Good question. Besides midlevel providers, medicine is be affronted by technology as well. It's not as important to have a highly trained physician who know the "art" of practicing medicine anymore. We have algorithms for that now. We even have data that shows when we try to get "artsy" with our practices, our outcomes are probably worse than if we had just used the algorithm some PhD whipped up in their free time with an excel sheet and some stats work. The idea that more education makes you more useful is only valid if you can prove there is some added value to that education. The medicine system is built like a guild, where all the training is a rite of passage in which you "buy in" and gain the RIGHT to treat patients. AMA is one of the most successful groups at maintaining high barriers to entry (in this case entry is lawful ability to treat humans for medical diseases).
I would love it if someone here could show some data that clearly demonstrates increased mortality when patients are treated by NP instead of physician, but I'm not aware of it. I have noticed in my own experience that MLP's seem to "over workup" patients. Perhaps due to their inferior training. This would increase the cost of care/diagnosis per patient, but the hospitals (who employ MLP and physicians) also make money of this stuff, so they have no incentive there to slow that down do they?
I agree surgeons will be the final line in the battle. You have a highly trained person intellectually, but you also have a carefully learned technical skill. An NP may be able to work through the pre-surgical diagnosis and treatment, but they are a LOOOONG ways away from being able to supplant a surgeon in the operating room with any level of facility. Also, a patient is probably fine with an NP ordering a chest X-ray and giving them antibiotics, but I'm thinking they will not be so eager to sign up for the craniotomy, whipple, hip replacement etc done by a MLP.
I think for you as a medical student, the bigger challenge isn't the NP supplanting your role as a physician (you will always be needed in some manner), but the reality that it is getting harder for medical students to find residency spots. This is because medical school is shifting toward the "for profit" mentality (like law schools), and they are increasing enrollment far quicker than residency positions are growing. More and more american grads are now holding an MD, but not matching in their desired specialty, or not even matching at all. This is the problem that needs to be addressed.
Increasing residency positions will make it easier to match, but will shift the supply/demand curve that helps keep physician pay high.....
