Yes,
it's too late.
The healthcare moneymakers have decided that we have reached the point where we are so dependent on them that we can be constrained to do whatever the heck they want (every little percent they squeeze out of us translates into billions of profit for them). The last nail in the coffin was the ACA. When a large regional hospital is allowed to merge with the only other hospital in the same city, and it's not monopoly per the FTC, you know that Big Health owns the government, too.
The midlevel movement is part of the "conspiracy" to decrease the costs, and thus increase their profits. It has nothing to do with decreasing the costs for the patients. When the doctor costs only 7-8% of the entire bill, and they are trying to squeeze that (instead of the drug companies and the device manufacturers), you know they would sell even their mothers into slavery for enough money. They want to make money on as many fronts as possible: selling expensive drugs and selling expensive devices to a bunch of technicians that cost next to nothing and use dumb algorithms to overuse said drugs and devices. (Remember when amiodarone became first choice instead of lidocaine in the ACLS, despite of no real evidence?)
Just see where Psych has gone with the DSM; it's a joke, not a science anymore. A joke that sells $billions more of unneeded drugs to 3+ year-old individuals; e.g. "oppositional defiant disorder" seems to be taken out of "1984". 50+% of my patients are on some anxiety drug. They are the new cigarettes one takes with one's morning coffee.
I do not want to hijack the thread, but all of these are part of a much bigger offensive that tries to transform healthcare providers into a big mass of commoditized and relatively stupid herd of sheep. And, as long as we accept to supervise/teach/accept referrals from midlevels, they are winning... We are training our replacements.
I foresee a big influx of residents into the few specialties where midlevels are not present... yet. It's just a matter of time till all becomes techs, computers and Big Health algorithms.
