Once you have worked with a PA for several years, you'll know what their knowledge base is and what their limits are. I don't see anything wrong with giving a PA added responsiblities if you are comfortable and trust the PA. The PA in turn should know what their limits are and ask for help when needed.
Most of these PAs who are getting minimal supervision are the ones that have been in practice for 5+ years with the same doc who has knows the PA very well. NO idiot would give an newly graduated PA that kind of responsibility or even a seasoned PA with whom a Doc just hired.
I don't see how this is "f-ing up the medical system for the younger generations." If anything, it helps provide health care to patients who the Doc wasn't able to see anyway. I'm sure you wouldn't be complaining either if your PA, you trust, was able to do more and could do more to help finance your new house, car, third wife, j/k 🙂
Hope you read the sarcasm there.