Thats the school giving them some flexibility regarding less than 5% of their overall clinical hours when residency is factored in, with the vast majority of med student hours still being entirely set up and facilitated by the school with major oversight. And, as you said, it is optional. The image I see here is a bright med student who knows a doctor he shadowed during undergrad and is given the chance to do a rotation with him if he so chooses. Contrast this with the online NP student cold calling offices and begging on allnurses threads, willing to drive up to 2 hours if they can just find ANYONE so they don't fail out of use program. The situations are not at all analogous. Far from it. One is to allow flexibility and expand horizons while the other is the shifting of responsibility on the gullible student so the schools don't have to deal with it or pay for it, and can take maximum students without the limiting factor of running out of preceptors.
All the accrediting agencies have to do is add one simple little clause to the accreditation requirements and we could fix so many issues in NP education: schools must provide preceptors. Suddenly, the for profits would no longer be interested (benefit #1), remaining programs would take less students and become more selective (benefit #2), probably begin requiring more out of candidates such as higher GRE scores and interviews (benefit #3), clinicals would be more structured (benefit #4), and unintelligent nurses who seem to be able to get into NP programs due to lax standards and for profit programs taking anyone would finally be kept away from the provider role (benefit #6). It would also have the effect of increasing the professional image, stopping oversaturation, raising salaries, etc.
Too bad all the boards care about is money and power.