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

Practice Ideas and Skills for the Nurse Practitioner

Most nurse practitioners go to school and learn the general medical practices either being family practice, pediatrics, acute care, geriatrics, woman’s health or psychiatry. Therefore, we are all skilled in providing the general population “routine” health care which is our strong suit. Let the physicians have their specialties if it affords increasing our independent practice.

But what if you want to learn a more specialized or “niche” skill? What is a niche skill? A niche skill denotes a medical service that few others are providing. Plain and simple.

Any nurse practitioner can open a family, mental health, or pediatric practice. There are needs for those, but they generally require one to put their entire focus into it. If you follow the Elite Nurse Practitioner Model of having a part time job, multiple side businesses, having low expenses, avoiding insurance, and only accepting cash than these practices are difficult to do.

Physicians have fellowships and residencies. We unfortunately have very few of these thus it is our responsibility to increase our medical knowledge. Then how does a nurse practitioner break into other niche practice areas? The only way is to learn new skills on your own by either taking a course or self-studying.

Taking a course can be expensive and from my experience is overrated. Most of these skills that are taught in these courses can be learned on your own or on YouTube. If it rewards CME that can go towards your licensing then go for it but a lot of times they do not.

If you decide to take a course, ensure that it is teaching you something specialized and marketable. A course on hormone replacement therapy will generally be generic information that can easily be learned online. So be very selective with what course you decide.

Self-studying is what I advocate for because it is cheap and often results in the same outcomes if your astute and truly focus on the material. If you lack the discipline to self-study though, you might want to opt for a course.

So, what niche skills and practice areas are out there for nurse practitioners to learn and implement into a side business?

  1. Medical Cannabis. Big money here. I make a significant portion of my yearly income performing medical cannabis evaluations. If your state has this, seriously consider it. Opening a medical cannabis clinic is cheap and easy with little liability.
  2. Opioid Addiction. A niche practice where few dare to venture and for good reason. These patients need a lot of “babying” and are very unreliable. But the good news is that you will likely be one of the few people doing this. Depending on your location you might have to accept insurance or write for a grant, so be aware of that.
  3. Aesthetics. In my opinion it is overdone. I know many people certified to do Botox injections yet very few capitalize on it. If you decide to go down the aesthetic path you must ensure that you are able to market your side practice correctly and be competitively priced.
  4. Weight Loss. Another overdone practice but if done right you could do VERY well. Be different. Don’t just hand out phentermine and B12 shots. Truly develop a program that delivers results. Be CAUTIOUS though. There are a lot of sharks out there selling weight loss programs to providers thinking about starting a weight loss clinic. Keep it simple: increase the metabolism, lower calories and increase activity. It is not rocket science.
  5. Hormone Replacement Therapy. Prescribing testosterone is my bread and butter. I truly am passionate about delivering men’s health. Men between the ages of 30-55 are a forgotten patient group and optimizing their testosterone levels can be life changing. The same goes with post-menopausal women. If you can make them feel better, they will HAPPILY hand over money to you.
  6. Allergy Clinics. Learning how to treat asthma and allergies is not terribly difficult. It is mostly figuring out what the individual is allergic to and slowly desensitizing their system to it with “allergy” shots. Most allergy clinics have 2 month wait times. So, what does this mean for you? A perfect market to jump into it because it is a needed service.
  7. Transgender and LGBTQ Care. The LGBTQ community is generally an under-served one. Therefore, it is a perfect patient base for a nurse practitioner to provide services to. Transitional hormone therapy, PrEP, STD testing/treatment, and other LGBTQ specific medical needs are easy to learn and implement. One downside though is this population will not have disposable income so you will need to consider taking insurance.
  8. Stem Cell Injections. If you are skilled in doing intra-articular and trigger point injections, then injecting umbilical and placental stem cells can be very lucrative.

There are many more niche skills a nurse practitioner can learn but these are relatively easy to learn and can provide BIG returns on your investment. Any one of these practices could be started for less than $10,000 which in terms of business creation is a pretty damn good deal.

16 Responses

  1. I am interested in offering allergy testing and treatments. Do you recommend a specific company or protocol?

    1. I do not but there are so many guidelines available from the immunology and asthma societies that you can follow.

      1. Live in Ohio want to do women’s health but cash only and been offered a room in chiropractors office. Also spoke with someone from OPTAVIA on health coaching. Can’t decide. Plus I need a collaborator. Also would love cannibas but again collaborating physician I need. I have a friend that is a doc left oncology and only does cannibas. 250 a patient. Maybe I should ask her if she would collaborate ?

        1. Absolutely, see if you can use her as your collaborator. If you can, then first open a cannabis clinic. It is easy fast money with little liability. Then use those profits to open your other practices. It is what I did and I will explain it much more in my book I will be releasing in the next 1-2 months.

    2. Dual certified and independent practice FNP, PMHNP in Virginia. I am currently working in a private practice women’s health office with two physicians. I am looking to start a women’s health practice that encompasses Integrative care and sexual wellness. I have another NP peer from urogynecology that practices sexual wellness and would like to provide bioidentical services. There are so many programs for bioidenticals, do you recommend one in particular?

  2. I am interested in opening a cosmetic business such as laser etc.. What are your recommendations? The area I live has the potential!

    1. The first thing you need to do before opening a practice is to find out who your competition is. And is there a need for this service in your area? Do not start something that is already being done. Find your niche!

    1. It really just depends on your interests and experience. I actually cover multiple ideas in the telemedicine course. Common niches are hormone replacement, weight loss, sick visits, etc… The trick though is to find a specific market to advertise towards. So if you decide to do sick visits for example, you will want to market it to a specific demographic: Single dads who like baseball, for example. I hope that makes sense.

  3. Hey Justin! First off, thank you so much for sharing your knowledge. Forever thankful! I am curious on advice you may have for securing a collaborating physician? Thank you!

    1. Medical cannabis clinics write the certifications to patients. Many primary care providers will not do it. So, it makes for a great cash based niche practice.

  4. hI thank you so much for the work you are doing to help us advance our practice and independence as nurse practitioners! after your reading your blog, I would like to dig deeper and consider a medical cannabis evaluation as a service ad on to a clinic and i am in the process of opening for cancer patients. I am in California. Do you know how to start this process? are there sites i should be looking at for legal concerns/legalities and paperwork?

    Thank you again!

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