I started a job with a clinic in Colorado Springs.
I was a nurse practitioner there for seeing patients.
That was my primary role for about 18 months.
And then at that point I was offered a clinic
director position and I was able to, yeah, it
was awesome. My startup costs like initially
probably around two or $3 ,000. What kinds of
things does she do for you? Everything. I at
least am putting force. On average, probably
about five to seven hours a week. I think that
that's what is the building block of wanting
to own a private practice. Welcome to No Prior
Off. My guest today is Robin Goldsmith, a psychiatric
mental health nurse practitioner and the founder
of Agape Psychiatric Care. Robin's been in practice
for about 12 years. She got into this work back
in 2014 after spotting the gaps and how people
were actually getting mental health care, and
she's been building around those gaps ever since.
Agape is a mostly virtual practice with three
physical offices spread across the Southwest
so her team can prescribe controlled substances
and still meet DEA requirements. It's her plus
three other nurse practitioners treating anxiety,
depression, ADHD, PTSD, OCD, the usual, but with
a functional medicine lens. She uses labs to
rule things out that often get missed like thyroid,
hormones, nutrient gaps, metabolics. Her philosophy
is no stigma, just understanding. What I really
wanted to dig into today is how she built this,
a hybrid psych and pee practice with a real team
using a hybrid model, and the physical offices
as the compliance layer, not the other way around.
Robin, welcome in. Thank you so much for having
me. I'm so excited to be here and just kind of
share a little bit about my story. We are so
excited that you're here. So you were born and
raised in Arizona, correct? Yeah. Yeah, I was
born and raised in Arizona and got married at
a young age and my husband joined the military
and we kind of built our life around the military
lifestyle. So you've moved around a lot. Yeah.
Oh, yeah. We actually got stationed in Arizona,
our first duty station. So from Pine Top Lakeside,
Cholo area. And we then got stationed at Davis
-Monthan. We were in Tucson for about six years.
We had our son and then we moved to Texas for
four years. And then from there, we went to Colorado
and we were there for about seven years. And
then we went to, we're now in South Georgia.
South Georgia. Oh, wow. Okay. You have moved
around quite a bit. Yeah. What made you decide
to get into mental health and become a psychiatric
nurse practitioner? Honestly, it was just the
gap in care. I saw it in my husband's career
field. He used security forces in the Air Force.
And so we just saw like, and I think it really
has improved, honestly, over the course of time.
I think pre -COVID, it wasn't as widely talked
about post -COVID. We see that there's a lot
more communication going on in the military installations.
But that was a big push for me to get into the
mental health space and realm. Yeah, absolutely.
That makes sense. So how do you feel about starting
into private practice as a new grad psych NP
versus like getting experience? And what was
your experience? Yeah. Yeah. I graduated from
Second Peace School in May of 2020. So I got
kicked into. crazy, you know, changes and just
our world was upside down. Right. So telehealth
was just starting to come out. I started a job
with a clinic in Colorado Springs. I was a nurse
practitioner there for just, you know, seeing
patients. That was my primary role for about
18 months. And then at that point I was offered
a clinic director position and I was able to,
yeah, it was awesome because I was able to see
the inner workings of the clinic. So, and I didn't.
you know it was great experience so i managed
a tms chair we had two in that clinic i had 10
other therapists three other medical providers
front office staff mas so it really allowed for
me to get a good understanding of numbers and
caseloads and how to manage and networking and
collaborating um so if anybody can get some kind
of experience like that even if it's you know
honestly in my opinion even if it's like they're
not going to pay you really well you're the information
that you're going to gain is like tenfold. It'll
come back to you. Yeah, I know that's like a
controversial topic, right? Like do you take
something with lower pay now if it's something
that you think the experience will pay off in?
I think take it situation to situation, you know,
but I do think that there are situations where
it makes sense. At what point did you realize
like, hmm, maybe I could build my own? private
practice? Like how did that happen for you? Yeah,
I really just saw the inner workings of the clinic.
And so, you know, managing 10 other therapists
and three other medical providers and the clinic
numbers, that was, I mean, it's a lot, you know?
And so I realized like, okay, well, if I can
do this, then I can do this at a smaller scale
likely. So I continued on with that, with that
job for, gosh, I was in that role for about a
year and a half. And my husband got orders. We
thought, wow, we're going to retire out of Colorado
Springs. Well, you know, I don't know why I thought
that I could control the military because I can't.
And so we got orders and that was like my, that
was the fast route for me to just say, okay,
I have to take this into my own hands and just
run with private practice. So it worked out perfectly.
It worked out just the way that it was supposed
to. Yeah. So it was kind of that experience you
think that gave you more confidence because of
what you learned, it sounds like. Yeah. Absolutely.
Yeah, absolutely. I was already kind of like,
you know, thinking about it. I was thinking about
what that was going to look like in my future.
But I really think us getting those orders to
move was like, it was a push that I was like,
okay, I have to do this now. Like, there's no
other option. I'm not taking this job with me.
And, you know, paying South Georgia, unfortunately,
is horrible. And it's such a restricted state
to work in that I wasn't really willing to kind
of run by those guidelines, you know. Yep. What
states are you licensed in? I'm licensed in Arizona
and Colorado. So it works out really well for
me from a business standpoint. I love Colorado.
We have lots of ties still there. So I go back
to Colorado three or four times a year to tax
write off. And so tax strategy is a huge piece.
I think of business ownership, really understanding
how you can write, you know, travel off, expenses
off. Arizona, I go home to see my family. I mean,
really probably about four times a year. So I'm
also able to write that off. I see patients and
kind of, you know, incorporate that. That's exciting.
So how much money would you say that you spent
when you first were launching your practice roughly?
Because that's a question and it's across the
map. Honestly, the answers I've been getting
as I ask people this, how much they spend to
get going. Yeah, I would probably say my startup
costs like initially. probably around two or
$3 ,000. I did spend some money. I have intake
Q and I did spend some money to have somebody
build that program out for me because it is a
little bit more DIY. Now that I've used it for
the amount of time I have, I've reinvented my
intake forms and I know exactly how to code those
out. And so I'm not really doing that as much
and having to pay that, but that was invaluable
at the beginning, another company that built
that out. And so it just made my life so much
easier. So that was a big chunk of money. I didn't
really have, I had maybe like a two to $300 bill
a month to have office space, you know, and it
was just as needed and where my mail would go
and stuff like that. And then we utilized Spruce
for communication. So that was so helpful and
it still is. That's an invaluable tool. I love
Spruce. Me too. It's a great, great tool. And
it's just seamless for patients to be able to
communicate. Okay. That's interesting. That's
interesting. I think maybe you and I use the
same company to set up our interview. Yeah. So
at what point, like, did you know that you were,
did you start out thinking I'm going to be a
solo practice or I want to do a group situation
and then talk to me about like the credentialing
and referral sources? Yeah. Yeah. So I went into
this really just thinking like, I'm doing this
for myself. I want to control my own schedule.
I really don't want to manage a lot of people
because again, I was dealing with different modalities
inside of the last clinic I worked with. So that
was a little bit harder. I'm really understanding
job structures and roles. different degree paths
and all those things. So I was really good at
the med side of things. I, I was the medical
director as well. And so I was able to kind of
incorporate that in my day -to -day practice,
but I really went into this almost in a sense
of like burnout of like, Nope, I'm just doing
my own thing. I'm just going to create my own
destiny and do my own schedule. But I quickly
realized it's kind of lonely by yourself. And
so I did that for about a year though, on my
own and it was great, but I also. started to
realize like, wow, I, I really need some help
answering the phones. And I'd really like to
go on a vacation and somebody cover my time or
have more, you know, help with intakes. So I
hired another nurse practitioner. I also hired
an assistant through HelloRage game changer.
Um, I read the book, um, who not how that. book
literally changed my life. And it may not be
as impactful for others, but for me, I have a
mindset. I grew up with an entrepreneurial father
that does everything himself. And so just that
mind frame of just, I have to do all the tasks.
And once I realized like, wow, I just need to
figure out who can do this job, not how I need
to do this job. And I need to be able to focus
on my patient care. It changed the structure
of the game for me, for sure. Okay. That's awesome.
So did you hire the virtual assistant first or
the nurse practitioner first? Actually together,
almost at the same time. So I brought the nurse
practitioner on and I started to realize like,
okay, within that same timeframe, I can't answer
phone calls to get intakes on the schedule. I
need to be able to still focus on my caseload.
So I did them both at the same time. And that
person, my virtual assistant is still with me.
She's amazing. Yeah. She's been with me for now.
Almost three years. Wow. And is that kind of
an affordable hourly rate that you pay? Oh, yeah.
I think it's like $9, $9 .50 an hour. And that's
really good money for them. And she's a pharmacist
in her country, in the Philippines. And so she
kind of works that, you know, on off -duty hours
or whatever. And that's incredible because she's
bringing other knowledge to the company. Yeah.
So it's great. What kinds of things does she
do for you? Everything. I mean, literally, yeah,
everything. She answers the phones, she schedules,
she helps with my billing. She helps with my
marketing. She assists with my social media.
I just hired another assistant and he does all
of my, everything that she's doing too. So it's
just kind of a replication of her. So it just,
it makes the clinic flow just so much easier.
totally worth spending the money because it really,
that money comes back to your tenfold. Yeah,
absolutely. So pretty cool that you have hired
one of the nurse practitioners who graduated
from the Psych NP bootcamp and fellowship. Tell
me about like, how was that for you? Like hiring
someone who was maybe a little bit more prepared?
she's amazing she's great she's good at what
she does she's and and here's the point too like
I've really and I've tried to hone this in with
the other nurse practitioners that I've hired
maybe and just the mind frame that I have of
hiring like I can help you learn really anything
that there is in psychiatry. It's that personality
piece that is so important to me. And she just
exemplifies the personality plus the knowledge,
you know, so she's like the total package, you
know, so she's been a great, great hire for the
company. She's really like exemplified in patient
care. She gets really great feedback. So it's
been a positive experience for sure. That's awesome.
I love to hear that. So you'd hire from the fellowship.
fellowship graduate again. Yeah, I think I already
reached out to you to hire my next one. So I'm
ready. Posted on socials the other day that sometimes
I feel like a psych NP matchmaker. And I kind
of love it. You know what I mean? Yeah, absolutely.
As far as getting credentialed independently
versus like using some of these companies, tell
me about that. Yeah. Yeah. So I went with headway
and Alma at first, and I still honestly use both
of those platforms to tell you the truth. I have
diversified a lot more since, um, getting started
though. I've credentialed my business and I'll
leave all of these companies that I've used.
I'll leave for you. So that way you can like
post it within the podcast, but I found a really
great biller. Um, and she has changed, you know,
the, the career or the. How did you find her,
your biller? Word of mouth, actually. Yeah. There
was another, my mentor used her. And so she told
me about her. Yeah. So she's fantastic. Actually,
both of my, the credentialer and the biller I
found through word of mouth. So, and they're
great. Then my credentialer is like, so organized,
so organized. We'll give you the whole spreadsheet,
tell you exactly where you're at in the process.
Here's all your passwords. These are your usernames.
This is where you log on. It's incredible. So
she's been a game changer for my practice though.
And then I hired on somebody that did my website
development and I'll list her information too.
Originally, I used her for my first website build
out. And so that was great. Just keeping the
expenses low and being able to work efficiently.
Yeah. Was that through HelloRage as well or no?
No, no. So the website development was here.
She's located in Arizona. And then both of the
biller is actually, I think she's in New Jersey.
And then the credentialer is in Colorado. Okay,
gotcha. You mentioned your mentor and how she
kind of had used them. was vetted. How did you
find your mentor and was it like a coaching program
you did? I like to know kind of, yeah, how, how
people feel about like the coaching and mentorship
and, and whatnot and investing in that. Yeah,
I actually, she is my second PE mentor. So she
was one of my receptors when I first started
school. And then I worked alongside of her in
the same clinic. I left the clinic. She remained
with the clinic a little bit longer than me.
I went into private practice. And so our roles
kind of switched just a little bit because I
went to private practice a little bit sooner,
but she found the credentialer. before, you know,
I had really started to explore that area. I
was still just using headway and Alma. And so
she shared that with me. So we've kind of like,
we've just remained really good friends and been
able to kind of engage in a great way. She's
one of my best friends. So it's awesome how it
works that way. I love that. Yeah. So is all
your billing now, like through your own stuff?
Yeah, not all of it through. Some of it's still
through headway. Yeah. So I do some of it through
headway still from some through Alma, some of
it's through my company through, you know, my
credential, like my contracts that I, I carry
with the insurance and it works out great. Like
there's some like TRICARE, Medicaid, you know,
those are going to be ones that are going to
have to go into through my, through the company.
And then the other ones will have to go through
Alma and headway. Gotcha. Gotcha. So does it
come down to like rates? Yeah, sometimes it does.
And I will say like, as I brought people on,
Headway has been great for group practice. So,
and they do that. So that's really cool. It's
interesting. I just got off of another podcast
interview where same thing. And it's funny because
I had looked into doing this and I swear I met
with Headway maybe right at a time where something
was funky, but they were like, we're not, we
can't do the group practice thing. But like.
people still continued to use headway and continued
to scale group practices so I don't know I was
maybe asking I don't I don't know but it's it's
awesome that it's worked out that way well and
it's awesome because then we get payout so quickly
so we can you know as long as the notes are closed
sent to billing you're going to get paid within
two weeks so it's awesome it's fast you know
so it keeps my payroll in check in order to get
everybody paid out for the end of the the weeks
As opposed to like credentialing, how long does
that typically take? I think it just depends
on company. I think it depends on where you're
at in the year. I think there's so many variables,
you know, so there's sometimes where it's like
Medicaid. They pay out so fast. You know, I get
my payout within a week of closing that note
and getting it sent off to billing. So whereas
there's other companies that, you know, they're
sitting on it for 60 days, you know, so you're
waiting to pay out there. And that's where maybe
hiring hourly versus split. It's you have to
make those decisions kind of accordingly. So,
yeah, and I've done both and they work well in
practice. It's just trying to figure out how
how your numbers are going to work for your clinic.
Yeah, absolutely. Absolutely. So you see patients
in person once a year. Right. If, if they're
on average. Yeah, I'll go. I mean, I, I try to
like break it up to where I'm like, okay, I'm
going to, I want to go to Colorado. I want to
go, you know, like I said, I, I use this to my
advantage too, you know, so I'm going to go see
patients and then I'm going to go and go snowboarding,
you know, in Colorado. It was an awful year this
year, but just in general, that's what I'll do.
And so I'll see patients for two or three days
out of that week. And then I'll spend the weekend
doing whatever I want to do and then fly back
to wherever I'm going. So yeah. Yeah. I love
that. Sorry, I'm like all over the map, but I
forgot to ask you about, are there any other
platforms you use other than like the Alma and
Headway? No, that's really it. Alma and Headway
for, yeah, the billing purposes. I know there's
like Rula and stuff. I haven't even researched
it. I just feel like we're plugging along with
what we got. What percentage of your referrals
would you say have come from Headway and Alma?
Almost probably a little bit better, honestly.
I haven't tracked the numbers. I could probably
get those though for, you know, after the show,
but headway, barely any, like I don't get very
many referrals from them. I get a lot of my referrals
from the relationships that I'm, you know, creating
outside and just networking. So meeting with
therapists, meeting with primary care offices,
collaborating on care, I, those relationships
go. so far yeah and talk to me about that like
because i think people it's helpful for them
to hear is that something that you do primarily
or do you have any of the support staff helping
you with that and is it just like you're reaching
out on facebook groups and setting up like coffee
chats or like practically how does that look
yeah i mean all the above i i really am doing
a majority of those calls because i really think
it's important that people are putting the name
to the face of the company. So I do a lot of
those warm touches. Yeah, they're assisting with,
you know. scheduling and, you know, making sure
that those appointments take place. But for the
most part, like I'm the one that's conversating.
I do a lot of, you know, just like, Hey, you
just want to get to know your practice. I want
to understand what your specialty is. I softly,
I know that we can't require, but I softly require
that my patients are all engaged in therapy.
So that makes that relationship building process
so easy because it's like, I need to have referral
sources. If I'm going to, you know, really encourage
these practices, like those referral sources
need to be. on the ready and when I'm ready to
send my patients to a place. And I also want
to make sure that that place is vetted with good
providers and they're going to get what it is
that they need. Yeah, absolutely. So you've been
in practice about three or four years, private
practice, right? Yeah. You might not know the
answer, but roughly how many hours a week do
you think you spend networking, marketing, relationship
building? Yeah, gosh, I, I at least am putting
forth on average, probably about five to seven
hours a week. You know, really, I think that
that part's what is the building block of wanting
to own a private practice, like, and building
those relationships and making sure that you're
getting those referral sources. It's so important.
Yeah, absolutely. Yeah, that's helpful. How do
you like being in private practice? How is your
quality of life? Are you burned out? Do you have
other sources of income? I don't have any other
sources of, I mean, minus my husband's military.
So, you know, total income there, but no, I definitely
am just, I love my job. I love what I'm doing.
I'm passionate about what I'm doing. I'm starting
to realize though that. I can touch so many more
lives if I continue to kind of grow my practice
and surround myself with people that like to
practice the same way that I do. I really have
a functional thought process about care. I really
aim to really provide pretty decent therapy,
you know, motivational interviewing. I want goal
setting. purpose in people's lives. I think that
these were really important. It's beyond medications.
I didn't go into this to push meds. And if they
work, that's great. But I literally am probably
the worst business owner in the sense of I'm
so excited when I get to discharge a patient
because we've figured it out or they got down
to the bottom of it. They found resolution. It's
just, it's so fulfilling. Yeah. It's incredible.
The impact piece for sure. I think you and I
are Or maybe you did it in the past, but we're
in the same integrative psych fellowship, right?
Psych redefined. Yep. When did you do it? I did
it this last year. I didn't finish it. fully,
you get two years and somebody should have never
told me that because I'm like, Oh, I get to like,
I know, come back in and do more coursework.
That's great. You know? So I probably did a little
bit, you know, I did it a little bit slower than
I should have, but I have the rest of the year
to complete it. So, but it has been, Oh my gosh,
that program has been so energizing for my practice
because I just take some of those protocols.
I implement them. I see how they work. And I'm
just like, wow, like that was a game changer
that. changed for that patient. I know that's
anecdotal, but you can pull the research and
you can see exactly what it's doing. So yeah.
Anything specific that you've implemented that
you've been surprised by, I guess the results
of. Yeah. I mean, honestly, I'm, I'm big on sleep.
So I've now everybody's on magnesium glycinate.
Like I use that stuff like candy. I do a lot
of lab protocol. I'm big on. making sure iron
ferritin is where it should be. I really like
to look at hormones. I don't specifically do
them myself, but I do get them set up, sent off
to get hormone replacement if need be. I'm looking
at thyroid, really just doing deep dives on some
of these things that may be contributing to their
mental health symptoms. MTHFR, huge B12, homocysteine.
You know, I just think like these are things
that we can incorporate that can really impact.
quality of life for our patients. Yeah. And how
about the providers you hire? Are they, do they
practice kind of that integrative functional
way? Yeah, absolutely. It's probably one of the
big key. factors when I'm hiring that I'm discussing
that because the protocols that I'm kind of putting
together in my clinic is guidance, you know,
for the clinic, you know, for the providers,
of course, they don't have to use it to its T
to the fullest. They're independent, but it is,
you know, I want that to be integrated there.
That's cool. So you've, you have some protocols
that you've shared with them. So you kind of
like educate and help them implement some of
those strategies. It sounds like. Yeah, absolutely.
A hundred percent. Okay. Very cool. Where do
you see things for you? Psych NP wise in like
five years from now? I know that's kind of a
big question. I hate when people ask me this.
No, I think that's good. Actually. I would probably
say I would, I may have a couple more second
piece. I may, you know, there may be growth for
others though, too. And so there may, there's
a little bit of movement there. I'm hopeful to
continue to feed into more psych and peas. I
feel, you know, once I started to realize like,
wow, like. My caseload can really only be about
300. 300 is like my sweet spot. You know, there's
a lot that are maybe I'm only seeing every three
months, you know, it's just a good spot for me.
And so I start to, you really start to look at
that number. Like you think it's a lot as an
individual person, but then when you look at
into your state numbers or your community numbers,
it's like, oh my gosh, I'm like, literally it's
a fraction. It's nothing. So if I can bring on
more people that are able to collectively. care
the same way that I care, we can impact so many
more people. So I'm hopeful that there'll be
clinic growth for sure. Yeah. I'm curious about
like, have your stress levels gone up with managing
other people? having hired people yeah in some
ways it has there there has been you know there's
there's always going to be some sort of um stress
that kind of entails there but i i don't think
it's like from a way that is losing sleep or
you know it's just a different kind of stress
it's either i have that stress when i'm doing
patient care or i'm helping you know other providers
kind of obtain their goals and you know and obtain
court their load of patience and do it in a safe,
effective way. Yeah. Okay. That makes sense.
What would you say is like an underrated hack
or I don't know, just like a tool you've used
that you're like, man, people don't appreciate
this enough, but this really is a game changer.
Yeah. I was just playing with AI today, yesterday,
actually. in regards to like 1099 pay and things
like that. And I'm like, Oh my gosh, I like coded
out something. I'm like, how, this is so crazy.
This is where our life is going though. And we
better figure it out because we're gonna, we're
gonna, it's going to happen fast. What, how many
hours a week or do you commit to like learning
about AI? Oh gosh, not enough. Probably like
one, one hour a week. I need to definitely be
putting more time into that. I was just saying
that yesterday to my husband, who's like a total
numbers guy. You know, he really helps in the
background with like financial stuff. And I just,
I think like some of these things that we may
spin our wheels on for two hours can be done
in one or two minutes, you know? How are you
using AI right now? I'm using it definitely in
my appointments. So I'm using it for note writing
and stuff like that. So I'm doing the, I use
berries. That has been a game changer for me.
Like I said, I built out this 1099 calculator
because that's really important that they kind
of realize how much money they can make or how
much they need to work, how much time they can
take off in order to kind of incorporate what
their overall quality of life looks like. I built
that out. What else am I using it for? I don't,
I have, I don't even think I've scratched the
surface with what it can do. Yeah. Right. Yeah.
No, that makes sense. That makes a lot of sense.
What do you think about, like, do you think it's
important for psych NPs to build personal brands
and why or why not? And what does that look like?
Do you think in 2026? Yeah, absolutely. I actually
took your, your branding course at the beginning
of the year and it like, it's been such a cool
change to watch. I was uncomfortable. I didn't
want to do it. I said, I'm going to sign it.
I saw it in a December posting and I was like,
this is what I'm going to do in 2026. And then
2026 rolled around and I was like, why did you
do this? But you guys held me accountable. You
and Ryan did an incredible job with that course.
And there was a great group of women that were
kind of surrounding and it was positive and it
was influential. And now I have like over a thousand
followers. Like I didn't do much. You're very
natural on there. And like when you do put content
out, it resonates and people are like, so go
follow Robin. What are your handles? Robin Psych
NP with a Y. Okay. Awesome. Has there been anything
interesting or opportunities that have come,
you know, out of that yet or not so much? You
know, I feel like I haven't put as much, you
know, into it as I probably should be putting
into it. But I do see like when you put your
face out for other patients to see you, they
understand what they're getting. You know, like
I think that's something that we don't think
about frequently is like patients are really
searching for their next provider. They're not
just like, oh. There's the name. I'm just going
to go with them. They're like looking at their
social media. They're looking at how, what their
personality is. And so it's important to be out
there and, you know, ready for the next person
that's coming along. A hundred percent. Do you
remember how we got connected? Oh gosh. I just,
I probably saw you on Facebook. I don't really
remember to tell you the truth. I was thinking
a Facebook group too, for some reason. So that
sounds right. One of us DMing the other one and
doing like one of our little coffee networking
chats, I think probably. Yeah. Yeah. Yeah. Yeah.
Yeah. It's yeah. It's fun. It's, I feel so much
more connected when I'm, since I've been visible,
you know what I mean? Oh, a hundred percent.
Yeah. Relationships. It helps you not feel isolated.
Yeah. Yeah. The isolation. And then it's just
putting the, you know, the connection with that
person. So it's so cool. Yeah, absolutely. What
advice would you have for a new psych NP who's
having a hard time finding a job? Oh, that's
a good one. Honestly, I would say if you can
find yourself a private practice, that's already
kind of built out and maybe just do a drop in
like, Hey, like this is what I'm looking for
this, you know, You kind of instill some of these
values. I'd like to work with you as a contractor
or, you know, hourly if that's the route in which
you want to go. I think doing being a little
bit more bold in these and in this time is like
it's so important for us to be bold and just
put ourselves out there. I think sometimes we
get into our own head more than we should, you
know, and so. I think boldness is good. Is that
really what's going on right now in the job market?
Like are people not finding jobs because there
are patients for sure. People are not finding
jobs. Yeah. People are not finding jobs. It's,
you know, geographically that matters and, you
know, what people are accepting pay wise, but
for sure it's a struggle, you know? So I think
just like getting creative, the last provider
I interviewed, he hired. his providers from LinkedIn
you know and LinkedIn I think is like an underrated
tool where it's like get your profile updated
you know have it reflect if you do a mentorship
program or a fellowship put that on there like
put anything that's going to differentiate yourself
on there have a professional headshot you know
what I mean like that can make a big difference
so Yeah, absolutely. A hundred percent. So I
don't know, you know, that boldness, I just feel
like it just kind of puts you out there and says
like, Hey, this is what I want to do. And this
is why I want to work for your company. You know,
I think that that's the most important piece.
Yeah. Did networking come pretty like easy for
you? Are you pretty like social person? Like
as far as like, yeah, just networking and meeting
other providers. Yeah. I mean, it's definitely
right. You have to start, you have to be confident
in what you're talking about. So is that hard
the first couple of times? Yeah, absolutely.
But at the end of the day, I think, you know,
it's not like people aren't really quizzing each
other on what knowledge you have. It's like,
are you personable? Can you, can you carry a
conversation? Do you feel like these are skills,
you know, that you really, it's not going to
be in -depth conversations where it's like, we're
going to quiz every bit of knowledge that you
have right now. So yeah, no, a hundred percent.
How long are your follow -up appointments in
your practice? And what percentage would you
say of the providers or what percentage of the
follow -up appointments do you guys build psychotherapy?
And would you say roughly? Probably roughly about
50 to 60 % of psychotherapy. We do 30 minute
appointments. So I really try to incorporate
that as much for our follow -ups. For our intakes,
we're closer to the 90 minute, you know, 60 to
90 minutes. Everything's blocked at 60 minutes,
but there's a lot of appointments that if I am
afforded the time, I go into the 90 minute mark
because it's like, there's so much information
to obtain in that first initial appointment.
Yeah. A hundred percent. Have you reinvested
profits back into your business, would you say?
And if yes, how so? And do you think that's important?
I definitely in marketing. Absolutely. Like I
spend, I spend a large chunk of money in making
sure that community involvement, engagement is
where it needs to be. So that's probably my biggest
one. And I really think like that's important.
If you want to continue with growth, like you
have to spend money to make money. Okay. And
practically speaking, is that like ads or is
that like. Yeah, it's ads. It's maybe dropping
off some cookies. It's here's a coffee card.
Let's chat, you know, over coffee. What else
have I done? The ads are probably the most expensive
though. And that, you know, if they, they pay
off, those are a little bit harder to track though.
You know what I mean? So it's really, it's like
community engagement. That's I think the most
key. Yeah. how did you figure out how to do ads
and how much have you spent on them roughly,
if you don't mind us asking? Yeah. So probably
ads, I would probably say when I was like really
heavy into doing ads, I've kind of paused for
just a little bit on that one, but my like SEO
and ads and stuff, I was paying like $800 a month
in order to kind of get that up and going. And
it did, it paid off. It was helpful. Any conferences
or resources that you like love? as a psych NP
that you would recommend to, to others? Yeah,
I'm really big in open evidence right now. That
one's awesome. You know, just being able to pull
all that, all that information from journals
has been so helpful. Carla is my favorite. He's,
oh gosh, just all of his podcasts are great.
His books, his decision tree models. I bought
his book when I first graduated as a psych NP
and that was. It's truly the best resource that
I have ever used. And I still use it to this
day. NEI, I utilize the resources. I don't so
much go to there. Really just heavy on a lot
of ad management there. And then as far as conferences,
don't have anything lined up for this year. I
went to a functional health one. I forgot what
it was called. I'll drop that for you too. And
that was great. I did that. probably about two
years ago. I did NEI as well, like a couple of
years ago, that one was good. I try to get one
in at least a year. So. Okay. Awesome. Awesome.
And I know we're jumping around here, but what,
what percentage of your referrals would you say
come from like therapists and other providers,
I guess, in the community? Yeah, I would probably
say like, honestly, a solid 60 % are coming from
therapists. Yeah, I've been in some really good
relationships with therapists in the community.
So that's really a large chunk of where those
are coming from. And then I've got a really a
lot of primary care offices that I'm connected
with as well. And so we take care of their mental
health stuff. You know, we do a fax back after
we see them, you know, that truly helps kind
of solidify that relationship. Yeah. So you,
you're sure to like coordinate care and like
kind of continue to provide that level of continuity
so that they see the value of continuing to refer.
Yeah, absolutely. Yep. I love that. What do you
do self -care wise to like try to manage, you
know, life? Yeah, absolutely. I, you know, this
last year has been the worst for me for exercise.
Like, yeah. so bad. It's the worst it's ever
been in my adult life. So trying to get back
into that. My husband loves to golf. I really
like to golf too. So I've been getting into that
a little bit more frequently. And I just told
myself I was going to sign up for a half marathon.
Maybe I'll do that before the end of the year.
So that'll maybe just push me into back and getting
back into the exercise space. Yeah. I love that.
I love that. Good for you. Anything else that
you think that psych NPs should know in 2026,
as far as just like advice, having been in the
game for, I guess, what, six years now as a psych
NP? Yeah. Get yourself a really good mentor,
you know, get yourself somebody that you can,
you can lean in on. That's going to assist with
maybe some decision -making when it gets, when
it seems like it's messy. I oftentimes will tell
myself when I have, and I still tell myself this,
if I get, have like a messy intake and I'm like,
wow, there's a lot going on here. One thing at
a time. We're just going to deal with the, you
know, we're going to start with step one. And
so what is step one? Typically for me, step one
is sleep. If my patient is sleeping overall,
you know, a large chunk of their symptoms are
going to start to find relief. So if you can
start to develop some of those protocols in your
mind, have a mentor that you can maybe, you know,
chat with about, you know, being in inside of
your program or. Outside of your program, I just
feel like that is crucial. We should not be doing
this alone. We should be doing this as a team.
We should be able to have collaboration. I think
that's forgotten about in the school setting.
You just are like, oh, okay, survival of the
fittest. Like, let's make sure it happens. And
it's like, oh my gosh, there's no way. Like,
this is really people's lives, the people's livelihoods.
And so we need to make sure that we have the
most appropriate protocols in place. Yeah. Absolutely.
One last question. Well, actually two last questions.
So working with these platforms like Headway
and Alma is controversial, right? You hear a
lot of like black and white polarized opinions.
So that's another reason why I wanted to kind
of talk about some of this on the podcast because
I don't think it's black and white, but do you
recommend them? Yeah. I mean, I would for startup.
I still use them. I absolutely, I've had really
a very positive just interaction with using them.
I have quick payout, um, an easy way to build
a practice. You're able to integrate some group
stuff, but. I really think it's so important
that you're credentialing on the back end too.
We don't know what's going to happen. You know,
like these are tech industries. We have to remember
that at the end of the day. Yeah, they do have
people that are running these programs that,
you know, are credentialed. that they can, they
can absolutely speak for, you know, the billing
purposes and protocols and things like that.
But it's important at the end of the day, if
these were to go under, how would that shake
the industry? And I think it would shake it pretty
heavily if they did. So it's important that we
have a backup plan ourselves, you know, that
we're individually credentialed, our business
is credentialed. And we, if something changed
tomorrow, we could, we wouldn't skip a beat.
Yeah. I think that I totally agree with you where
it's like, I think that there's a place for these
platforms, you know, and a time and, but also
like longer term plan, you know, diversifying
and getting credentialed like that is important
as well. So yeah, I agree. I agree completely.
So one other question I ask every provider this,
what does the term no prior auth mean to you?
Ooh, good one. We come as we are. Here we are.
And we don't need that prayer off. So I love
it. I love it. That's a good one. Well, thank
you so much, Robin, for taking the time to share
your expertise and knowledge with us. Hopefully
I'll have you on again in the future and we can
kind of get updates as far as like just how things
are progressing for you. I just want more and
more psych NPs to. have access to this kind of
information because I know that I would have
like eaten it up when I was opening my private
practice. Yes, absolutely. These resources, I
was digging for them. So now that you're making
it a little bit more widely available, I think
that that's so important. Well, thank you for
being transparent. We appreciate it. Yeah. Thanks
for having me. Of course. Bye Robin.