I got some issue with this sentiment. If you are in academic neurosurgery, you are in a secure turf and PA/NP can increase your earnings.
However, how do you define "simple"?
Is placing an EVD a simple procedure? I suppose you will tell me no. Is placining a central line or mediport simple procedure? You may say, sure, it's simple. Let's train PAs to do it.
Before you know it, it's a few academic physicians and an army of PAs. When you already got your job, it's not a big deal, but to declare things simple (things like consult or "basic workup"), you are handing away medicine to mid levels and decrease demand for physicians, ultimately decreasing demand for physicians.
In that world, I am sure you and me, from the ivory tower to the next, will be fine. But what about the majority of posters here who don't go to an big ivory tower? What about the vast majority of DOs? Are most of their jobs so simple that a NP can do?
Here's the deal. You can train NP and PAs to do ANY Procedure. Hell, if you argue that work up for NPH is simple, I can counter and say basic stroke endovascular work is simple too.
However, you never know whether a work up or a problem or a procedure is going to be simple, and I am sure you know that very well.
NPs and PAs, due to limitations of their training, don't know what they don't know and will not recognize when a problem is no longer "simple". That will lead to patient harm.
As a result, we simply cannot declare things as "simple" and hand them away to mid levels. This happened already, to anesthesia.
Alternatively, we can give most things to mid levels, close most med schools instead of the top 30, and train enough physicians only to staff academic centers and a few to lead private pracicss. Is that the future you would like to see?