Every healthcare practitioner evaluating an independent telehealth build is implicitly making a comparison against the employed or group practice alternative. Making this comparison explicit — with real numbers — helps practitioners make an informed decision rather than defaulting to the employed option out of familiarity or the independent option out of idealism.
The employed model in 2026: NPs and PAs in employed positions in hormone optimization, men’s health, or functional medicine typically earn $85,000–$130,000 per year in base salary, with benefits (health insurance, malpractice coverage, retirement contribution, CME allowance) adding 20–30% to the total compensation value. The ceiling is constrained by salary bands and performance bonus structures. The income is predictable. The administrative burden is largely someone else’s problem. The downside is the ceiling, the loss of clinical autonomy, the patient volume pressure, and the total compensation value to the employer being 2–4x your own earnings.
The independent telehealth model at 12 months: As modeled in our 12-month revenue projection post, a realistically built hormone optimization telehealth practice can generate $150,000–$250,000 in year one revenue for a part-to-full-time practice. Net income after practice expenses (EHR, malpractice, licensing, marketing, any staff) at this revenue level: $100,000–$180,000 — comparable to or higher than employed compensation in year one, with compounding growth in year two and beyond as the patient base and referral network mature.
The risk comparison is also not what practitioners expect. The employed model has risk too — practices close, positions are eliminated, clinical autonomy is constrained, and the income ceiling is real. The independent model has a different risk profile: lower and more controllable when the infrastructure is built correctly. The practitioners who fail independently typically did so because of preventable infrastructure decisions, not because of insufficient market demand.
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