> Generally they claim that these NPs with uncomplicated patients do as well as physicians with complicated patients.
The studies I've seen have compared practices where NPs are seen first vs. physicians are seen first.
> They're not conserving expensive resources. Imagine a patient comes in with a lump on their hand. An NP might see a weird lump, order an MRI which gets read by a radiologist, refer to an orthopedic surgeon who specializes in the hand, who removes tissue to send to a pathologist, who determines it's a common benign tumor of the fascia. That's three physicians who spent much more time here!
Your claim is this kind of excessive testing and referral doesn't happen with physicians? Do you have some kind of evidence this is more common with NPs?
This kind of overtesting leading to unnecessary procedures and bad outcomes has been pervasive through care in the US. Don't blame it on NPs.
> Bad incentives - Medicaid would not in a million years cover this, but the game of medical pinball where patients bounce around through in-network referrals can funnel those with decent insurance into procedures. Especially when most people have poor health literacy. A hospital executive probably just splooged in his pants seeing how much money their loss-leader of primary care is driving to radiology and the surgical specialties where they actually make money.
Ditto
> It's insincere. All of this can be viewed as possibly successful when the midlevels are part of the healthcare _team_ and know their limitations. But the NP groups are increasingly pushing for independent practice and prescribing rights in state legislatures across the country. CRNAs require a physician supervisor...
Welp, we're not creating anywhere near enough residencies to create enough physicians to do the work, so I'd suggest we'd figure out ways to either do that or use people with lower levels of training well (preferably both!).