For what it's worth, the same thing happens with physicians.

For some reason when I was living in Jersey City about 7 years ago, there was a lack of dermatologists in the area that took my insurance and were also taking new patients. I finally found one, made an appointment, and went in for a full skin exam. I waited for about 20 minutes after my appointment time, finally was called in, the dermatologist commented that someone my age (late 20s) shouldn't have any acne on their chest and tried to prescribe and sell me a bunch of ointments directly from his office. He spent maybe 2 minutes looking at me and definitely didn't do a full skin exam.

A couple of years ago I moved and had to find a new PCP. Went to the first one I could find that was close-ish and took my insurance. While I'm in the waiting room, I see 50% of the people leaving with these packs of meal replacement shakes for weight loss. When I was finally called back, I see a bunch of signs about subscriptions for the shakes and all of the different flavors they had. I ended up getting a physical from the PA in the office instead of the physician that I had made my appointment with. I have nothing against PAs or NPs, but I expect to see the physician I make my appointment with. The whole thing was so shady that I ended up just finding a new PCP.