The challenges lay in getting small business loans, headaches with insurance reimbursement, prior authorizations, etc... basically the business aspect of owning your own business. Those are true whether you are a PA or an NP. Then you need a physician provider willing to put their liability on the line to endorse you as a supervising physician, and also will possess the proper scope of practice for what you are practicing in. When you get sued, the physician will be the one that they lawyers go after. They won't take on that risk out of the goodness of their heart... it's going to cost you. I'm not privy to any specific numbers, but I can't imagine a physician wanting to entertain that kind of exposure for meager salary. I would expect that the privilege to employ a physician for that role to cost enough so as to make them your most expensive employee.... probably more than the PA is able to pay himself/herself.
