Well, first of all, medicine is becoming increasingly more complex on the molecular level. Because of this, expect some really radical new treatment options that will amaze the world. Secondly, I have the utmost respect for all practitioners regardless of what level they're at....that being said, a physician is a physican and the public knows it. There is no substitute....before I say this, let me qualify my statement in saying that there are always going to be Dr's who are complete *******es.....okay, here we go..........I'm going to direct this to the future of family physicians.........it's kinda like I can't believe it's not butter.....most PA's and NP's are perfectly capable of competently handling a very wide variety of clinical presentations and cases. They will treat identically to and with the same end result as the Physician. You couldn't tell the difference. However, every now and then there's that time where you just plain need real butter to get the recipe right. This is exactly why the family physician will NEVER go away! There is always going to be the need for their expertise in managing certain patients. Now will the number decrease in the future? Maybe.....I can visualize a system where in the clinic most healthy or mildly ill patients are mostly seen by NP's and PA's but then seen by the physician every so often just so they can check in. Also, the more complex patient's would be seen by the physician routinely.
I may be wayyyyyyyy off when I say this because nobody knows for sure, but I can confidently say that if you love medicine.....GO FOR IT because you will ALWAYS be needed and have the security of the occupation. Just think about it, I've gained a lot of knowledge in my years as an ICU nurse......many times, my knowledge was equal to or superior than some of the NP's I worked with, however, my knowledge wasn't even a drop in the bucket compared the physicians knowledge. Let's use a scale of 1-10 arbitrarily for in depth knowledge of everything that goes into medicine........
average Joes knowledge is about a 1-2......they know what they read on the internet and thus mostly have tunnel vision.
Mid-level Healthcare workers such as RN's etc have about a 4-5 on average.....they know quite a bit about the basics of stuff and some in-depth clinical info due to their experience......for example....an ICU nurse......she knows that vagal responses will decrease heart rate, BP, etc....and knows that a wedge pressure measures pressure in the Left Atrium and when combined with a CVP gives you appropriate hydration info, etc.
Your advanced practitioner such as a PA or NP is about a 7-8 on this scale. They are well versed in their area....So they in turn would know that the vagal response is a parasympathetic response mediated by the vagus nerve which will blah blah blah.........also they will be able to diagnose a variety of conditions, give appropriate orders concerning various meds, and I really don't have to tell you because you're a PA....so you know what your knowledge base is.
A Good Physician is about a 12 on this scale. They will not only tell you that a vagal response is parasympathetic and mediated by the vagus nerve, but they will also tell you that the vagus nerve is CN #10, sends branches to the carotid body, is composed of superior and inferior laryngeal branches which provide input and output from the larynx and that the neurotransmitter used in the preganglionic neurons is Acetylcholine which is received by nicotinic receptors in the postganglionic axon which then transmits the neuronal action potential to the target organ by once again using Acetylcholine....but with the muscarinic receptor this time....this will result in a greater trend towards hyperpolarization of the myocardium and decreased conduction at the AV node thereby causing the decreased heart rate.....also, this response will constrict bronchiole smooth muscle. By the way, there are 3 isotypes of muscarinic receptors ....M1, M2, M3.
So you see my point.....this is a little oversimplified but nonetheless accurate. If you want to do it man......DO IT. I know I did, and I don't regret one minute of it. Knowledge, especially about the human body, is perhaps the most sacred gift of all. If one has the talent and ability to acquire this knowledge then they are blessed because if they pass the opportunity by, they will always be thinking about what could have been. I say this because you will never stop thinking about being a Dr until you do it. I know I couldn't. Hope this helps.....remember, physicians are not going anywhere.....there will ALWAYS be a need for Good Doctors as well as NP's and PA's.
