... and they offer you an appointment with a nurse practitioner or physician's assistant instead, do you accept it without much resistance?
I have had one or two PA appointments. The insurance Explanation of Benefits (EOB) always lists some MD's name. But the physician (let's call him Dr. Lee) did not see me in any sense. How can Dr. Lee legally bill for an encounter with me? Even it is something legal with my state's licensing board, do you think it is ethical? I would never explicitly state that I looked after someone child for 1 hour and now wanted to be paid for it if I had never in my life gazed upon that child and couldn't identify him/her if my life depended in it.
Next question, do you think you should be charged the same rate whether you saw an MD or PA, or NP at any given practice?