Regardless, I doubt this will fix the problem, which is the undervaluing of the medical doctor’s services in primary care. Am I really to believe that the gap between the exorbinant subspecialist salaries and the ever-falling primary care compensation will close when 3 APNs are working under an internist? What color curtains have you picked out for your House of Lies?

The reason this idea is being pushed is because it would save hospitals money by being able to get away with paying nurses for trying to do a physician’s work under the guise of it being “supervised” by a “collaborating” physician (i.e. a doctor not even on the premises). My hospital in particular wants to do this so that they have leverage over PCPs who want equitable compensation by threatening them with replacement on the cheap.

You don’t think the insurance companies are eventually going to say, “Well, now that you’re billing 40% more visits, and they’re being seen by APNs, we’re going to pay you less unless the doctor actually touches the patient.” Then what?

Medical students aren’t dumb. They see the ridiculousness going on. Pay primary care what it’s worth, or stop complaining when everyone continues to go to the ER for primary care.