You have been hired as a consultant by the Practice to look into the use of physician extenders. 

Dr. Mason has asked you 

(1) to estimate the financial impact of using one physician extender at each of the three clinics and 

(2) to recommend the type of extender that is most appropriate for each setting. These tasks are not trivial and might require assumptions and information to supplement the data presented in the case.

As a start, you conclude that the national financial impact data presented earlier must be modified to reflect the actual impact on physician productivity in the three settings. Next, you plan to estimate how many additional visits might be generated at each clinic if one extender is employed. Then,
the impact on costs and revenues must be examined. Of course, it might be possible to use an extender to reduce the number of physician FTEs rather
than to increase volume. This outcome should be explored if appropriate. Regarding physician extender costs, annual compensation for both NPs and
PAs falls into the $80,000 to $100,000 range, depending on geographic location, clinical setting, and work experience.

One of the keys to the analysis is an estimate of the volumes that could be realized at each clinic should an extender be added. Unfortunately, Dr.
Mason has only anecdotal evidence (office watercooler speculation) on future demand. The best estimate is that patient volume at the preoperative and
postoperative clinic is increasing at a 15 percent annual rate as outpatient surgery volume increases. The situation at the internal medicine clinic is quite different. There is a several-month backlog in scheduling, and hence a physician extender could be fully used in a relatively short time. Finally, volume at the eldercare clinic has been sporadic and growing very slowly, so there is some doubt about whether another clinician is needed at this time.

Dr. Mason recognizes that you are working with a minimum amount of hard data. Thus, you must very clearly express and support the assumptions
used in your analysis.