the real problem with NP/PA is now what they know. It is that they don't even know what they don't know. There's a large body of basic science, biology, that a doctor has to acquire that helps underpins a lot of the clinical medicine they practise. It's not just following guidelines and algorithms. It is understanding why the guidelines are, it is understanding why what looks like a typical case isn't, but is that one rare thing you absolutely can't miss.

Honestly, if not for the weirdness of the US system, mid-level providers shouldn't exist. But we are where we are. There absolutely is no room for independent practise for mid-level providers.