A lot of them are more at the medical student level. There are many dangerously under-trained NPs out there. It's only going to get worse now that you can get your NP from places like an online program at University of Phoenix. Some of these NP programs accept 100% of the people who apply to them. The standards for NP programs are nothing like the standards for medical school.
In procedural specialties mid levels do the scut work and free up the physician to do procedures. In primary care I suspect the change has happened slowly enough and physicians have such little leverage and so much patient load demand, they've been coerced into supervising mid levels and can't turn back. It's an evil irony that family doctors are training their replacements, and all the while keeping all of the liability.
But, isn't this how it works? In states where NPs have independent practice rights, the doctors are not liable for them.
True to some extent. However even in independent practice states, some clinics and hospitals require mid levels be supervised by physicians for liability reasons. Namely to shift the liability from the clinic/hospital onto the physician.
They really are a pain in the butt.
It is really hard to be successfully sued as an outpatient psychiatrist (or NP for that matter) because the standard of care is so low in our field. But it is not true that liability would primarily belong to the NP. This is due to two doctrines. One is "captain of the ship". Physicians, as the most qualified healthcare professional, and typically leaders of the team are seen as captains of the ship and thus liable for any negligence on the part of anyone working under them. the second is "respondeat superior" which literally means "let the master respond" and essentially means that you can be appropriately named as party for a lawsuit for any negligence committed by anyone under your supervision. Typically when a negligence/malpractice suit is filed, they name everyone and then whittle it down. Even med students get named. But they really want to go after those with the deepest pockets. First is the hospital or organization, because no one likes corporations and people feel better about suing faceless organizations. Second is the physician because they get paid the most. So it is true that your liability only slightly increases because the chance of the NP being successfully sued is so low to begin with. But, if there is a successful suit, they will go after you because why go after the monkey, if you can have the organ grinder? It would not matter if you have never even heard of the patient in question (in fact that would make it worse!)
No they do not. Unless you're in Oregon.
