,
    Thank you so much for the wealth of information you continue to provide for NPs. I am grateful.

    So question, I am planning on starting my own telehealth cash only private practice. I have been doing tons of research. Now, a colleague told me that it will be challenging to build a healthy clientele in another state, I live in Texas which is a restricted stated, my practice will be located in Arizona which is an fpa state. Since I do not live in Arizona, I do not have a physical address there, which means my practice will not prescribe controlleds (DEA requires physical address). She thinks these 2 obstacles, not being able to prescribe controlled substances and also being cash based, my practice might never grow. I am curious to know what your thoughts are on this?

    Secondly, I am struggling with finding my niche, especially in psychiatry. I really want to work with patients that have issues with anxiety and depression, higher functioning patients that want to get better and needing some help to attain thier MH goals. I would like to work with both men and women, no kids. I am just not sure how to find a niche with this population.

    Thanks for your insight in advance.

    1. It ultimately depends on what you are providing. Sick visits vs. hormone replacement therapy will fetch varying cash reimbursements. I think it is very possible to start a profitable telemedicine practice, but it depends on your service offerings and marketing budget.

      Niche = high end concierge primary care for the working professional. They pay you $50 a month for concierge psych care. I think that would work.

  8. Justin,
    After reading your blog on ” finding your niche side hustle’ I found my niche. I was so confused with multiple service ideas before reading your article.
    You are a great contributor to the NP profession because of you I am ready to start my niche this year.
    I am ready to do HRT for transgender Population and add STD care, what do you think?

    1. You are certainly welcome! I am happy the article helped. I think that is a great niche! Just ensure you narrow down your target market!

  9. Justin,

    I have started my own telemedicine practice through a telehealth platform. I have been waiting to get credentialed with them since signing up. Prior to coming across your blog, I had already thought of doing a cash only business. I was thinking of doing direct primary care and urgent care; however, after reading your blog, I see that it’s best if I find my niche as there are so many primary care businesses out there already. I am having trouble finding my niche though. I done internal medicine/primary care as my first NP job. I am currently an independent contractor for a company doing VA disability exams. The thing that I find in my current job is that many of the service members who are getting out don’t have a PCP and many don’t have insurance since they are getting out of the military so they really have a gap in their care. Other areas that interest me are high blood pressure, diabetes, endometriosis, respiratory conditions like asthma and COPD, just to name a few. But finding my niche seems to be hard to narrow down. Any suggestions?

    1. Carrie,

      Finding your niche comes down to finding a NEED amongst a certain demographic really. This and figuring out what is valuable enough to them to justify paying cash. Primary care and urgent care is just no valuable enough to most people to justify paying cash for. All of the areas you are listing are what insurance covers unless you tackle it from a functional medicine/integrative/holistic medicine approach.

      Treating veterans for needs is definitely a worthwhile endeavor, but you need to make sure you are providing them something valuable enough to justify paying cash outside of just regular primary care. I treat LOTS of vertains at my men’s health clinic. Testosterone replacement therapy helps them feel better. I also do A LOT of cannabis evaluations for veterans. I am not saying to do the above, but I am providing them a specific service that is in demand by them.

      Articles for you to read:
      Provide Value to Your Patients Life
      Provide What Insurance Does Not Cover!
      Marketing Tip Monday #35: Recipe for Telemedicine Marketing Success for the Nurse Practitioner Business

  10. Hello Justin

    I am interested in starting tele medicine practice. I am from NJ. I am interested in hormonal therapy/ integrative health. Any suggestions?
    My background is primary care / pulmonary / integrative health/ Hormonal therapy.

    1. I would stick with an integrative health approach. Thinking HRT and functional medicine basically. I say go for it! Check out our courses, they walk you through the steps.

  11. Hi Justin. Thank you so much for your content. It’s been so helpful for me as I start to venture into my own practice. I’ve been and FNP in various settings for the last 4 years and recently got a postmasters certificate as a PMHNP last year. I plan on opening my own tele-psychiatry practice by the end of the year once I gain a little more experience. However, in the interim, I’m considering starting a medical weight loss clinic with your course and offering those services for my psychiatric patients in the future to combat some of the metabolic side effects of long-term use of psychotropic medications. Is that doing too much?

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