What one can do in New York depends on their laws there, and I have no knowledge about what regulations they have their regarding supervision.
The theory behind PA run clinics goes something like this... a PA wants to open their own practice, so he or she (I’ll refer to the PA as “they”) goes out and hires a physician to be their supervisor of record and then goes about working essentially on their own each day, and sends a cut of the revenue to the physician to basically rent their credentials. The theory relies on the notion that the PA and the supervising physician will go through the motions that are required by law in a pysician/PA relationship. The devil is in the details, and there are many. Some states prohibit a practice being owned by a pa. Some states require the supervising physician to be on site, or to review a certain amount of patient plans with the PA. There are issues surrounding liability. I think you’d find many physicians would be very wary about lending risk to a PA, and if they did, I don’t think 10% would entice them to do so. If something happened, and a patient decided to sue, the lawyers would come straight after the supervising physician first...that would be a given. And no MD would take that on. They theoretically could... but not for an amount that would makes it worth your effort.
Another issue is that you will have to get insurance companies to be willing to allow patients to see you so you can get them to pay for the work you do for their customers. They won’t want to do that because the practice isn’t run by a physician. They will do the research and find out who they are allowing into their network, and uncover your methods. Even if they didn’t, your physician competitors would let them know about your arrangement, and your patients wouldn’t be able to have insurance pay for the care you provide.
Derm is competitive. Dermatologists jealously guard their turf. A PA owned practice would elicit a response that would include ads from derms saying “come to our practice where you see real physicians, not the wannabes”. The my would cede no ground. And dermatologists wouldn’t sign on to sponsor you. PAs have to functiin within the scope of practice of their supervising physician, and for you that would mean you’d have to find a dermatologist specifically to sign on with you... not a family practice doc, nor any other kind. Derms do so well, they would balk at signing on with you for the chump change you could offer them. Like I say, why would one take the risk of supervising someone who offers them competition and risk to their license and finances? The revenue you would churn up is probably what they generate in a short amount of time in their own practice.
There are many more roadblocks, those are just a few of the first ones that come to mind. In theory, it’s possible. In reality, it’s not.
As a nurse practitioner in a state where NPs can function fully independent of a physician (and which is about half of them), then it’s a lot easier... in theory. They might not have to have the supervision arrangement with the physician. However, the deadly part is getting insurance arrangements made with patients insurance providers. Then there are issues regarding getting a steady flow of business. It’s difficult enough that it’s about as rare to find NP owned practices as PA owned ones. I’m in psyche, and I see quite a few of NP run practices in that arena, but a psyche practice involves less physical infrastructure... it can basically just be office space. But there are considerable hurdles to navigate, and that is a lot to take on.
Go buy into a service franchise if you really want to own a business. Don’t take on thousands of dollars of debt and spend time in school when you could open a cleaning business or a pizza kitchen and make more profit in less time. I know a kid who started a night janitor company that made millions within 5 years.
