How to Decide Between Telehealth, In-Person, and Hybrid Practice Models

One of the first decisions you will make as a new PMHNP practice owner is whether you want to offer telehealth, in-person care, or a hybrid of the two. Each model shapes your workflow, your schedule, and your patient relationships in different ways. There is no perfect answer. There is only the model that fits your life, your values, and the experience you want your patients to have.

Below is a simple breakdown to help you choose with clarity, not overwhelm…

Telehealth: flexible, efficient, accessible

Telehealth can be a great option for new PMHNPs because it keeps overhead low and protects your time. You can work from home or a small office, avoid long commutes, and serve patients across your state.

Pros:
• Lower costs and fewer logistics
• Easier scheduling for both you and your patients
• More privacy and comfort for anxious patients
• Smooth workflows for medication management and follow-up visits

Cons:
• Some patients prefer face to face connection
• Harder to read subtle nonverbal cues
• Technology issues can interrupt sessions
• Certain assessments feel more natural in person

Best for: clinicians who value flexibility, minimal overhead, and structured schedules.

In person: connection, presence, and grounded care

Seeing patients in person creates a different type of therapeutic presence. You watch the full body language. You create a welcoming space. You offer a ritual of stepping into care rather than logging onto a screen.

Pros:
• Stronger rapport for many patients
• Fewer technology barriers
• A grounded, contained environment
• Easier for more complex assessments

Cons:
• Higher overhead costs
• More time spent on commuting and office logistics
• Less schedule flexibility
• Smaller geographic reach

Best for: clinicians who value in-person presence and want a practice rooted in community.

Hybrid: the best of both worlds

Many PMHNPs land on a hybrid model because it offers both flexibility and connection. You might see new patients in person, then move to telehealth for maintenance. Or you might offer telehealth as the default and reserve in-person care for those who need it.

Pros:
• Wider patient reach
• More flexible schedule options
• Ability to reserve in-person care for complex cases
• Smoother patient experience over time

Cons:
• Requires managing two workflows
• Tracking which patients you see where can get complicated
• Higher costs than telehealth alone

Best for: clinicians who want choice and adaptability without committing to only one model.

How to choose your model

Here are a few grounding questions to help you decide.

1. What kind of work environment supports your nervous system?

2. How important is scheduling flexibility to you?

3. What type of patient experience do you want to create?

4. How much overhead are you comfortable with?

5. What do your state regulations allow?

Your answer does not need to be permanent. You can start with one model and adjust as you grow. A good practice model is not the one that looks perfect on paper. It is the one that supports your energy, your patients, and your season of life.

If you’re feeling overwhelmed, stuck, or unsure where to start, join us inside Strong Roots Mentorship. We take you step by step from ground zero to seeing patients and beyond, without the overwhelm.