Psych/Mental Health NP

core0 · Jan 28, 2010

Very interesting. I live in TX and supposedly we're independent, but not really, since we also have to have a signed collaborative practice agreement and another form signed for prescribing CS's.
I'm opening a minor emergency clinic (should be open by April) and I'm having to pay a physician $1,000 per month to come on site and review 10% of my charts. We have to keep a log of the charts reviewed and the number of hours the physician is on site each month. I was wondering if $1,000 per month sounded excessive to you?
Also, how long did it take to get credentialed with insurance companies? I know someone who has been waiting 7 months, however I was told it would take less than 90 days, since I'm already credentialed and just have to "switch" everything to my business name.
One more thing, how did you go about buying stock medications for your clinic? I was told that I can purchase supplies, but I have to go through my "collaborative physician" in order to buy meds (Toradol, Decadron, and other noncontrolled substances). I'm trying to have as little to do with my collaborative physician as possible, so the last thing I want to do is buy my stock medications through him. Is there any way around this? This is ridiculous!
You are 100% right about these stupid collaborative agreements being designed to keep us dependent and under the "control" of the doctors. I can tell you this, it all comes down to MONEY! Doctors don't want us practicing on our own b/c they can't handle the competition.

Your clinic can get its own DEA number and use that to order stock medicines for the clinic. This is what most clinics do. There is a separate license if you want to retail (which will also probably involve a Pharmacist). Texas law is a bit strange so you may need the physician license to administer. Its really unclear. Finally take a careful look at the record keeping to decide if you want to do this.

David Carpenter, PA-c

Nelly, FNP · Aug 22, 2011

Hello. I have a question for al dente or any others who are in private practice. First, congratulations on all of your professional and academic success!! I am an aspiring PMHNP and Im wondering how your practice differs from a private PMHNP practice? Also, what are the main differences between short-term therapy offered by PMHNP's and longer term therapy offered by PsyD's? Thanks for your help?

al dente · Sep 2, 2011

Hello. I have a question for al dente or any others who are in private practice. First, congratulations on all of your professional and academic success!! I am an aspiring PMHNP and Im wondering how your practice differs from a private PMHNP practice? Also, what are the main differences between short-term therapy offered by PMHNP's and longer term therapy offered by PsyD's? Thanks for your help?

Most PMHNPs in private practice focus on medication management. Very similar to typical psychiatry practice except that PMHNPs are more likely to spend more time with a patient. For example, most psychiatrists in my city offer 15-minute med check appointments while the PMHNPs are more likely to offer 20-30 minutes, but most still focus on medication management with some supportive counseling.

As a general rule, PMHNP programs do not adequately prepare one to be a competent psychotherapist. You can still do psychotherapy as a PMHNP, but you will likely need to seek out post-grad psychotherapy training in order to become proficient. Since I was trained as a clinical psychologist first, I engage in in-depth and longer-term therapy with many of my patients, several of whom are not on medication. I also do med management only and combined med management/psychotherapy for patients depending on their needs as well as psychological evaluations and testing. I would estimate that 50% of my caseload is integrated med management and psychotherapy, 30% is pure med management, and 20% is psychotherapy alone.

Nelly, FNP · Sep 2, 2011

Awesome, thanks for the reply!