And all along, I’ve never said that physicians aren’t great at what they do on the whole. I’ve only said that I don’t want to be tied to them in the model of dependency just like a squire is tied to a knight. As an RN, I didn’t need a physician agreement to work within my scope. We work WITH them, and complete the orders they write for us, but I’m not tied to them in any regulatory fashion. If I were an RN and am hired by a doctors office, then that puts me under their employment, but I can go work somewhere else instead and not have to gain favor of a physician in order to draw a wage or function. Same thing can be had by an NP. My contract for both my jobs say that I have sole say over my decisions for my patients. Nobody can compel me to operate against myself. I can be fired. I can be reported. My license can be yanked. Someone else can plead to me that I’m wrongheaded. But my work is my work. Same as if I was an RN. That’s the same for every NP in my state, at least from a state licensure standpoint. Now for the PAs, the moment their supervising physician dies, gets their license yanked, goes out of business, gets arrested for Medicare/Medicaid fraud, or develops an unfavorable opinion of that PA.... they are F’d. In the case of criminal action, the PA probably better watch their back and check their numbers because they might have had their overlord doing something shady under their name. But ultimately The Pa can then do no work. Complete domination. What other career has that kind of hierarchy?.... surely not one that has as much trust placed in them as the medical industry places with non physician providers. The PA situation is as creepy as can be considering the PAs at one of my jobs do the same thing as me, and consult the physicians there not even a little. But I can leave that job one day and be working the next, and they have to go through a totally different process. Independence is mostly about the circumstances of employment rather than the handful of NPs that go out to run their own operation. Incidentally, it’s at around the same number of PAs that do it, and it’s at less than 5%.