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I hate that this shift is being driven almost entirely by profit motives, but I also wonder if this is such a bad thing. I love my doctor; she's been my doctor for 25 years. However, I sometimes wonder what real value she provides. All she ever does is send me to a specialist. Couldn't a PA or NP do the same thing?

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Yes. But PAs and NPs lack the training and will more likely give referral for the wrong things or provide worse clinical care.

Management did the same thing with offshoring engineering. It's akin to saying, "competent engineers who understand business requirements and good software engineering principles are expensive. Can't engineers from another country (who often cost less) do the same thing if all they do is write the same code?"

Your doctor has significantly more education and training than a PA or NP.

The additional cost of seeing a doctor would quickly be recouped by the reduction in unnecessary / inaccurate referrals that would come from a lesser-trained medical professional.

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