I was referred to a “dermatologist” recently that turned out to be a PA with a background in nutrition. She had virtually no experience with actual dermatology. I was forced to wait over an hour after my appointment was set to begin, and my insurance was billed $500 for a 15-minute visit. She did not improve my situation one iota, so that was a complete waste of time and money.

Our health system is failing spectacularly at every level.

Heck, even regular nurses with a few years experience could probably look at your sore throat, check your blood sugars and adjust your meds.

Everybody thinks whatever they have wrong with them is something unique and special that requires a full blown MD - usually it is not.

If I need a transplant, I am going to want a full blown MD to do it - for most run of the mill things, I am happy to see a NP or PA.

And, as we know, if you have a passion for something, you deserve to get paid less for it. That is sarcasm.

You are not completely wrong, but it is not that simple - the problem most PCPs have is that 'doc in a box' places tend to soak up all the quick and easy visits, that pay just as much as the long and complicated ones that can takes hours for a typical PCP to resolve - but they often pay the same - so urgent care clinics see you, look at your throat, write you a prescription and send you on the way - "treat'em and street'em"

Meanwhile the 82 year old 400lb diabetic, pre-dementia patient on 12 different medicines with 7 different things they want to talk about during the visit, takes a doctor and team of nurses and medical assistants a hugely disproportionate amount of time to diagnose and treat - and they can't bill all that much more than the doc-in-the-box got for writing a script for a sore throat.

In other words, these places are skimming all the profitable and easy to resolve cases, and the PCP now only has complicated patients that proportionally pay less, further eroding the finances of most primary care facilities, which then means they can't pay as much, so then they have an even harder time attracting talent.

It is also difficult to ask a PCP to see 16-20 complicated cases in a typical day - they need a few easy ones thrown in that they can quickly resolve and move on. Nobody can go 100% all day long on hard problems.