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

The Most Profitable Niche Practices for the Nurse Practitioner

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 I am asked on an almost DAILY basis: “Justin, what is the most profitable niche practice a nurse practitioner could start on a part-time basis?” or “Justin, what is the most profitable service I can integrate into my practice to generate more revenue?”

That answer is going to vary on multiple factors:

The competition of that service in your area.

How saturated your market is.

How much you can relate to your patients (remember, you want to be able to SPEAK to your patients).

How much YOU must invest in your practice/business.

How well you market your practice.

How hard you hustle.

And at the end of the day………………. Luck!

So, I cannot tell you what the most profitable practice you can open is, but I can provide you how much my practices make and averages from the hundreds of nurse practitioners I have consulted with over the past few years make.

Remember, many factors come into play here. These numbers and rankings are based off my experiences and my observations from the hundreds if not thousands of nurse practitioner I have spoken with.

So, what is the number one most profitable niche practice?

It is going to be a close tie between hormone replacement services and weight loss

That may surprise many of you, but aesthetics has a very slim profit margin, and IV infusion is laborsome and restricted by patient volume limitations (but these practices are still profitable!).

Therefore, I am going to provide rankings of the most profitable practices when you factor in profit margins and the TIME required to put into the practice. The amount of time you have to invest into your business is a VERY important consideration when you are determining its profitability. Two businesses that make $500,000 a year are equal from a profit standpoint, but if one only takes 20 hours to run and the other takes 60 hours to run, you tell me which one is actually more profitable

From MY observations and from nurse practitioners I have spoken with, these are the rankings (this is not 100% fact… variations of this DO exist…):

  1. Men’s Health
  2. Weight Loss
  3. Pellets/Women’s HRT
  4. Aesthetics
  5. IV infusion/Vitamin injections
  6. Regenerative medicine
  7. Ketamine
  8. Functional/Integrative Medicine (Course coming out soon!)
  9. Opioid addiction
  10. A mix of primary care, DPC, concierge medicine, psych, wound care, and other more “general medicine” type of services.

I am sure many of these rankings surprise you. I am sure many of you do not agree with them. But these were determined by multiple years of providing niche clinic educational services and consulting with nurse practitioners. I am simply regurgitating what I hear.

The biggest factors I used to determine these rankings were profitability of the service being offered and how much time you actually have to invest in the business. So, lets start with the top 3: Men’s Health, Weight Loss, and Women’s HRT/Pellets.

Why are these the highest? Simple: the margins are SOLID, and it does not require a significant amount of time to operate and generate a profit.

I work a whopping 5-8 hours a week at my men’s health clinic anymore. I have built a solid patient base over the past 4 years, therefore most of my patients don’t need follow up but every 6 months. So, I spend 30 minutes per established patient a YEAR and yet they pay me on average $165 a month. Talk about a PASSIVE income stream. Sure, I have medical assistants that do the majority of the busy work, but as a nurse practitioner business owner, I don’t need to spend much time on actual patient care. It is a piece of cake. Others that provide men’s health services will no doubt agree with me on this. Additionally, the profit margins are fantastic.

My men’s health clinic generates approximately $70k a month in revenue. I work around 20-26 hours a month at it. I take home around $20k a month. Tell me another niche practice with similar numbers for the time investment. I am open ears.

Similar profits and time investments are also seen with Women’s HRT and weight loss. Profit margins are solid, and the time investment is minimal once you establish a consistent patient base. Think of it this way:

You start a patient on estrogen/testosterone pellets or semaglutide. They LOVE the way they feel and look now. You know what that means? A VERY LONG-TERM PATIENT. And the good news? Once established and stabilized, you only need to see them 2-3 times a year. It is the same with men’s health as well.

Also, these services are easy to learn and the barrier to entry is low. This means you can start a men’s health, women’s health, or weight loss clinical with minimal investment. You can also train other nurse practitioners and staff to do a lot of the work for you. That is what I do at my men’s health clinic… I have multiple nurse practitioners working for me now. If I did not, then I would need to work closer to 15-18 hours a week at it. Still, that is a SOLID niche practice!

Now, I am sure many of you make great money doing aesthetics, IV infusion, functional medicine, primary care, and so forth… Some of you probably make more than a men’s health, women’s health, or weight loss clinic providing other services. But what is your time investment? How much do you work?

Aesthetics = great profits, but you actually have to perform the procedure. It requires your time unless you outsource the work to others.

IV infusion = great profits, but it is laborsome. Mixing the bags, starting the IVs, managing the IVs, and so forth requires time. It is best to outsource that work to an RN or LPN in my opinion. IV infusion makes for a GREAT accessory service though to ANY type of niche practice! It is still a great niche practice on its own, but it requires more work is all.

Ketamine = great profits, but it is the same as an IV infusion clinic… it is laborsome.

Primary care/Functional Medicine/Integrative Medicine/Basically anything that requires consistent patient visits = great profits, but it requires your TIME. You must see the patients. You must have an encounter. While these are great services, they will require your time. Therefore, you better like what you are doing. The moment it starts feeling like “work”, is the moment you need to step away just FYI.

Opioid addiction = great profits ONCE you establish a solid patient base. Getting 100 compliant and reliant Suboxone patients takes TIME and a lot of patience from the clinician. But once it happens, it is a GREAT income source with minimal time investment needed.

The main trend is this: you want income sources that can SCALE/GROW, that are partially passive in nature, and that are easily learned and/or trainable. That is how you build a very profitable practice that will give you back the most valuable asset of all…… your time! Remember, you want a business that works for YOU, not where you are working for it!

Listen, all of the niche practices that we teach in our courses are profitable. I wouldn’t develop a course on them if they were not. My mission is to help nurse practitioners break free, and a component of that is income generation. Therefore, the profit potential and the time investment necessary to start and operate the niche practice should be a consideration when you are starting a practice or considering integrating another service into it.

Another consideration is how much you enjoy providing that service. If you LOVE it, then it will never feel like work, so it doesn’t matter what the time investment is. If you are “okay” with it, then you need it to become partially passive for you. If you are “eh” about the service, then you need it to become as hands off as possible because once it starts feeling like a grind and a rat race, you are back to square one!

THAT is the main reason why I ranked the services as I did. Remember, time for dollars… You must exchange your time for dollars, there is no way around it. Owning and operating a practice typically takes a lot of active work at first, but it should begin to passively generate income for you. Men’s health, weight loss, and women’s health/HRT are services that can do just that if you follow the model in the courses and have a subscription-based payment model.

I know nurse practitioners who operate these types of practices and generate $100,000+ a month in revenue working 15-20 hours a week. That is going to be VERY hard to do with services that are more hands on such as aesthetics or IV infusion in my opinion (unless you outsource work, WHICH YOU SHOULD if you want to scale your business and become one of the few nurse practitioner millionaires).

I hope this article was helpful and enlightening. I would LOVE if you could comment on your estimated numbers and the services you offer. It will really help all our nurse practitioner family see just how POWERFUL we really are in addition to assisting one another on what path to choose based off:

Profit margins

Time investment

Enjoyment of the niche service

These are the 3 main factors to consider in addition to the competition in your area. If you can truly think and reflect on all 4 factors, you will be LIGHT YEARS ahead of anyone else wanting to start a particular niche practice or integrate a new service into their practice in your area. I guarantee it!

12 Responses

  1. Thank you Justin! I started my IV hydration business in December. I rent a space around 120sqft (super small) and have three lounge chairs, a desk and a sink with above and below cabinets. My room is inside a beautiful spa, but I do not get any clients from within the spa, my new clients come from Google search. Facebook ads weren’t successful for my business and I am not very present on social media. My website gets a lot of compliments, my clients love how easy it is to navigate and schedule. Problem is with Square, they do NOT utilize SEO, can you believe that?! I’m not exactly sure how I am organically top of google searches but I get 90% of new clients from Google search and 10% by word of mouth.

    When I opened my business in December, I was only open 15 hours a week at the spa, and 30 hours at a corporate health clinic. I hired 3 nurses in March to pick up hours that I couldn’t be at the spa, and pay them commission. That’s when I started weight loss. Holy crap! I spend $0 on marketing for weight loss and it’s taking off, I am the only one in my area prescribing it, and everyone losing weight on my program is free marketing for my business! My six month goal was to gross $10,000, which I achieved. And last month my business gross was $18,000. I work 10 hours a week at my spa doing in-person consults and follow-ups and IVs. My nurses LOVE their job and make more money than I do as an NP in corporate med. My next business plan is to add Men’s Health, and will be taking the course soon and moving into a larger space. Thanks to you and the group, my nurses and I love our jobs especially during the time we almost threw in the towel with healthcare.

    1. Hi Jami!

      Awesome, good for you! Continue adding additional services and see that income GROW GROW GROW!!!!

  2. I’m in the primary care (rural) category and income is excellent. The hours depend on how anal you are about details and I’m one of those. I cannot do a cash based practice where I am, no one has cash. LOL. I’m more like a train wreck investigator and these people with a million issues keep me up at night. In response to that, I have started limiting who I will accept as a new patient and forcing myself to take some breaks.

    1. You need to do that… You need to learn how to say NO… it is good for your mental health. But I GUARANTEE you people will pay cash. There are ALWAYS going to be people in any area that pay cash. I practice in one of the poorest counties in the country and my cash practice is thriving. People Will Pay You Cash

  3. I wish there was a forum like this for RN’s we need and deserve our own businesses as well. Great read!

  4. Hi Justin,

    I have owned my own family practice clinic since 12/2019 and already do some men’s hrt. How would you suggest that I transition into having a “men’s health clinc” separate from my family practice? Maybe do men’s health one day per week? I employ one other nurse practitioner currently and we each work 4 days per week.

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