Better with noctors than nothing at all. I know that's a false dichotomy in the long run, but for the present it isn't, given the regulatory environment. PA/NP is basically backup plan for a lot of people that don't get into med school or don't anticipate they could.
Incompetent treatment is worse than not being treated at all.
It’s not to say that noctors can’t be competent within a narrow domain; it’s that they’re being taught to increase their scope of treatment beyond their training.
If it becomes common, then it’d be safer and more cost-effective to pay out of pocket and get treatment in another Westernized nation.
I basically treat NP/PAs and doctors as a pulse with a DEA license attached. Once you realize you basically need to figure it out for yourself, for much of anything but surgery and meds, you'll realize you are better off with them vs having police put you in a tiny cage for ordering drugs without a prescription (in my state I can self order imagery and labs, so don't need docs for that). I consider their opinion totally disposable but they offer some stuff the government will imprison me for if I don't get the magic signature for.
Just treat them as totally incompetent and nudge them where they need to go. No need to assume or rely on competence that may not exist.
IMHO the problem usually isn't the degree history, it's putting providers in situations where they lack the requisite training, or are understaffed in general. So you have, e.g., complaints about incompetent PAs being put into roles they are not as good at, but when you look at the details, they are being asked to do these things right out of school without background training, and there are insufficient staff period. But then the blame is put on the use of PAs, rather than the lack of supervision in a type of intervention or procedure before doing them, and insufficient staffing. The problem to me usually is e.g., private equity firms not requiring the right experience for the job, not the degree itself.
It's a bit weird and disingenuous to me — if you took a bunch of MDs right out of medical school with no residency training and asked them to function as a senior staff physician in a given specialty, there would be complaints about them as well. It's no different from hiring an inexperienced computer science BA graduate to handle a complex high-stakes network security position.
