Great points. I think we (the big we, including physicians, society and regulators) need to be looking more closely at what 'access to care' actually means and looks like. You could arbitrarily say that the system's goal or new standard of care for a pt with a mental health complaint is to see a 'medication prescriber' within x number of weeks. But the care delivered, outcomes, and risks are dramatically different depending on who that prescriber is - PCP, well-trained NP, online degree NP with no experience, psychiatrist, behavioral health integrated team, etc. To sloppily say the patient has 'access to care' because they saw a random MSW and an online degree-trained NP within 2-3 weeks of seeking care is nonsensical. Is it still access to care if the undertrained 'prescriber' throws an unsupported diagnosis on and prescribes a benzo or a stimulant? Is it access to care if they prescribe 50 mg of Zoloft with follow-up in 3 months? What about if they follow their algorithms, prescribe what seem to be appropriate meds on paper, and completely miss sleep apnea, hyperthyroidism, dementia, substance abuse, DV... and the patient suffers the consequences? I know it's tough to relay these concepts to regulators and the public, but we need to do more, either via APA, in our own communities, or elsewhere, because people are still not getting the difference between a full, well-practiced, evidence-based psychiatric evaluation, and a chat with an online-degree provider that will lead to one of four prescriptions nearly at random. It's dangerous to say that a patient has 'accessed care' when that care is not evidence-based, supported by sufficient training, or supervised closely by someone with such training and experience. This goes well beyond mental health to the explosions of undertrained NPs in numerous fields, and I hope it does not take a series of horrible outcomes to finally educate the public and regulating bodies.