This is a very polarizing topic in the field of medicine, especially when it comes to independent practice of midlevel providers. I’d just point out that NPs have a very aggressive national organization that promotes such studies, and the issue of equivalent patient outcomes is certainly not yet decided. There are significant questions about the study design, namely that midlevel providers are seeing less complex and critical patients, while physicians take on cases where their more advanced and thorough knowledge is needed (and outcomes tend to be poorer due to the patient condition, not the care provided).

This is well and good, aside from potentially misrepresenting the research - midlevels are supposed to handle what they can and escalate what they’re unable to handle to a supervising physician.

There is similar research that shows NPs and PAs order more unnecessary diagnostic tests like labs and imaging, and are more likely to prescribe antibiotics and narcotics when it isn’t indicated.

I agree 100%. I should have put "lower quality" in quotes because from an economic perspective it costs less. From an economic perspective, a "lower quality" alternative is one that costs less.

To expand further on the absurdity mentioned in my other comment: Before germ theory was known, maternity wards where baby deliveries were done by doctors had higher mortality rates for mothers and babies than wards where the deliveries were done by relatively "untrained" midwives (because doctors worked with cadavers and didn't wash hands).

However, from a certain economic standpoint, the midwife service would be considered "inferior" to the doctors service due to the difference in training and licenses.

I understand what GP means.

But I would rather put it in the "increase total factor productivity" category.

The idea here is that nurses are less costly than doctors: less training, lower barrier to entry, etc... And presumably, with the new organization, you are able to get the same quality of care with more nurses and less doctors. It is actually an increase in productivity: equivalent outcome for cheaper.