don t know what s going to come through the door. in a home environment, say a medical home or a hospital environment where collaboration can occur, then they fulfill a great role. but an independent, autonomous practice, i have a problem with that as do most people. doctor, what do you say to at that? i say that right now, when we say collaboration and supervision in the united states, there s an implication that there s a physician looking over our shoulder. here in new york state where i practice, i have a collaborative practice agreement, but that collaborative practice agreement does not assure quality, indeed a collaborative practice in new york state is a retro-effective chart review, no need for a physician on site or mileage requirement. i can have a physician in rochester be collaborative with hee in new york. a retro effective chart review is not someone over my shoulder. an interesting point and important one is that there are 16 states in the united states, there is no