You have an interesting perspective being in an industry that has sort of driven the shift from physician care to midlevel care in the USA (sounds like you work for a hedge fund that does medical investments; not sure in direct patient care companies or not).
Usually the argument has been that we “need” midlevels because we can’t provide enough care with physicians only, and they are cheaper.
The problem is that “cheaper” doesn’t mean patients ever see this money. As everyone knows healthcare costs in the USA are way higher than any other first-world country, most of which provide their citizens with largely physician-level care. So where is all that extra money going?? Probably to the admins and investor class (ie siphoned off by vehicles such as hedge funds and PE).
You well know that one of the major ways large PE firms can pocket that money is taking over a physician group, move the “provider balance” to less physicians and more midlevels - and pocket the salary difference.
Do the patients pay less? No, of course not. Do they get inferior care? Hard to prove, and while you use the common argument “well, there are incompetent physicians just like incompetent PAs/NPs” we ALL know there is a bell curve. Common sense would say that on AVERAGE more/higher intensity training (and higher caliper initial intellectual talent bar on average to start) would result in a better qualified caregiver.
That’s why I find your arguments so.... disconnected with reality on the ground.
No one is arguing against better midlevel training. We are arguing against blurring the lines between physicians and midlevels. And the continued vested interests to blur these lines (with likely harm to patients in the name of corporate profits).