@hallowmann I hear you, I really do. Not necessarily the examples, as flagrant as they are there's plenty of physician examples, but the lack of regulatory repercussion as a feedback mechanism is troubling and would preclude independent practice.
I think the bigger issue, is that while I would, and I suspect you might, support independent practice under X conditions (standardization of training, competency based exit exams, effective boards, etc), many if not most who are posting would oppose under any conditions didn't mirror physician requirements point by point. It's a matter of principle devoid of the context. If the framework is that mid-levels do have a different, narrower, scope, then by definition the training and demands are not the same so we should be comfortable accepting that. And then its the matter of how central is independent practice to the definition of appropriate scope where we might vary.
The financial interests driving this are of course suspect. But that's across the board in American medicine from reimbursements, specialty salaries and the RVU cabal, the division of GME funding, the regulatory/safety nexus and much more. That doesn't mean that there isn't merit in approaches to allow the best use of a professional's skills while trying to mitigate the consequences of doing so as to not drive us further into the asylum our healthcare system inhabits. Family medicine began as a counterculture, it should continue as one, and for me that means questioning and challenging restrictions of practice, both our own and for others.
