Denis Grigorov

One of the biggest mistakes I see PMHNPs make when building private practices is trying to be everything to everyone. It feels safer. It feels responsible. It feels like you're creating more opportunity. But often the opposite happens. You become harder to remember. Harder to refer to. Harder to find. Over the last few weeks I've been thinking a lot about autism-focused psychiatry and the incredible need that exists right now. Families are searching. Parents are waiting months for appointments. Adults are finally receiving diagnoses after years of feeling misunderstood. And many are struggling to find psychiatric providers who truly understand the unique challenges that come with autism. Not just the diagnosis. The anxiety. The executive functioning struggles. The ADHD overlap. The emotional regulation challenges. The family dynamics. The sensory differences. The reality is that many autism families aren't looking for a general psychiatric provider. They're looking for someone who gets it. Someone who understands their world. And that's why specialization can be so powerful. When you become known for helping a specific population: ✓ Trust develops faster ✓ Referrals become easier ✓ Marketing becomes clearer ✓ Content becomes more meaningful ✓ Patients begin seeking you out The providers who grow the fastest aren't always the most experienced. They're often the clearest. The most visible. The most trusted. And sometimes the difference between struggling to find patients and becoming fully booked isn't clinical skill. It's clarity. I'm curious: If you were going to build a specialty practice tomorrow, what population would you focus on and why? 👇 Let's discuss. Interested in learning how to build an autism specialty practice that consistently attracts the right patients? www.ThePsychNPConsultant.com alewis@lewisfamilypsych.com

New comment Jun 23

Denis Grigorov

1 like • Jun 21

I do see tremendous demand for autism evaluations in our community. At the same time, this is not a service PMHNPs should add simply because the market opportunity is strong for it. Autism assessment is a complex sub-specialty that requires far more than administering a screening questionnaire or completing a brief course in the ADOS-2. An evaluation should include things like: detailed developmental history, collateral information, assessment of functional impairment and co-occurring conditions, and careful differentials—involving ADHD, trauma, anxiety, OCD, intellectual or communication differences, and other psychiatric conditions. We must to be honest about the limitations of our NP initial training. Before advertising comprehensive autism testing, a PMHNP needs to obtain substantial postgraduate education, including supervised clinical experience, where we can show competency with any instruments being used. This needs to include referral relationships with psychologists, developmental specialists, speech-language pathologists, and other professionals as needed. The need for autism is absolutely real—but demand should never be mistaken for competence. Building a specialty responsibly means we need to become qualified first, not learning through trial and error through our patients.