Yep. The midlevels are supported by automatic protocols in Epic (e.g. sepsis, DKA -> put these dozens of orders in with 5 clicks) that physicians decide on and approve. They also rely more heavily on imaging instead of a physical exam and history. When unsure, they can consult a physician, even a specialist.
It’s a very polarizing topic in medicine that patients generally aren’t privy to. Especially for resident physicians who often make half as much as these midlevels yet have more education, there’s a lot of bitterness. The federal government is ultimately to blame… having a fixed number of residency spots to artificially limit the supply of new physicians is terrible, and this is the predictable result.
I think hospitals support inefficient midlevels because they can bill patients for the increased resource usage, but it’s not good for the system overall when unnecessary scans and consults are done, and more complex patients don’t get comprehensive care. Many foresee a two-tiered system developing, where the rich see physicians, and the poor see midlevels.
It’s a very polarizing topic in medicine that patients generally aren’t privy to. Especially for resident physicians who often make half as much as these midlevels yet have more education, there’s a lot of bitterness. The federal government is ultimately to blame… having a fixed number of residency spots to artificially limit the supply of new physicians is terrible, and this is the predictable result.
I think hospitals support inefficient midlevels because they can bill patients for the increased resource usage, but it’s not good for the system overall when unnecessary scans and consults are done, and more complex patients don’t get comprehensive care. Many foresee a two-tiered system developing, where the rich see physicians, and the poor see midlevels.