To be frank in answering this question: Because parents cheat. Parents have been trying to game and cheat us into admitting their child for consultative services since we started—understandable given that demand is high and our availability is limited. With all consultative services now being cash-only, the cheat takes a different form: Once in the exam room with Dr Dickerson for a presumed “routine” primary-care issue, the parent will launch the “while we’re here, can we discuss [insert consultative issue]?” to get a consultative visit “paid for” by their third-party payer as an acute office visit. We have a zero-tolerance policy for this cheat, and doing so will result in immediate discharge from the practice.
Our mid-tier providers are well trained and equipped to render primary-care services with sensitivity to any underlying chronic health issue(s). If during the visit for an acute issue, the provider has a concern(s) as it might relate to an underlying chronic issue(s), she has access to Dr Dickerson for consultation. Furthermore, Dr Dickerson personally reviews all charting for every visit performed by our mid-tier providers. You should have no fear that your child will receive inadequate or inappropriate primary-care from our mid-tier providers.