In this special feature, we explore the deep connection between family legacy and the field of psychiatry. The podcast interview offers a unique perspective on the journey into medicine, showcasing a personal story intertwined with professional dedication. The discussion touches upon aspects of mental health and psychology, providing insight into the motivations behind pursuing a career as a doctor.

Before Dr. Daniel Carlat built one of the most trusted names in psychiatric education, he was on Wyeth's payroll promoting Effexor. He stopped when the science didn't hold up, wrote a New York Times piece called "Dr. Drug Rep," and spent the next two decades building an alternative — industry-independent CME that psych NPs and psychiatrists could actually trust. In this conversation, Lindsay and Dr. Carlat cover the real story behind his career shift, why he thinks NP education needs structured residencies, what deprescribing looks like when it's done right (not just political), and how his new AI tool, Ask Carlat, pulls clinical answers from 23 years of unbiased content instead of the open internet. He also drops some blunt advice for any NP who's been approached by a drug rep.

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She got fired three times from community mental health jobs for refusing to see patients in 15-minute pill mill rotations. The third time, in October 2020, she had a mortgage, a husband in nursing school, and zero interest in starting a private practice. She did it anyway.

Dr. Maria Ingalla is the founder of Paper Flower Psychiatry, a 16-provider, five-location neurodivergent-affirming practice in Arizona. She launched it with about $150 — a $100 website she built herself, a $20 Fiverr logo, and a Psychology Today listing. No loans. No investors. No business plan. Just a refusal to keep getting fired for having ethics.

In this episode, Maria and Lindsay get into all of it: how insurance companies deliberately underpay claims by pennies hoping you won't notice (she lost $30,000–$40,000 to Blue Cross before catching it), why she hires virtual assistants directly from the Philippines and pays them fairly instead of going through exploitative agencies, and how she built a nonprofit — Paper Flower Foundation — that pays for psychiatric medications and therapy sessions for patients who fall through the cracks.

Maria also talks about why she thinks most psych NP programs are failing their graduates, what she actually looks for in a preceptor application (hint: ditch the professional cover letter), and why she diagnoses autism in adults when other providers are still ruling it out because the patient makes eye contact. She's autistic herself, late-diagnosed, and both of her kids are autistic.

And yes, she tattoos herself in her free time. Her dogs are named Marshmallow and Potato. She's been offered millions for her practice and turned it down without thinking twice.

Kailee Lenczycki and Lindsay used to sell Miss Me jeans together at The Buckle in Beavercreek, Ohio. Now Kailee runs a group psychiatric practice out of Fort Collins, Colorado with five NPs, two full-time admin staff, and in-house billing — and she built most of it while pregnant with her fourth child. In this episode, Kailee walks through the full timeline: a psychology degree from Cedarville, a 13-month accelerated nursing program at Loyola in Chicago, inpatient psych units, a TMS clinic doing clinical research, then four years at North Range Behavioral Health in Greeley where a mentor named Dan France — 52 years in nursing, Florence Nightingale award recipient — gave her the clinical foundation she says made everything else possible.

She talks about launching Present Life Psychiatry in March 2024 while still working her W-2 job, spending $3,000–$5,000 on a lawyer and about $2,000 on Silverleaf to set up IntakeQ, doing her own credentialing by going straight to the insurance company websites, and learning billing on one payer before bringing it all in-house. She tried the billing platforms — Headway and others — and left because she couldn't control the customer service. Now her team drops claims, chases denials, and gets 99-plus percent of them paid.

She explains why she hired her office manager Sarah — who once sat on the panel that interviewed Kailee for her first NP job — and how she found her first two NPs through a LinkedIn post and a Facebook group. She breaks down why she's firmly W-2 for her providers, what benefits she offers, and how she thinks about the 1099 debate after talking to lawyers.

Kailee gets into the integrative psychiatry piece too. She's in the Psych Redefined fellowship with Lindsay, she's running Genome Mind testing on her NPs and her patients (Medicaid covers it at 100%), and she's building weekly case review meetings into the practice culture. She's moving her own clinical focus toward perinatal psychiatry and keeping the practice small on purpose — no 80-patient weeks, no three-month wait lists, direct messaging through Spruce so patients can actually reach their provider.

85% of her referrals come from local therapists she networked with in person. She started the Colorado PMHNPs Facebook group because one didn't exist, and she runs a virtual networking lunch on the second Wednesday of every month. Her son knocked on the door mid-recording. That's the reality. She builds the business from the living room, after the kids are asleep, with her husband working his own job from the next room over. And somehow, a month in Florida with the whole family still worked.

Lindsay Hill is a psychiatric NP and coach helping NPs scale freedom and impact.

Join us for a "day in the life" as we follow a nurse practitioner at a clinic in Colorado Springs. This "nurse vlog" offers a glimpse into the "real world np" experience, providing insights into "nursing" practice. Come to work with me to see the daily responsibilities of a registered nurse in this dynamic setting.

No Prior Auth Podcast with Lindsay Hill, DNP, PMHNP-BC. Founder of The Psych NP Fellowship. Private Practice Owner, APNA - AZ Chapter Past President, Co-Founder of The Psych NP Network.

On this episode of No Prior Auth, Lindsay speaks with Miguel De La Mora about his decision to start his private practice immediately after graduation.

Many new graduates ponder the path to independence versus traditional employment. This discussion explores what it takes to build "self confidence" and embrace "entrepreneurship" early in one's career journey. We dive into essential "career advice" for those considering "how to start a business" right out of school, focusing on "personal growth" and the motivations behind such bold steps. 🚀

Heidi Reed contacted over 200 people trying to find preceptors for her psych NP program. She paid $5,600 out of pocket for her last two rotations — and the teaching wasn't worth the price tag. She once asked her nurse anesthetist for a preceptor connection right before being put under for surgery. When she woke up, the name was sitting on her lap.

That's the kind of person Heidi is. Scared and doing it anyway.

In this episode, Heidi talks about going from substitute school nurse to board-certified PMHNP, graduating during COVID in 2020 after more than a decade of starting and restarting nursing school while raising three kids. She shares why she decided to skip the employed-provider route entirely and build Intersect Mental Wellness, a cash-pay telehealth practice launching across Arizona and Nevada with her husband handling the tech side.

She breaks down the real startup costs — roughly $10,000–$11,000 including a $7,500 attorney retainer for a healthcare-specialized law firm that handled federal and state compliance so she could sleep at night. She walks through the DEA registration process, why each state handles it differently, what a registered agent actually is (and that it costs about $35–$50 a year), and why she refused to take insurance after watching providers get paid and then forced to give the money back months later.

Heidi's advice to anyone behind her in the journey: ask everybody, start early, and swallow your fear. Don't let it make the decision for you.

Lindsay Hill is a psychiatric NP and coach helping NPs scale freedom and impact.

Allison Sikorsky has been in healthcare since she was 16. Pharmacy tech, hospice nurse, clinical coordinator, geriatric psych on a floor so acute the ratio was 1:2. She graduated from Rush University's PMHNP program in 2011, spent seven years learning every setting she could get into, and then decided she was done being an employee.

• In this episode, Allison talks about building At Your Service Psychiatry into a multi-state telehealth practice years before COVID made virtual care mainstream. She did 50 EHR demos, couldn't find what she needed, and built her own system. She walked away from insurance contracts, applied for licensure in 25 states, and figured out direct-to-consumer psychiatric care when most people thought telehealth was "just for rural."
• She also gets real about the hard stuff. A colleague getting stabbed by a patient. Losing patients to suicide and sitting through root cause analysis meetings. A very public meltdown on an inpatient unit that ended with her walking out for good. And how she processes all of it now, including breathwork, calling families, and giving herself exactly 30 minutes to obsess before putting it down.
• Then there's PMHScribe, the AI documentation tool she built from her own audit-tested templates after years of being flagged as a "high numbers provider." She designed it so the charting practically writes itself for the auditor. https://pmhscribe.com/

If you've ever thought about going independent, going telehealth, or building something that doesn't exist yet, this one's for you.