The problem is when midlevels want to become terminal providers who work independently (i.e. not "mid" anything)
I'm all for work-life balance. Most people going down the PA/NP care more about lifestyle than advancing their knowledge or becoming excellent providers. Unfortunately, many doctors and doctors in training today have drifted towards that mentality as well. This is how we help close the gap between the value we provide and that of midlevels.
Most people going down the PA/NP route may have hopes of transforming their lifestyle, however, there are many who truly want to create change in healthcare. While you say this is the case with NP/PA's, I'm very positive we've all seen the same with physicians too. There are some that don't give a rat's a$$ either because they were expected to become a physician, and it wasn't all what it was cracked up to be, or they've become disenchanted because the medical care services arena has changed. We are now serving a broken system that doesn't know what to do to fix itself. Companies/Hospitals are running nurses and support staff into the ground amidst staff shortages, while demanding patient turnover rates from physicians. Who WOULDN'T be angry and defensive at this point?! Physicians feel stifled by foolish, greedy demands made by corporate idiots. No wonder half of the people on this forum are angry regarding the influx of midlevel's and questioning their career choice, or threatening "sexual harassment" as a way to get rid of NP's? (I chuckled at that one, since nurses get sexually harassed by patients numerous times a day).
At the same time, nurses feel stifled for similar reasons and experience similar existential crises. The amount of physical, emotional, and mental labor that goes into nursing is absolutely ridiculous--nobody wants to do it! Most nurses came into the field with the hope that they could make a difference in someone's life, when in reality,---they are treated with disrespect by both the employer and the people they serve. I have become a legal drug dealer/waitress/teacher/janitor/babysitter/body guard/paper shuffler/court reporter with mounds of repetitive documentation, etc. Sometimes I never eat lunch. Sometimes I hold my urine for 12 hours and completely forget about it because I was busy monitoring multiple patient statuses, and their needs were more important than mine. --While I would like to get away from this lifestyle, I also have the ridiculous idea that I can help renovate health care into something it should have been all along: holistic, personal, and preventative. Suddenly, I am reminded of the harsh reality that nobody will ever pay for that because it makes too much sense. Then there are other days I feel that health care will NEVER change as long as we keep the current systems in place, and if I "can't beat 'em,---JOIN 'em" in their greed. However, that's not me. That's not why I became a nurse and that's NOT why I'm becoming a nurse practitioner. Yes, the money may be a little better than a travel-nurse job---MAYBE.... BUT, I want to really help influence how care is delivered. I want to take my bedside experience and use it far beyond traditional medicine. I want to use it to help empower and educate patients besides throwing prescriptions/pills at them. Many of my physician coworkers have supported this and encouraged me to make this step for years. It's sad to come to a forum where nurses/np's/pa's are not welcome. I came to crash the party and remind you all that you're very valuable and we need you just as much as you need us, obviously.
As far as value goes? Yeah, I challenge you to do that---for the sake of your patients. If NP's/PA's challenge you to do that, then I hope you always have someone to inspire/anger/empower you to do better than you did yesterday. Because while there are some really good physicians, there are also some really awful ones we have to put up with and vice versa. So, let's agree in saying that not all physicians are alike. Because they aren't. There are some physicians and surgeons that I wouldn't let touch me with a 50 foot pole after seeing their patient outcomes--(yes, nurses notice that stuff). Same goes with NP's/PA's. Some patients would rather see a physician, while some of them would rather see the PA/NP. Some of them couldn't care less. It's a balance--and that's why you'll always have your job.
But, here's an idea: Imagine a sick population that is continually growing (because it is). Now imagine the immense stress and strain of having to see all of those patients with wait times up to 6 months? Some of them are critically ill. Would you rather them have to wait that long? Is that fair healthcare? Yes, you could hire another physician, but that's a lot of money--plus training and startup, and STILL won't reduce the wait-time by much. OR, you could hire several very qualified, top-notch NP's/PA's, etc.,--resulting in less money spent, plus--------the workload gets divided. You save money and increase your revenue as well. As a consequence, patients are happy/happier because they've been seen/and/or treated, and you don't have to refer them to someone else instead. There's also value in that. Think about it.