Speaking as an MD, I think a distinction should be drawn between specialist and generalist midlevels. Specialists, and I include midwives here, do an actual residency and are usually excellent on the practical aspects. As a resident I learned a lot of my orthopedics from PA orthos, who were sharp cookies and in their field were highly useful adjuncts to the ortho surgeons for the bread and butter like uncomplicated fractures and surgical assists.
On the other hand, generalist midlevels have no explicit residency and even long-time midlevels who never really got any proper oversight can be nightmares. On internal medicine hospital call we used to groan when the urgent care paged us because we were always cleaning up their messes. I can't see how that saved any money or yielded equivalent outcomes.
On the other hand, generalist midlevels have no explicit residency and even long-time midlevels who never really got any proper oversight can be nightmares. On internal medicine hospital call we used to groan when the urgent care paged us because we were always cleaning up their messes. I can't see how that saved any money or yielded equivalent outcomes.