YES, I am serious. the patients know up front what the arrangement is. they sign something up front when they join the practice that acknowledges that the care will be provided by pa's with referal to specialists as appropriate.no one is forcing patients to join the practice. there are other md practices in the same town.they have a fee schedule which pts agree to up front that specifies what an office visit costs, etc. most of their pts pay cash or are medicare/medicaid. I think medicare/medicaid allow a pa to bill for around 80% what an md can for the same service,but since most of their folks pay cah it is not an issue. the only limit on a pa's scope of practice is their state scope of practice and what the superviseing doc allows. for instance, mine says may evaluate and treat pts with ambulatory, urgent, and emergent complaints to the extent of training and experience.
