You know, my mom worked at the state hospital
as a social worker that I was just going to be,
mental health was what was interesting to me.
I think it was fine. I think it was great. I
don't, everyone's tried to travel on nurse practitioner
colleges, like, like, oh, okay. Like, that was
so easy. Like, so unprepared. I don't, I mean,
it's like this thing of like. Okay, so nurse
practitioners or nurses who become nurse practitioners,
nurses are working women majorly, right? So this
nurse practitioner degree, the history of this
degree was to allow for women who are working
in the hardest job in the world, which is being
a nurse. So they're getting the best experience.
Now, did you know that you wanted to do a group
practice from the start? The first nurse practitioners
I hired were friends of mine. Nothing happens
overnight. Everything's slow. I remember I went
on this three week long trip right when I graduated
and I created this business. Like, we're going
to have to find places for me to stop and see
clients because I was going to see clients for
a little time. It took a really long time. I
think that the business funneling them, the psychiatric
course for the NP was my baby. Like, that is
all me. You know what I mean? Like, that was,
I love that course. It's still there. It's updated.
It has an incredible section on ADHD now. People
should check it out. If you've bought it, they
just updated it. So go check out the ADHD stuff.
Check out the Suboxone. I have, like, injectables
on there. This week on No Prior Roth, I'm sitting
down with Nick Goodwin. Nick is a psychiatric
nurse practitioner and the founder of Goodwin
Health Cafe, a multi -provider psychiatric practice
in Spokane, Washington, that specializes in treatment
-resistant depression. He offers medication management,
Spravato, and TMS, and he has grown his team
from one to four providers across two locations.
Before opening his practice, he spent five years
as a psych nurse in a state hospital, taught
undergrad psych nursing, and worked in adolescent
residential treatment. He's also created four
courses with the elite nurse practitioner that
teach NPs both the clinical side and the business
side of psychiatric practice. Nick has some clear
opinions on where psychiatric treatment is heading,
including psychedelics and functional approaches.
Let's get into it. Welcome, Nick. What's up?
Hey, how did you know all that? That's a great
bio. Can you send that to me? I'm going to put
it on my website. Yeah, absolutely. Yeah, that's
great. That's a good background, man. I'd like
that to stay. Good. I'm doing good. How are you
doing? Good. Good. It's been a while. It's been
a while. I'm happy that you're on because we
need you to tell us all the things. Nick and
I first connected, I think because of Facebook
Messenger. He's been in private practice for
a long time, I feel. How many years has it been?
Eight years, maybe. Yeah. Seven years. Because
I remember when I was getting started, I was
like messaging you like, hey. Do you want to
coach me? You want to do some mentorship? Do
you remember that? Yeah, I remember you reached
out. That was great. That was great. I was super
flattered. And it was cool. And then you were
doing mentorship already. So I was like, well,
tell me about what you're doing. So I thought
that was a cool conversation. Yeah, it was. And
then now we just are both like we haven't connected.
So this is so great to have you here. Can you
tell us a little bit about just kind of what
got you into being a psych NP and why you're
so passionate about it? Sure. Yeah. But real
quick, I want to say this podcast is killer.
This is super rad. You have like these guests
are also really like Daniel Carlette. I know
you're working with him, too. That is super badass.
That's super dope. That was super intimidating
to interview him. But it went well. It was a
great interview. I learned a lot. He's cool to
hear. I like that you got into kind of his background
and his dad is a psychiatrist. I thought that
was because he's kind of on the back end. Like,
you know, they're giving the Carlette content.
You know, you don't see a lot of his stuff. They
got a couple of books. That was really fun. Good.
I'm glad you enjoyed it. So I have actually interviewed
Alison Sikorsky and Maria Ingala. I know I told
you this already. I'm acting like you're so surprised
we've already talked about this. But I had updated
my Elite NP course and I wanted to include a
section on AI documentation. And Alison created
PMH NP Scribe, which is crazy and super awesome.
And that program is fabulous, by the way. I've
used it. It's really, really great. And then
I had cold called Maria. I guess it was cold
call for both. But Maria, just like her email.
And because I had taken her course on how to
hire virtual assistants who are overseas, which
was a really great course. I mean, I haven't
done it yet, but I still thought the course was
super worth it. It was super cool. And so she
was willing to interview me. I was willing to
get interviewed for this course as well. And
she's really a great personality. She's super
funny. If you guys, so that, that course is really
good. The, at the end of it, there's this great
part where she is interviewing her employees.
So you're actually talking to these people who
live in the Philippines and she's asking them
what it's like in that dynamic. Cause it's, you
know, you can't help but be like, is this wrong?
Like, is that a bad thing to do? Like you're
paying, you know, 10 bucks an hour for somebody
for a professional in the Philippines. And so
she interviews them and it's like, Holy smokes.
She's taking care of these, you know, staff and
these staff are taking care of her. it's it's
really cool to see that dynamic that was a great
touch to that painting that's very cool i don't
i didn't realize that so that's actually part
of the elite np course is like no no that's her
course no no that's her course i'm trying to
okay yeah go paper flower institute go check
out her her course don't rely on my course for
that she's a pro she also did one on for autism
which was a great course i took that one as well
so yeah which people have been like in my programs
get maria to come so just yesterday i was like
that's why okay webinar on autism and luca and
she's like she doesn't want to do it yeah she
doesn't want to do it that's great yeah so yeah
you found some pretty cool people and and uh
uh miguel had texted me out of it was funny because
we had talked about it when we set this up and
i was like i haven't heard from a long time because
he had sent me a picture from this conference
he's at um um i don't know what's maybe the nei
conference it's a day elevated okay so it's a
day devoted to Private practice. Are you there
right now? No, you're at home. No, I wish I was.
Yeah. And he's like, why aren't you talking?
And I was like, that's the sweetest thing to
hit me up. And then, but then to hear about all
the cool things he's doing, like four practices,
I was like, man, you should be talking like you're
the, you know what I mean? The run one practice
is no joke, let alone four. So, or whatever he's
doing, it's killer. So yeah. Great guests. You
guys, this is a great podcast. Yeah. Oh, thanks
Nick. I appreciate it. Appreciate it a lot. So.
Yeah. Just tell us a little bit about like how
you got into being a psych NP and just kind of
how you got into private practice. Eight years
is a long time. I mean, are you enjoying it?
Are you burned out? Like, give us the give us
the tea, Nick. I think I started. Yeah, I think
that mental health was always going to be what
I was going to do if I did something, you know,
like when I got to when I decided what I was
ultimately deciding on nursing school, you know,
very young and. And it was clear that I had already
sort of going into it. You know, my mom worked
at the state hospital as a social worker that
I was just going to be, mental health was what
was interesting to me. And that just made sense
for a career. So as a nurse, I went and worked
for a state psychiatric hospital. I also went
and worked at a state hospital and hoping that
they could pay for my, or at least waive state
tuition, which was a thing, which I was actually
having access to. So it was sort of this thought
that I would go to the nurse practitioner school
and hope that they would, they would you know
offset the cost which it did happen it worked
out really well so um worked at the state hospital
for two years before i started into a nurse practitioner
program which took me five years and i ended
up teaching at that time as well um with the
community college which is the best job i ever
had and so um so then yeah when it when i when
i graduated you know i there was i was just going
to start my own practice i didn't it wasn't this
wish i get a job I don't I'm not exactly sure
why that was just the decision I had made. There's
nothing against me. That's interesting. Yeah.
I don't have a problem with with employers or
supervisors. You know, I mean, I didn't I didn't
get fired four times like Maria did. Right. So,
you know, it wasn't like this. It's just the
only it is what I was going to do. And. And so
I, you know, opened up a practice. This was pre
-COVID and my practice was online. So there wasn't
quite the open arms to, to online services. And
so I, you know, and I was trying to credential
with insurances. I wasn't sure I was going to
do it. So ultimately I think what got me, got
me a headstart was I got a job working inpatient.
You know, it was, it was, it was contracted.
So my LLC and my, you know, was, was used, but
that gave me money. I made money, quite a bit
of money because I worked quite a bit. And then
it also gave me sort of experience and autonomy
as a nurse practitioner and pretty quickly, I
think. And so then eventually I couldn't do all
the things I was doing and I cut back and now
I'm just doing private practice. Okay. Okay.
And how many clinical hours do you think you
do weekly right now versus administrative? Yeah,
that's a great question. Probably close to 25,
30 clinical. And maybe five or 10 administrative.
It kind of blends together. So I think I'm, I'm
only slotted to work three days a week through
the summer for clinical. And, and some of the
clinical days are, you know, you, you're doing
a lot of administration throughout. It's so hard
to time that, but yeah. No, that makes sense.
So why was your, why were you in school for five
years for the psych NP? How long did it take
you? No, no. Why did, how long did it take you
to do it? three and a half I think I don't know
five years just sounds so extensive yeah yeah
yeah I like to tell people because then I ultimately
went to college for nine years and they're like
nurse practitioners go to school for three years
like I went to school for nine years I don't
know what it was talking about um yeah I mean
it was it was a it was a BS in the DNP program
so it had a kind of extra year tacked on I don't
know if you did that or not and then I didn't
do it necessarily full -time so okay that makes
sense you were doing it part -time Okay. Yeah.
Gotcha. And have you always been, oh, go ahead.
I didn't have any money either when I started.
And so I was trying to use that waiver program.
So I was just barely taking classes. And I remember
I emailed the teacher saying, hey, I have to
not take the summer class because I don't have
any money. And she was not, that was not something,
you know, the program wanted to hear. This is
the last time we're offering this course. I don't
know what you're going to take instead. And I
was like, oh, they ended up offering it again.
But I needed like, okay, maybe I need to start
spending some money on this. So the first year
was kind of. First year or two, I just took the
amount of classes I needed to in order to not
have to pay anything. And then I was like, OK,
clinical wasn't covered by the waiver. And I
had to start where the practicum or whatever.
So I had to start paying money. And so I kind
of went slower at first. Gotcha. OK, so how how
was your schooling experience and your clinicals?
I think it was fine. I think it was great. I
don't everyone's try to grab on nurse practitioner
colleges like like, OK, like it was so easy.
So unprepared. I mean, it's like this thing of
like, okay, so nurse practitioners are nurses
who become nurse practitioners. Nurses are working
women, majorly, right? So this nurse practitioner
degree, the history of this degree, was to allow
for women who are working in the hardest job
in the world, which is being a nurse, so they're
getting the best experience. They got the hardest
BSN, the hardest degree to get. It's like statistically
the hardest degree to get an RN and they're working
and they have kids and they want to go back to
school. So these programs were designed for them.
And so it is horrifically sexist and terrible
that we're getting shit on so hard right now.
But it's the programs are designed for that.
And we were competent, prepared, you know, like,
you know, good, you know, really nurses don't
mess around in a sense that I know that a nurse
is going to be an incredible communicator. Obviously,
there's exceptions, but. But nurses just know
how to talk to people. And so none of that, they
go into school and they learn what they need
to know. They get the hours they need to get
and then they're proficient. And, you know, so
now the schools are scrambling to fix things
because of the reputation. And they're still
getting critique. And it's like, well, I don't
know. I think the school is getting harder and
harder. So obviously the world or other people
are saying that it needed to be more intense
for nurse practitioners or whatever. And now
it's becoming more intense. So they're going
to have to stop. you know telling us that because
schools are just getting harder and harder i
think yeah no i hear you okay one of the questions
we get a lot is what are your suggestions for
someone who's preparing for psych np clinical
what would you tell that person i would say like
you know a private practice is is where people
are going to end up and it's a hard place to
get a lot of hands -on experience Um, and I think
that, um, you're going to want the hands -on
experience. And I don't think that people who
are taking clinical, you know, taking students
are like, sit there, be quiet, just watch. Obviously
they shouldn't be doing that, but I don't, sometimes
they don't know exactly how to, you know, use
you as, you know, and, and the ideal situation,
I think like, ideally you do an intake, you follow
up with that patient and you sort of fill the
caseload while you're being supervised. Um, cause
sometimes it's hard to be like, I have a patient
here who's been on, you know, Latuda for three
years and we're going to talk about his boat
he just got this weekend and make sure he doesn't
have any side effects. You know what I mean?
Like, I mean, you could do that too. And, you
know, but so I would say kind of come in with
a game plan, maybe even communicate with your
preceptor. Like, hey, I really tell them I really
want to be involved. Maybe you have a hard time
initiating. Maybe you do have some of that social
anxiety. And so just maybe be upfront. Like,
I really want to be involved. I really want to
step in. I want to share appointment space and
communicate. I want to lead appointments. And
so just to give a heads up, if, you know, if,
if you don't mind helping me be accountable to
that. So I'm not, so I think sometimes the preceptors
think, well, they just want to sit there and,
you know, they need to, they need to be pulled
in. So, and, and I remember doing that as a student
being like, Hey, I'll lead the session or I can
do this intake. Or I didn't know that I never
met the person coming in. Like, Hey, how's it
going today? You know, and my preceptor is super
cool with it. And so sometimes I'm surprised
there's, you know, I, and, and now, you know,
we do offer other services that actually are
being pretty student friendly, like Spirato.
where it's very easy like oh you go into the
room and you do the treatment you know and you
talk about their mental health and their their
meds and and you do it with them a couple times
and they're proficient and i see the patient
they see the patient so it ends up being really
clean but but you really want to have that hands
-on experience because because private practice
is pretty unique it's hard to get it's hard to
see it as an rn rn experience i think is really
important but it's hard to see that world as
an rn and that's probably where we'll be where
most of us will end up that's right yeah i know
those are all Great suggestions. OK, so when
you opened your private practice, that was what,
2018? Yeah, I think so. I think that's when I
graduated. So I opened it right away. So not
that it was like just, you know, it took it took
a little while for it to be, you know, its own
entity. But but it existed in 2018. How much
money did you spend? on getting it started and
where did you go for advice or like how did you
how'd you do it yeah so that's a great question
i think my mom gave me like three thousand dollars
when i graduated so i could use that to pay for
my dea which was maybe the biggest expense at
the time eight hundred dollars to feed my uh
office ally account to feed my i don't know if
i was using grasshopper at the time which i'm
not using anymore um don't use grasshopper maybe
you should cut that i'm sorry um the uh Um, you
know, whatever softwares I had sort of, I used
Doximity, which is free fax. I use Doximy for
free telehealth and I didn't have an office and,
and I used, and so I worked from home, you know,
and just didn't see, saw a couple of people.
And then a friend of mine who had a nonprofit
had an office and she rented it to me for $500,
I think. No, no. Maybe she just told me I could
work there. She could, she told me I could use
it for free. She didn't rent it to me. She said,
you could be here for free, which was a gift.
And I worked there until they didn't really want
to rent the office anymore. And the entire office
suite, which was three offices, four offices,
I think, but kind of a janky building, it was
500. And so I took it over and then sort of returned
the favor. They worked there for free because
we had space for it. And so that ended up being
my biggest expense for a while. And nothing has
to be expensive, especially if you're not trying
to eat, right? If you have another source of
income. Which you did. which I did, being a psychiatric
nurse practitioner is not expensive at all as
a private practice. And then once you make money,
buy the expensive EHR. I would get an EHR right
away. I would use Spruce right away. I can't
think of another example, but those are expenses
I would say, try to budget those in right away
because adding an EHR later. You don't have to
be, I guess, I don't know. But those things felt
like I should have used a phone service right
away. I used my cell phone, which was a mistake.
Yeah. What EHR are you on? I'm doing advanced
MD now. I've messed around with OzMind. I've
messed around with Office Ally. I've messed around
with Simple Practice. And Office Ally, I think,
checked the boxes and met the needs. It is painful
to switch. So sometimes it's nice just to have
the right one right away. I think maybe practice
queue could do that for a lot of people. I think
the most important thing to me became very obvious.
I need to have an EHR that is the same company
as a billing software and I need them to, to
communicate seamlessly. And because that's what,
that's the issue I had with Ozmind is that it
was trying to communicate with advanced MD for
billing and it was awful. It was, it was, it
was, it was undoable. It just wasn't. And I think
I heard later that they had switched companies.
I was like, well, they didn't switch with me.
Cause I'm still, you know, so they, So it was
just wasn't, it was not realistic. And I think
I wouldn't try that again. And I think that practice
queue does it through office ally, which I haven't
heard complaints about. So maybe that's an exception,
but ultimately there's pros and cons to each
as mine was new and super buggy. Our calendar
for Spravato was bananas and it just could not,
it just could not keep up with it. It was super
laggy. So we just honestly switched to advanced
MD because that's who we had, we're building
throughout the time when we swapped and. It was
going to be so much less painful to keep the
billing side and just add the EHR, which is fine.
It's fine now. It's expensive. Gotcha. Okay.
Gotcha. Now, did you know that you wanted to
do a group practice from the start? Or how did
kind of people want to know about the hiring
of other psych MPs and how to do that? Like any
tips for that and how you did it? Yeah, I have
some painful stories about that. I mean, I think
I did. I must have because I tried to hire people
right away. So whether or not I articulated that
desire in the beginning, I did try to hire people
right away. And I hired the first, the first
nurse practitioners I hired were friends of mine
and both of them aren't working with me anymore.
One of them, well, one of them is really, was
like my best friend. Maybe he's still a really
good bud of mine. I like him a lot. I wish I
saw more. And I talked to him in a joining and
I think that's what I did. I think I talked him
into it. And, and, and. sort of lined up weird
where the first day I really saw people I had
I couldn't be there and and I think that's that
was the mistake on my end I should have made
sure his first day and and he started and he
like and he had like he couldn't make it one
day like we can't so I think we both sort of
non like just without speaking about it just
sort of decided it wasn't going to be a fit and
later on he was sorry about it but I think it
was one of those things where I'm just sort of
like I kept like hey you're doing this with me
you're doing this with me um so that friendship
maintained even after that Another friend who
I hired to help me out with a residential, I
had this weird thing where I'm like, my own business,
I can hire people. I should just let them hire
him. I was young, right? So he was hired under
me and we were tag teaming these days because
we had to work seven days a week. And I had emailed
him some feedback I got from the organization.
And it probably should have been a face -to -face
conversation. Part of me thinks he was trying
to leave anyways. And so he emails me back and
he's like, he was mad at me for the feedback
and he told me he was quitting and i was like
so i tried to make a joke like i said something
like they told me you were saucy like i was trying
to give him an out like in case he was just mad
he was like i'm not mad i'm just done so i was
like all right you can just just give them your
keys before you leave so i don't have to try
to find you afterwards and and uh uh it was my
birthday too i was so sad i was like out of town
on my birthday the uh yeah i know you can feel
bad for me too it's fine i don't he's cool we're
cool to some extent we're not hanging out anymore
You know what I mean? I don't think there was
a way to survive that encounter. There wasn't
any value to debriefing it either. So it's too
bad. We've done some stuff since we've reached
out, but there's not really an end to friendship
with me. So hiring is hard. I have three incredible
psychiatric nurse practitioners or four. I don't
remember how. I have two full -time and one part
-time and one very, very part -time. And, uh,
all of them are, are wonderful and lovely. And
they're my friends too. You know, I mean, I guess
one I hired before I knew her, uh, but one was
a student, one was a friend. The other one was
a pre -student who was a friend. And so I'm not
saying don't hire your friends, but I mean, you,
it's really the ideal if you work with like hiring
a student is a great idea because you see them
and you, you know, if they're up for it. Um,
but it's, you know, yeah, when you hire the wrong
person, it's, it's pretty, it's pretty painful.
And it's, and it's, uh, And they're really difficult
to manage. Yeah. Yeah. I appreciate you sharing
that because I think a lot of I know a lot of
people can relate. And I know other psych NPs
who have been like, yeah, I started with a friend.
Didn't work out. I had two failed business partnerships.
I think, you know, you don't know what you don't
know going into it. But I do think it's helpful
to kind of share the lessons learned so that
other people can just hear. What were you going
to say? I was like, my dad, he worked in tech.
He worked at Silicon Valley. Actually, the movie
Office Space is based off his company because
Mike Judge worked for his company, which is kind
of funny. He didn't realize that until later.
He's like, they made a movie about me. But he
worked at Parallax, which my dad was a co -founder
of. And he told me that he started his company
with two other people. And once it became very
consequential, one person decided to make things,
you know, just change his mind or take control
or switch whatever gears. There's nothing you
can do when you're that far into it. We're so
debilitated by the co -ownership of the business.
And so that was something that he sort of said,
no one should be, you should not run it with
anybody. No one should be a co -owner. You own
the business. And I think anybody was like, I'd
rather do my own thing. A student who I wanted
to work with me or she talked about it, but if
she wanted to do her own thing, I'm so glad she
did. You know what I mean? So there's no like,
go do your own thing or if you want to hang out
with me, that's cool too. But yeah, there's no
employees or. No partners. That was something
that I felt like I did a good job at not doing.
No offense. I thought your partners were lovely.
Yeah. So are they W -2s? Yeah. Yeah, yeah. W
-2s. Okay. Okay. I did a little bit of contracting,
like independent contractor. I'm not – it feels
cleaner to do a W -2. I know I've read multiple
things. I think a couple of people who do contractors
have a really good defense and argument as to
why they're using contractors. It doesn't seem
to be that much less work to hire contractors
versus W -2s. If you see advantages to it and
maybe they want the 1099 so they can put it in
their Roth at 401k or they can do their write
-offs, then maybe there's value to it. But I
don't think it's that much more work to do a
W -2, especially if you have a staff who can
be hired to do it. Yeah. Yeah. That's good points.
Good points. I was just thinking, I got some
feedback from some of my past episodes being
like... from new grads who are starting private
practices and being like, oh, it brought out
some insecurities because this episode or that
episode kind of sounded like maybe a little negative
about it. And I like to basically get the perspective
of whoever I'm interviewing. And so I'd love
to hear from you, your perspective on psych NP
new grads going into private practice since you
did it. And people want to know and people are
doing it and they want to know, you know, am
I going to be okay? Yeah. yeah it's it's a lot
of fun um and it's very interesting and and you
know there's a lot of freedom you have as a private
practice if you like to kind of play with things
play with ideas and grow or if you want to just
be really quiet and small sometimes i cover it
those days like i remember the day where it's
just you know like that's so much flexibility
not that you know what's going on now it's not
wonderful so it's it's nothing's gonna there's
no like roller coaster effect there's no like
come on there's no turning back There's a lot
of turning back. You can turn back at any point,
right? Nothing happens overnight. Everything's
slow. I remember I went on this three week long
trip right when I graduated and I created this
business. I was like, we're going to have to
find places for me to stop and see clients because
I was going to see clients for a little time.
I think I had one appointment. You know what
I mean? I was way too big for my britches. I
thought that was going to, you know what I mean?
It took a really long time to, you know, and
if you were like, I'm a marketing guru, I know
how to get people in the door, then you'll get
people in the door. But if you're just playing
with it, like. The consequences are tremendously
low in a big sense. You start the LLC, you do
a telehealth thing, you do the headway, whatever,
and you just see what happens and see what you
like and you don't like. I think it's no biggie.
If you're a new grad and so you're trying to
know what you don't know, if you're sort of weak
on pharmacology, you probably want to be in an
environment where you can get... you know, a
lot of mentorship or have someone you can talk
to. I have a lot of students who I think this
guy could, if this person worked with me, I would
probably never have to counsel them on medications.
Or this person, I'd probably have to teach them
the medications while they're practicing. So
if you're weak on pharmacology, you probably
want to work in an environment with more support.
If you are strong on pharmacology, not that you're
going to need to, you know, fast track your learning
a little bit, but, you know, if you're up for
it, give it a shot. I mean, it's so easy to do
alongside something. sunday afternoon or you
know you have a day off or after work or you
work part -time it's it's it's i think i think
just go if you kind of want to do it it's start
start doing things like look at the llc you know
play with some ehrs and and it's it's super easy
to do it and if you find yourself not minding
that sort of busyness and exploring that it's
probably for you if you find that stuff super
tedious and struggle to have the time for it
it may not you know you may want to do something
that's easier it's easier for you to spend your
time with it's really hard to do something that
you don't sort of subconsciously want to do or
willing to do. It's really hard to do those things.
And sometimes I want to like, oh, I'm going to
do this or I'm going to do that. And then I try
it and it sucks and I don't like doing it. And
I have to sort of accept it. Like there's something
that I have cannot control that tells me what
I can or cannot spend time doing. And I get that.
That's worth listening to. Yeah, it's worth listening
to. That's how I felt about creating the psychiatric
interview course with Carlat that I have not
yet to create. And I'm like kind of at that point
where I'm like, it's OK if I'm not like the course
creator. It's OK. You know what I mean? And I
think it's honestly like the pressure of it,
too. I think if I was just making a video out
there on my social media, like I could do it.
But there's something about sometimes when you
feel pressured and under, you know what I'm saying?
It can kind of shut down your creativity. A hundred
percent. Yeah. Where you're just like, I actually
don't know if I'm that interested in this topic.
So it's going to be super hard for me to milk,
you know, content or spend time on it. It's really
nice to sort of exploit and leverage your own
passions and your own interests so much easier
to do work. Yeah, exactly. I was going to ask
you, did you work with Headway or do you still?
No, they weren't around when I got started. So
at certain points in time where I'm like, maybe
I would have or you should. Now I think there's.
I think there's enough content, there's enough
stuff on like Facebook sites that you could read
for days and get a million people's opinions
and people on there that will message you back.
And it seems like there's, I think the biggest
downside is there's ultimately a limiting effect.
Miguel says he does it with his four clinics,
which I'm not sure how, which I think is great.
So obviously there's some, he's figured out a
way to scale with it. Right? Didn't he say that?
Maybe not. But I think there's a limiting factor.
But there's so many pros to it too. So I have
a friend of mine started with headway. She did
a little bit and she's working with me and, and
she's like, I just, I don't know why I'm doing
an extra day. I'm just going to move all those
clients to you. And, and that, so, you know,
it's pros and cons for sure. And I think that's
easy to sort of to get information on. I never
used them though. Yeah, I almost did. Did you
use them? You almost did? I almost did. And then,
was it Headway or Alma at the time? It was whatever.
Do you remember that guy who used to be all over
the forums, Jonathan Wayne? That sounds super
cool. Yeah, that sounds original. Yeah. He had
like scaled this group practice. And so I was
like, whoa. This is crazy cool. And so then I
met with whatever company he had used on their
headway. But then they're like, oh, we're not
really supporting group practices like that.
Like a lot was messed up on the back. Not for
him specifically, but like just in general with
them trying to support. I don't know. So that's
what I was told. But I've had plenty of other
people who have figured out a way to make it
work or whatever. So. Plus, I just am like direct
to consumer right now. But anyway. OK. Yeah.
Tell me about. I'm trying to keep these episodes
shorter because that's feedback I've gotten,
too. So how you got into creating courses for
Justin, the elite NP, and, you know, like other
streams of income. Like, tell us about that because
I'm sure people are intrigued with that. I was.
I was like, oh, cool. He's Justin's psych course
creator. Yeah. Yeah. It's funny because I like
I really hadn't spoken to him for while I was
doing all that. Just emails for years. And then
I saw him at a conference finally. And then it
was a year later and I got to eat with them,
which was super fun. So it was so funny. I had
like, it was such an important relationship for
me, at least. It was like total 20 emails for
over three years. But so yeah, so I would, at
LeadNP, I think I'd done a couple of conferences.
At the time I was super interested in hormones.
I'd done WorldLink, which is not them. But I
was like, well, I'll do theirs too. So I did
their testosterone, I did their women's health.
And then I was like, did their ketamine, because
I was sort of interested in ketamine at the time.
Or maybe I was doing it. I don't remember, but
I was like, I need to learn more. And I was doing
Spravato and I was like, I needed normal academies
to do the course. And I thought their courses
were great. And I saw on their website, they're
like coming soon. Psychiatric nurse practitioner
practice. This is on the website. This is why
I have my hand up. If you look at the website,
the psychiatric nurse practitioner business course.
So I emailed, I just emailed them like, Hey,
love your stuff. Hey, I have a private practice.
It was super. I mean, I was only done it for
a couple of years at that point, but I was like,
I would be happy to peer review it for free.
That's what I said. And so he emails me back.
He's like, well, the person who's doing it, I
haven't heard from them in a while. So I don't
know what's going on there. And that was kind
of the entire email. Like there was no like invitation
or anything. It was just it was just I mean,
it was nice. I responded. So like, well, cool.
Keep me in mind. I don't know. I don't know what
I said. So then he comes back to me and says,
what do you think of a course where, you know,
a lot of the family nurse practitioners are talking
about wanting to know more about psychiatric
content? What about a psychiatric course that's
really, you know, designated to. um, FNPs or
non -psychiatric, you know, and, and as much
as it creates debate on forums, get out of here.
Like the FNPs are doing tons of psych as they
should be. Like they're doing depression, anxiety,
ADHD, like, like scope of practice, just, just
get out of here. Like it's crazy. It's, it's,
those conversations just drive me crazy. And
I am seeing for the most part of them getting
shut down on the forums now. Like, no, get out
of here. Like, like we're not in control of anyone's
scope of practice. We need the FNPs to be doing
psychiatric stuff. So, um, So I, so like, yeah,
so I gave him, so I, instead of responding, yeah,
I think you're right. I just gave him a course
outline or I think it was a good move. Cause
he was like, oh, cool. Can you do it? And I was
like, yeah. So, so he was, that was the handing
of the, that was the recruitment, right? It was
just me reaching out. So that speaks so much
to like reach out to people you're interested
in working with. I think I had asked you cause
that's classic me, right. Just to be like reaching
out to you and being like nosy, but like about
how you got into it. And I think you told me
that. And so I think I remember I reached out
to Justin about a course on DBT cause, and he's
like, I don't think there'd be enough interest,
which totally understandable, but it's just like,
it's just funny. This year I'm speaking at a
conference in person on DBT. Yeah, doing like
a webinar on it and stuff because it's like one
of my, you know, passion things that I like to
talk about. So I was creating the course and
I was like, what's your deadline? What do you
want me to do? He's like, don't worry about it,
man. Just, you know, whatever you're done. So
it was really hard to work on it because I didn't
have any deadlines. So I was trying to get him
like a PowerPoint a month and I'd send him the
PowerPoint. He'd be like, this is great. You
know, he didn't really give me specific feedback,
but. you know, when he didn't like something,
he, he, he, the response would be different.
You know, like the slides are a little, you know,
he'd tell you something. You're like, I don't
think he'd like that one, but he mostly, he was
just saying, this is great. Keep him coming.
And then at some point he's like, Hey, the business
course fell through or the person's, you know,
a wall or whatever. Do you want to do that? And
then, so I started doing the business course,
which at the time, you know, the original business
course, which is not on anymore. It's now updated.
It's like, it's like 50, 50 us. He does the first
part. I do the second part. Maybe it's 60, 40
him and me. And so, and then they're going to
bundle them, which I think that the business
bundling them, the psychiatric course for the
NP was my baby. Like that is all me. You know
what I mean? Like that was, I love that course.
It's still there. It's updated. It has a credible
section on ADHD now. People should check it out.
If you've bought it, they just updated it. So
go check out the ADHD stuff. Check out the Suboxone.
I have like injectables on there. So I just updated
the crap out of it. And it's really great. And
so, but because they bundled it. And they did
a business course. The business course, I think,
did really well. And at the time, the way they
had it set up, I could see how they were doing.
And the bundle, my little buddies come and join
us. The bundle was, the bundles did okay. And
then the clinical course sort of undersold, I
think. And he kind of told me that later because
then he sort of, I was going to do an advanced
course and he sort of vetoed it. I was going
to try to do a spermato course. He kind of vetoed
it. And then I did the functional course at that
point. Um, I was super happy with it. I had,
you know, they were paying me residuals at the
time or residuals or a percentage. And, and,
and it was, uh, what are you guys watching? Yeah.
Yeah. I'll never know. Yeah. The, uh, uh, four,
my four year old buddy. Uh, we got long hair.
Yeah. Yeah. And, uh, going crazy. so the um yeah
so that's how i created the first course and
they got published and there was always this
invitation to do more and so you know time would
go by and i'd you know ask him about another
one and um and eventually i did the functional
course because they're trying to do functional
content so that's out there um we're talking
about lithium and i don't know what else is functional
ashwagandha yeah and uh And then and then they
have some new leadership and they approve the
advanced psychiatric course, which I had created
years ago. And you even told me you were going
to help me do it. Remember that one time where
we'd met with a person from from Ohio or or I
don't remember where she was. You know, she was
going to credential it. The contact hours. Yeah.
Yeah. I was like doing the psych NP. That was
when I was doing the psych NP network with my
business partner. yeah yeah yeah and so i was
like hey elite np has not going to produce these
courses and not like kind of like your experience
was nothing it was just hey we don't think these
courses are going to do well with our audience
or whatever or at the time where we're not but
he told me we're focusing on functional in business
so that's why he switched me to functional which
was awesome so i had these courses i had made
the advanced psych course and this bravado course
and i was and we had talked because we found
each other on tiktok again after initially seeing
each other and And yeah, you were gung -ho. I
think it might have, you know, I think the agreement
or something, you were working on something with
somebody else. And she was like, hey, can we,
you know, let's prioritize something that we're
already prioritizing. It seemed super fair. But
then years later, now they're, you know, as things
shift, they were super, the new leadership was
like, yeah, we just want to create content. You
know, business, clinical stuff is great. And
so, you know, they just released an advanced
psych NP course this year. which, which the advertising
is funny. The advertisement is like, you know,
I have like a clausural section. I like a long
acting injectable. I have like a lithium section.
So it says for the nurse practitioner, clausural
lithium. So on some of the Facebook pages, like
they're trying to teach FNPs how to do clausural,
you know, like the course, the course is like,
like it's, it's really like, you know, it's,
it's, I think clearly for a psychiatric nurse
practitioner, but like, you know, go to the NEI
conference and it's like, who's this course for?
psychiatrists, nurse practitioners, family nurse
practitioners, therapists. You're allowed to
learn more. You're allowed to... You have to
manage things like constipation and the blood
lab draws. To have collaboration with a knowledgeable
primary care is going to be gold. If they wanted
to take it, get powers for it. Actually, I just
saw an advertisement on today. I asked... them
and said when does the elite when does the spravato
course hit a drop and like it might have already
dropped it's kind of a cage email but i saw advertisement
on so they'll probably announce it soon so the
spravato course is out there anybody wants to
learn how to do spravato it's cheaper Then the
Duprat version, no ill will to Duprat. But the
thing is, the Duprat version came out and I was
like, I've been trying to get this course out
for years. Like it would have been the first
one out if the Duprat, I don't know, you know,
Jason Duprat, who does the Ivy Ketamine Academy
or whatever. And so he dropped his bravado course
last year, which I think is pretty expensive,
but it might be. Maybe it's worth paying for.
Maybe they offer more hands -on stuff. This one's
really just a, you know, here's everything I
know about it. Of course, I've been doing it
for six years, but I'll email people back for
sure if you want help with it. That just dropped.
So I'm excited about this bravado course. I'm
interested to see what the, if it's, if it catches
on, if it seems like people are interested in
bravado, but it may be sort of, it may be kind
of a minority because it's kind of a unique thing.
So yeah. Yeah. If it's useful to people, that's
really cool. Okay. So, so you've made a good
amount of money selling these courses. It sounds
like, well, I mean, I couldn't give these courses
away. You know what I'm saying? I'm sure, you
know, how hard it is to, that you're just doing
so awesome. It's so rad, but just get people
to buy your stuff. is, you know what I mean?
Or, or even to self -produce it is incredible.
Right. So, um, so I feel super lucky to, to have
motivation to do something, have an audience
that said, and, and I couldn't, like I said,
I couldn't give this course away. So yeah, I've,
um, you know, the payment structure has changed
and, uh, and I just feel super lucky that I'm
making it. And yet I think you do private practice
long enough. Sometimes your idea of money shifts
a little bit. What, you know, what was a lot
of money back then sometimes doesn't feel like
a lot of money, but. You know, it's definitely
worth doing. And I think it's super awesome.
Yeah. And it's, and you've like spoken at the
conference and things like it's led to other
like networking opportunities. It seems like
I'm sure people are going to want to take your
courses. Where can they find them? Can we put
them in the, in the, in the show notes for them?
Yeah. Yeah. Put them on the link. Yeah. Yeah.
They're, they're on the only NP site, but you
know, it's not, maybe someday they'll put a little
psychiatric bundle section, but people can get
all of mine, but yeah, I'll give you the links
and you can put them on there so people can find
them. OK, awesome. I have one more question for
you. You guys, I'm going to have Nick on again.
So if you have specific questions, please comment
them. And I can ask Nick at our next appointment,
at our next appointment, at our next podcast
recording. Two weeks. Yeah. I ask all my my people
that I interview, except for Daniel Carlat, because
I got nervous. But what does no prior off mean
to you? I didn't get to that question. I don't
know. That would have prepped something. I mean,
I think there's a literal minor like, yeah, like
don't have to do briars for medication. So maybe
there's something more into it. Like what are
the, you know, prior authorizations, a barrier,
right? So it prevents you from accessing it.
I just had to deal with four prior odds yesterday.
Don't be crazy. Two of them had to walk away
from. And, and I think, and they're not even
like, they're not even, they're just like, I
think they're sincere and I think they're really
going to help the person. And so to be able to
have like, to be able to do, what you think is
best without any sort of roadblocks in the way
is a gift for sure. And a lot of that could come
from help, come from knowledge, you know, knowing
how to do things well, trying it out, failing.
So I think there's, you know, no prior auth is
an exciting thing. You see no prior auth is like,
oh, sweet, there's 30 minutes of my day, I get
back. So I think it's exciting literal meaning,
but I like the idea that maybe it could mean
something a little bit more for people, especially
just getting started. Yeah, I love that. Cool.
Well, thanks, Nick. And we will see you next
time. Yeah, let me know.