Whitecoat, one of my favorite bloggers has an entry about how the state of California is realizing that it won't have enough doctors to take care of the people who will have insurance with Obamacare. He seems to indicate that their solution will be to let people like PAs, NPs, optometrists (?) and such care for people because they are cheaper.
Of course docs are against all of this. Less money for them. Here's the thing: You are looking at the future of medicine. NPs and PAs as primary care providers, doctors as specialists. Its inevitable. Like I said, they are cheaper. Docs don't want to do primary care. There aren't enough docs.
Healthcare is undergoing a radical transformation right now and this is just the beginning. The group that will be most affected by all this: docs. The days of them being at the top of the health care system are done. They are another cog in the wheel. They can be pissed, but its reality. Unfortunately, even they can be replaced.
Speaking of being replaced, I often think about the nurses coming into nursing now. I feel sorry for them. The job is becoming more and more stressful. Another thing that concerns me is worrying about nurses being replaced. I think employers will move to replace nurses with paramedics, medical assistants or others, with nurses as supervisors. They are cheaper. Its already happening. I worry that young nurses, like most young people, don't realize what it took to get nurses to this point. I worry that nursing as a profession is so weak in having a national strength to stand up for us. I worry that we are too exhausted to fight for our profession. I worry that we are an endangered species.