At some point opinions need to be backed by facts. I've never met an MD/DO that shares your opinions, and people talk a lot in the hospital. I've also never witnessed a huge difference between midlevel providers. Our NP's actually have higher patient satisfaction scores. Only provider I've seen disciplined for lack of productivity was an MD.
These horror stories are mostly just online tales
You might want to go on r/noctor. There are literally a dozen posts a day at least of NPs (and some PAs) completely ****ing up, and multiple cases where mismanagement by the midlevel either nearly killed the patient or have caused the patient to have a permanent disability and/or shortened life span. It is atrocious. These are mistakes even I wouldn't make as a medical student.
And as far as "proof"*, there are a number of studies showing NP care is inferior to physicians or cost more/order more tests/prescribe more antibiotics or opioids, as well as debunking the propaganda that they are “filling the doctor shortage.”
*I put it in quotes, because we don't really "prove" things in science, we just accumulate evidence. So the more correct statement is that there is significant evidence that MLP care is worse and/or more expensive.
Resident teams are economically more efficient than MLP teams and have higher patient satisfaction.
Comparing Hospitalist-Resident to Hospitalist-Midlevel Practitioner Team Performance on Length of Stay and Direct Patient Care Cost - PubMed
Compared with dermatologists, PAs performed more skin biopsies per case of skin cancer diagnosed and diagnosed fewer melanomas in situ, suggesting that the diagnostic accuracy of PAs may be lower than that of dermatologists.
https://www.ncbi.nlm.nih.gov/pubmed/29710082
Advanced practice clinicians are associated with more imaging services than PCPs for similar patients during E&M office visits.
Comparison of Diagnostic Imaging Ordering Patterns
Nonphysician clinicians were more likely to prescribe antibiotics than practicing physicians in outpatient settings, and resident physicians were less likely to prescribe antibiotics.
Differences in antibiotic prescribing among physicians, residents, and nonphysician clinicians - PubMed
The quality of referrals to an academic medical center was higher for physicians than for NPs and PAs regarding the clarity of the referral question, understanding of pathophysiology, and adequate prereferral evaluation and documentation.
https://www.mayoclinicproceedings.org/article/S0025-6196(13)00732-5/abstract
Further research is needed to understand the impact of differences in NP and PCP patient populations on provider prescribing, such as the higher number of prescriptions issued by NPs for beneficiaries in moderate and high comorbidity groups and the implications of the duration of prescriptions for clinical outcomes, patient-provider rapport, costs, and potential gaps in medication coverage.
https://www.journalofnursingregulation.com/article/S2155-8256(17)30071-6/fulltext
Antibiotics were more frequently prescribed during visits involving NP/PA visits compared with physician-only visits, including overall visits (17% vs 12%, P < .0001) and acute respiratory infection visits (61% vs 54%, P < .001).
Editor's choice: Outpatient Antibiotic Prescribing Among United States Nurse Practitioners and Physician Assistants
NPs, relative to physicians, have taken an increasing role in prescribing psychotropic medications for Medicaid-insured youths. The quality of NP prescribing practices deserves further attention.
Comparing Nurse Practitioner and Physician Prescribing of Psychotropic Medications for Medicaid-Insured Youths - PubMed
(CRNA) We found an increased risk of adverse disposition in cases where the anesthesia provider was a nonanesthesiology professional.
Factors influencing unexpected disposition after orthopedic ambulatory surgery - PubMed
NPs/PAs practicing in states with independent prescription authority were > 20 times more likely to overprescribe opioids than NPs/PAs in prescription-restricted states.
Opioid Prescribing by Primary Care Providers: a Cross-Sectional Analysis of Nurse Practitioner, Physician Assistant, and Physician Prescribing Patterns - PubMed
Both 30-day mortality rate and mortality rate after complications (failure-to-rescue) were lower when anesthesiologists directed anesthesia care.
Anesthesiologist direction and patient outcomes - PubMed
Only 25% of all NPs in Oregon, an independent practice state, practiced in primary care settings.
https://oregoncenterfornursing.org/...020_PrimaryCareWorkforceCrisis_Report_Web.pdf
96% of NPs had regular contact with pharmaceutical representatives. 48% stated that they were more likely to prescribe a drug that was highlighted during a lunch or dinner event.
"Under the radar": nurse practitioner prescribers and pharmaceutical industry promotions - PubMed
85.02% of malpractice cases against NPs were due to diagnosis (41.46%), treatment (30.79%) and medication errors (12.77%). The malpractice cases due to diagnosing errors was further stratified into failure to diagnose (64.13%), delay to diagnose (27.29%), and misdiagnosis (7.59%).
Nurse practitioner malpractice data: Informing nursing education - PubMed
Advanced practice clinicians and PCPs ordered imaging in 2.8% and 1.9% episodes of care, respectively. Advanced practice clinicians are associated with more imaging services than PCPs for similar patients during E&M office visits .While increased use of imaging appears modest for individual patients, this increase may have ramifications on care and overall costs at the population level.
Comparison of Diagnostic Imaging Ordering Patterns
Although evidence-based healthcare results in improved patient outcomes and reduced costs, nurses do not consistently implement evidence based best practices.
The state of evidence-based practice in US nurses: critical implications for nurse leaders and educators - PubMed