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

The Niche Side Practice

What is a niche side business? I define it as a small business that provides a specialized product/service to a targeted market that can generate a profit with less than 12 hours a week spent on it.

If you want to follow the advice on this blog and build a life of professional and financial independence as a nurse practitioner, you must start a small niche side practice. It is imperative for 3 reasons:

  1. It will generate far more money then any part-time job ever will.
  2. The tax advantages that a small business provides are numerous, substantial, and impossible to obtain without owning a business.
  3. It provides an enormous amount of satisfaction and pride.

Listen, if you are a nurse practitioner picking up extra PRN shifts, doing Medicare home assessments, or working a part time job, then chances are you are not being compensated as well as you could be through a small business. Why is this?

First off, you will generate far more revenue through your business. I will perform 20 medical cannabis evaluations on a Friday morning between 9am-1pm and make $2,500. Tell me, what job can you get as a nurse practitioner that will pay you $450 an hour after expenses? NONE. If you know of one, please email me at theelitenp@elitenp.com. I want to know what kind of hustle that employer is pulling.

Secondly, you will save a tremendous amount of money through the tax deductions available to small business owners. You would never be able to write off your cell phone bill, car payment, car insurance, business dinners, laptops, internet bill, or business trips (vacations) through a standard W2 position. You can through a business though. My tax bill decreased significantly after I started my own businesses. Yours will too, just make sure you find a good accountant who understands tax law or consult with a tax attorney. I generated over $500,000 last year through my part-time urgent care job and my businesses last year. My tax rate was around 15% legally. You would never beat that working a standard W2 position. NEVER.

Lastly, the amount of pride and personal satisfaction that comes with owning a successful business cannot be described. You will NEVER reach that level of self-actualization through a standard W2 job. If you can, great, but I never could… I hated the fact that I was making my employer rich, it did not resonate nicely within me. If you are reading this, I would suspect you feel the same way as well.

Outside of its benefits, how do you create a niche side practice? There are 3 requirements:

  1. It provides a NICHE service/product to a specific market.
  2. It is profitable within 3-6 months.
  3. It does not require more than 12 hours a week to operate/maintain.

That is what a niched side practice truly is. The goal is to spend the least amount of time on the business as you can and generate a profit. More freedom in your life should be the goal. Freedom requires time, which requires easy money. This can be obtained with the right strategies.

There is an entire article about how to find your practices niche here. Read this and understand the concept. It is critical that you provide a niche service that interests a specific market of individuals. My men’s health and testosterone clinic targets upper middle class to wealthier men. My medical cannabis clinic targets baby boomers and individuals interested in alternative treatment options.

Finding a SPECIFIC market is critical. This allows you to TARGET that market and sell your niched service to them. This is probably the most important part of starting a business and will be what makes or breaks it… and adequate marketing.

A niche side practice should also be profitable within 3-6 months. If you are struggling to make a profit by month 6, it is time to seriously consider closing the practice and starting something else. Maybe the niche is to “niched” and there is not a market for your idea, or you aren’t spending enough on marketing. Remember, marketing should be the number one expense in your business.

Sometimes people specialize their service or product to much. There is a point where a niche is to “niched” for your region. For example, you cannot open a transgender clinic in a conservative midwestern town of 5,000 people. It won’t work. It is very important that you ensure there is a market for your niched service or it will be an uphill battle.

Lastly, this niche side practice must be something that you can do very part-time. You do not want to give yourself a second job. That will decrease your freedom, not enhance it. It will take a lot of work getting the practice up and running, but after that, it should work for you, not the other way around. You do not want to work for your business. To avoid that, ensure that this side practice can be operated and maintained on 12 hours or less a week.

If you follow The Elite Nurse Practitioner Model, the goal is to eventually build multiple side businesses. Therefore, it is imperative that each business you build can be maintained on 6-12 hours a week. This will allow you to maintain a part-time job to sustain your livelihood while the side businesses generate your wealth.

Your niche side practice must provide a specialized product and/or service that will generate a profit quickly and can be done on a very part-time basis. This is why choosing niche services like men’s health and testosterone replacement therapy, hormone replacement therapy in women, medical cannabis, ketamine infusion, IV hydration, stem cell injections, weight loss, and opioid addiction treatment are great niche side practices! They target a specific market and can be done part-time.

Every nurse practitioner reading this can easily generate an extra $5000-$10,000 a month with one niched side practice. This small side practice can be the catalyst in the snowball effect of business growth. Usually it takes 1 small business to become successful, this then snowballs into more and more income streams. Your first side practice will be the most important one you start, make it count!

24 Responses

  1. Thank you for this. I never thought about starting a small practice that tailors to a niche market.

  2. Looks like a developing niche might be telemedicine sick visits! People are scared to venture out to normal clinics any more. Thoughts?

  3. Hi there! What about when your current employer already manages your NPI number? My NPI is associated with their address/practice. It seems this would present challenges with using my NPI for my side business. Is this the case? Is there a way to work around this?

    1. If you accept insurance, then yes you will need to obtain another NPI. If it is a cash practice, don’t worry about it.

      1. Thank you for responding so quickly! I will not be accepting insurance. So I can use the same NPI for e-prescribing/labs? Any risk of my employer receiving any type of notifications about my activity on my NPI with my side practice?

        1. Yes, you can just use your personal NPI. Every once in a while your primary place of employment might get a letter for a lab bill or a request for a refill from your other practice, that has happened to me a HANDFUL of times at the urgent care I work at. Otherwise, there is no reason to have another NPI.

  4. Let’s say you have 3 to 4 target niche business ideas. Do you recommend spreading them out into different telemedicine practices? (For example all different company names, LLC’s, websites, etc? I hope that makes sense.

    1. If they are complimentary to each other, then it can be under the same practice. If they are totally opposite, then I would function under different LLCs

  5. One more question, so when you talk about making 2,500 for 4 hours of work, depending on taxes in your state, what you are actually making is significantly less than that, correct?

  6. I apologize, I don’t think my first question was posted. Operating a concierge business, do you have patients who feel as though you should either “prescribe” what they want or feel you should be at their beck and call? How do you deal with these individuals if this does happen>

    1. As long as you are charging enough to justify the “beck and call”, then so be it. What is your time worth? That is up to you to decide.

  7. I am new to this post. But my question is: how can a NP with her own NPI can prescribe meds without a MD collaboration?

    1. You can only do that in a full practice authority state. If you are in a restricted state, then you need a collaborator if you want to start your own business or do telemedicine in an independent state if you have a license there!

      1. HI Justin!

        I’m thrilled to have found your website! I can’t wait to take your PMHNP course. I’m still in grad school for PMHNP and have been racking my brain to figure out the best course of action once practicing. In my opionopn, telepsych is were it’s at; however, I live in PA-restricted. If I have a brick and mortor and obtain a license in PA and MD, saw patients there once or twice a week, could I do another day or two virtually from PA? Do you think this would take up too much time and therefore not be a part time business?

        I’m super excited to navigate all your material! NIce work!

  8. Do you have any advice/direction for a RN starting a new Mobile Vitamin Hydration and Injection business. I will also bring doing weight loss injections.

  9. Hi Justin,
    After reading multiple articles on your website regarding side niches, I think I came up with a side niche but I would like your input.
    I am thinking of creating a men’s wellness clinic which only focus on weight loss which can be done via tele visit. Once the business picks up, I will add other services such as TRT/ED. What do you think?

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