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Notes -
Is it still a waste if the doctor is someone with a 120 IQ who would have got into medical school in the alternative system but ends up as a replacement-level software engineer in the US system as it is? The work of a GP in the British NHS, or in a well-run HMO where paid-for access to specialists is gatekept, does require more knowledge than an NP/PA, because you are gatekeeping access to specialists, so you need to know at least enough cardiology to know when to call the cardiologist etc. And the people doing that work don't seem to think it is meaningless - the complaints of British GPs are about pay and workload, not about the nature of the work. What it doesn't require is a gunner personality (except in so far as you need to deal with the rigours of residency) or a 130+ IQ.
FWIW, NP-equivalents in the UK are mostly people whose IQ is too high for nursing but were incorrectly sorted into it (I suspect, but don't know, that we make more errors of the "poor therefore stupid" type than the US does) and want a low-risk route to something better. My experience dealing with them (asthma care is handled by NP-equivalents, as is uncomplicated diabetes after initial diagnosis) is that they are as good as a GP within their scope of practice, as long as the understand the limits of said scope.
Have you stayed abreast of the current furore? The two examples I gave of NP/AP failures were actually both from the UK.
Sure, and this is the point. The 120 IQ person has too much dignity to accept the title of “nurse practitioner” or “physician assistant” , but let him call himself doctor and put him through some more training and he’ll do the same work for the same pay happily.
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