welkins Posted June 17, 2019 Share Posted June 17, 2019 I have been a PA for over 15 yrs and am looking into the possibility of opening a clinic of my own in KY. My searches do not reveal any particular law or guideline prohibiting or allowing a PA to own a practice in KY. All I can find discusses physician supervision and the different levels of supervision. I have emailed KAPA for info, but haven't received a reply yet. That leads me to believe it can be done as long as I have a "supervising physician". My focus the last 12 years has been in orthopedics and anticipate providing non-operative orthopedic care (injections, splinting, simple fracture care, osteoporosis etc.), but would also provide primary care, DOT physicals etc so I would probably need a family practice MD/DO as a supervising physician. This is a new venture for me and plan to keep it on a small scale. Any info regarding the legality of a PA owning and running a clinic, suggestions, past experience, etc. would be appreciated. Quote Link to comment Share on other sites More sharing options...
sas5814 Posted June 17, 2019 Share Posted June 17, 2019 It is very variable by state. I'd make sure you knew the nuances of yours before starting. For instance in Texas the medical board, to stop PAs from owning practices, mandate any practice must be 51% owned by a physician or physicians. basically they made a law totally outside the scope of their authority to protect the financial interests of physicians. Then they tried to make it retroactive and take away practices from more than a hundred PAs that owned their own practices. So be well versed lest you get in deep and then find a big bump in the road. On the clinical side of things your SP can't delegate a skill or privilege they don't have so any procedures you do they must have as well. Lastly if you search the forum you will see a lot of strong opinions about DOT physicals. Personally I'd rather get out of bed every morning and let a horse kick me in the testicles than do DOT physicals again. 3 Quote Link to comment Share on other sites More sharing options...
welkins Posted June 17, 2019 Author Share Posted June 17, 2019 5 minutes ago, sas5814 said: It is very variable by state. I'd make sure you knew the nuances of yours before starting. For instance in Texas the medical board, to stop PAs from owning practices, mandate any practice must be 51% owned by a physician or physicians. basically they made a law totally outside the scope of their authority to protect the financial interests of physicians. Then they tried to make it retroactive and take away practices from more than a hundred PAs that owned their own practices. So be well versed lest you get in deep and then find a big bump in the road. On the clinical side of things your SP can't delegate a skill or privilege they don't have so any procedures you do they must have as well. Lastly if you search the forum you will see a lot of strong opinions about DOT physicals. Personally I'd rather get out of bed every morning and let a horse kick me in the testicles than do DOT physicals again. I am sure it is variable by state. KY does not say either way. Never did a DOT, but I have been kicked by a horse and dont want to do that again. Still in the planning and gathering info stage. Not ready to jump in with both feet. Need more information first. Thankk you. Quote Link to comment Share on other sites More sharing options...
Joelseff Posted June 17, 2019 Share Posted June 17, 2019 Check the Corporate Law regarding medical practice ownership. In California, the medical board doesn't regulate this, the corporate board does but BOM has input on it. I ultimately decided (8 yrs ago) that it was way too much hassle and didn't go through with it.Best of luck Sent from my SAMSUNG-SM-G891A using Tapatalk Quote Link to comment Share on other sites More sharing options...
sas5814 Posted June 17, 2019 Share Posted June 17, 2019 10 minutes ago, welkins said: I am sure it is variable by state. KY does not say either way. Never did a DOT, but I have been kicked by a horse and dont want to do that again. Still in the planning and gathering info stage. Not ready to jump in with both feet. Need more information first. Thankk you. Glad to help if I can. I had a practice here in Texas and didn't have any significant bumps but tripped a few times. I was very lucky to have several existing practice owners help me out. If you know of any or can find any they would be a great resource. I found the PA practice owners here very enthusiastic to help. I was kicked in the chest by a mule once. Still preferable to DOT physicals. Quote Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted June 17, 2019 Administrator Share Posted June 17, 2019 Meh, DOT physicals are fine if you set expectations right up front, don't be a jerk about it, and don't mind unhappy patients. I would MUCH rather do DOT physicals in a practice with a management team that backs me up than in corporate drone medicine ("Your DOT patient satisfaction scores are too low. We've scheduled you for reeducation") Quote Link to comment Share on other sites More sharing options...
sas5814 Posted June 17, 2019 Share Posted June 17, 2019 Its true. You just need thick skin. The 400 pound diabetic who can't pass the exam will cry poor about how this is how he pays his bills and try to make it all your fault because they aren't doing what they are supposed to do. I have had them threaten me and even threaten my life which just generated a police report in addition to their other issues. 1 Quote Link to comment Share on other sites More sharing options...
Cideous Posted June 17, 2019 Share Posted June 17, 2019 2 hours ago, sas5814 said: It is very variable by state. I'd make sure you knew the nuances of yours before starting. For instance in Texas the medical board, to stop PAs from owning practices, mandate any practice must be 51% owned by a physician or physicians. basically they made a law totally outside the scope of their authority to protect the financial interests of physicians. Then they tried to make it retroactive and take away practices from more than a hundred PAs that owned their own practices. So be well versed lest you get in deep and then find a big bump in the road. On the clinical side of things your SP can't delegate a skill or privilege they don't have so any procedures you do they must have as well. Lastly if you search the forum you will see a lot of strong opinions about DOT physicals. Personally I'd rather get out of bed every morning and let a horse kick me in the testicles than do DOT physicals again. LOL Yes to everything in this post. Can I get an Amen! Quote Link to comment Share on other sites More sharing options...
LKPAC Posted June 17, 2019 Share Posted June 17, 2019 8 hours ago, sas5814 said: It is very variable by state. I'd make sure you knew the nuances of yours before starting. For instance in Texas the medical board, to stop PAs from owning practices, mandate any practice must be 51% owned by a physician or physicians. basically they made a law totally outside the scope of their authority to protect the financial interests of physicians. Then they tried to make it retroactive and take away practices from more than a hundred PAs that owned their own practices. So be well versed lest you get in deep and then find a big bump in the road. On the clinical side of things your SP can't delegate a skill or privilege they don't have so any procedures you do they must have as well. Lastly if you search the forum you will see a lot of strong opinions about DOT physicals. Personally I'd rather get out of bed every morning and let a horse kick me in the testicles than do DOT physicals again. why isn't AAPA or Texas PAs taking this to court? Quote Link to comment Share on other sites More sharing options...
sas5814 Posted June 17, 2019 Share Posted June 17, 2019 Actually a small group of practice owners I was a part of spent 200k suing the medical board in federal court. We did not prevail but we did stop them from making the order retroactive. 1 Quote Link to comment Share on other sites More sharing options...
Gordon, PA-C Posted June 25, 2019 Share Posted June 25, 2019 On 6/17/2019 at 4:09 PM, sas5814 said: Actually a small group of practice owners I was a part of spent 200k suing the medical board in federal court. We did not prevail but we did stop them from making the order retroactive. There's actually some broad loopholes in that Texas law. For example Texas Health Resources runs and owns 30+ clinics in the DFW area, and none of those clinics is owned by MDs. Aslo the leadership of THR is all MBA/business types without any MDs at the helm. So they obviously found a loophole to exploit. Quote Link to comment Share on other sites More sharing options...
sas5814 Posted June 26, 2019 Share Posted June 26, 2019 There are loopholes but the medical board has been very clever in that they made the punishment apply to the physician that works in the "wrong" clinic. They have no control over anyone else. The whole thing in Texas started because some PAs exploited some existing loopholes and started their own practices and some physicians were complaining to the board about the competition. No complaints about risk or quality of care. So the board did what it does....protected the financial interests of physicians under the false flag of protecting patients. There are other states that are much friendlier for starting a practice. The experience here in Texas has left me with a very bitter taste in my mouth. 1 Quote Link to comment Share on other sites More sharing options...
Cideous Posted June 26, 2019 Share Posted June 26, 2019 ^^^ I know exactly how you feel. Quote Link to comment Share on other sites More sharing options...
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