Want to open PMHNP business on Oahu or Kauai

[myoglobin, ASN, BSN, MSN]

I'm just graduating and my wife has been a PMHNP for about four years. My goal is to move to Hawaii in about three years (I prefer Kauai, but Oahu or the Big island may be more realistic in terms of demand) and have a small clinic. My goal would be to offer weekend, and evening hours so that kids that need ADHD meds wouldn't have to miss school and that patients on meds, wouldn't have to miss work (as much). We would also stress alternative and complementary medicine in addition to the best evidenced based standard of care. What so you think about pitfalls (besides cost of course). She currently has a telemedicine job paying about 180K per year (no benefits) and I aspire to the same and at least one of us would probably keep the job until the business had a decent case load. Also, we currently live in Florida and I've pretty much wanted to move to Hawaii my whole life (wife is more marginal) indeed its the reason I became an RN (at the time about 10 years ago it was one of the few professions where you at least had "a shot" at a job in Hawaii).

[NRSKarenRN, BSN, RN]

Nurse practitioners (NPs) in Hawaii are authorized to diagnose and provide services to patients independently and without physician supervision or a collaborative agreement. Hawaii Admin. Rules §16-89-81

I 'm forum moderator, not an NP.... Suggest you contact Hawaii NP Associations for more info:

https://www.aanp.org/advocacy/hawaii

Hawaii Association of Professional Nurses

Best wishes with this endeavor.

[umbdude, MSN, APRN]

@myoglobin

I haven't done much actual research, but I'm wondering whether the demand is large enough for an independent PMHNP to build a large enough case load, especially outside of Oahu (Honolulu).

I'm in a similar boat - not so much about opening my own business, but moving to HI (Big Island) in 3 years. We've been to the big island a few times and I've been doing some researching online regarding the job market. The impression I got is that for the Big Island, demand for FNPs is much higher because most parts of BI are incredibly rural (we've driven extensively all over the BI). I have yet to see a job posting for PMHNP in BI, and only a few in Oahu. Overall, I don't feel that there's a lot of demand for psych in HI, along with a smaller population to begin with (at least on BI).

I'm guessing that most likely I'll be doing telepsych when I'm in HI, even though there are some downsides and I prefer to see patients face-to-face.

[myoglobin, ASN, BSN, MSN]

On 5/30/2019 at 5:30 PM, umbdude said:

@myoglobin

I haven't done much actual research, but I'm wondering whether the demand is large enough for an independent PMHNP to build a large enough case load, especially outside of Oahu (Honolulu).

I'm in a similar boat - not so much about opening my own business, but moving to HI (Big Island) in 3 years. We've been to the big island a few times and I've been doing some researching online regarding the job market. The impression I got is that for the Big Island, demand for FNPs is much higher because most parts of BI are incredibly rural (we've driven extensively all over the BI). I have yet to see a job posting for PMHNP in BI, and only a few in Oahu. Overall, I don't feel that there's a lot of demand for psych in HI, along with a smaller population to begin with (at least on BI).

I'm guessing that most likely I'll be doing telepsych when I'm in HI, even though there are some downsides and I prefer to see patients face-to-face.

I'm not sure about Kauai, but I feel that there would probably be sufficient business on Oahu especially if I offered "evenings and weekend" hours. Even many restaurants, and stores have limited hours on Kauai, thus finding a clinician's office that is open on Saturday's and evenings would be a rarity. The other thing I would offer is evidenced based complementary and alternative medicine something that is probably more highly valued in Hawaii (along with places such as certain areas of California) than many other locations.

[umbdude, MSN, APRN]

On 7/16/2019 at 4:05 PM, myoglobin said:

I'm not sure about Kauai, but I feel that there would probably be sufficient business on Oahu especially if I offered "evenings and weekend" hours. Even many restaurants, and stores have limited hours on Kauai, thus finding a clinician's office that is open on Saturday's and evenings would be a rarity. The other thing I would offer is evidenced based complementary and alternative medicine something that is probably more highly valued in Hawaii (along with places such as certain areas of California) than many other locations.

That sounds like a reasonable plan. Good luck!

[CRosalyn10, BSN, RN]

@myoglobin

I stumbled on this post as I've been researching PMHMP.  I applied to a program and I'm hoping to be accepted. I have read some of your other postings and was just wondering, did you start a practice in Hawaii?  Also, you speak of complimentary and alternative therapies. I'm a firm believer in this type of treatment, example, gut health... but I'm wondering what types of treatments you offer, as I would like to also focus on this if/when I graduate? In some of your other postings you mention 1099 jobs, etc.  I'd be interested to hear where your PMHNP has taken you thus far. Thanks!

[myoglobin, ASN, BSN, MSN]

3 hours ago, CRosalyn10 said:

@myoglobin

I stumbled on this post as I've been researching PMHMP.  I applied to a program and I'm hoping to be accepted. I have read some of your other postings and was just wondering, did you start a practice in Hawaii?  Also, you speak of complimentary and alternative therapies. I'm a firm believer in this type of treatment, example, gut health... but I'm wondering what types of treatments you offer, as I would like to also focus on this if/when I graduate? In some of your other postings you mention 1099 jobs, etc.  I'd be interested to hear where your PMHNP has taken you thus far. Thanks!

I never did make it to Hawaii that dream was before the world "moved on".  Some of the CAM approaches I use can be found in the March 16th episode of The Carlat Report Podcast "Top lifestyle Interventions for MDD and Bipolar". Other's include CBT-I for insomnia, SAMe for depression. Standardized lavender extract with Silexin for anxiety (both of which are RX in many parts of Europe) and NAC for skin picking disorder (and sometimes OCD although evidence is limited). Saint John's Wort for pure MDD when there are no troublesome drug interactions, B complex vitamins and methy Folate when MTHFR gene variant is an issue (in MDD), and Minocylcine when high reactivity CRP is elevated in resistant MDD>  

[CRosalyn10, BSN, RN]

1 hour ago, myoglobin said:

I never did make it to Hawaii that dream was before the world "moved on".  Some of the CAM approaches I use can be found in the March 16th episode of The Carlat Report Podcast "Top lifestyle Interventions for MDD and Bipolar". Other's include CBT-I for insomnia, SAMe for depression. Standardized lavender extract with Silexin for anxiety (both of which are RX in many parts of Europe) and NAC for skin picking disorder (and sometimes OCD although evidence is limited). Saint John's Wort for pure MDD when there are no troublesome drug interactions, B complex vitamins and methy Folate when MTHFR gene variant is an issue (in MDD), and Minocylcine when high reactivity CRP is elevated in resistant MDD>  

Thank you for this reply!