Never said less education is better, just that people without degrees can be ultra successful, even though most that do not have them are not. You are correct in saying that you can learn everything you need for primary care via an NP education at its current tone, and extra reading. But many people wont do that extra reading. The near guarantee via the physician route is they will not let people through an american medical school and residency without the set of knowledge to manage a PCP practice without help. Whether or not people choose to do what is best for the patient is up to them, but in there minds, somewhere in the past, they were taught what they need to know, even the worst in the class that barely scrape by with 70s.
NP education does not give that guarantee, it doesnt stop people from excelling on their own time, and some schools might give that guarantee, but not all do. Some programs graduate downright dangerous graduates that cant even do physical exams and dont even know which medicines are part of which CYP450 enzyme class.
To think that the current standardized NP curriculum is adequate is complete ignorance. Of course patients in BFE are going to have better outcomes, its either see any NP or not care at all, so basically anything would improve outcomes.
You may be one of those NP who went above and beyond to learn what needed to be learned, if so then your an awesome person for looking out for patients, but there are those who are not, and I have worked with them, its embarrassing. Even the good schools have lowered their admissions standards at many places recently, taking pretty much everybody that applies, while lowering clinical rotation control, thus making those 700 hours worth even less. Unless all NPs can handle everything, on their own, day one, as a family med trained physician should be able to, then it is not universally adequate.
Can all NPs day one out of school -
read EKGs well enough to determine all the variable heart blocks, and abnormal findings of genetic disorders (the rest should be basic)
suture everything that has not gone through muscle/tendon/ligaments
drain all types of superficial abscesses
manage HTN from stage 1 all the way to complex multimedicine combinations without their patient passing out over 5 minutes
read all plain film X rays without need of radiology
complex rheumatic workups
correctly diagnose headaches without throwing a ct at everybody
manage children with various genetic disorders, what they are at risk for, etc
apply splints to and know the time frame for referral for all types of tendon lacerations and fractures and which ones need ER care
know each bug that causes diarrhea and the exact workup for each with proper time frames
understand the results that radiologists provide for all sorts of ct/mri/NM/US, and know when to refer to a surgeon
manage all sorts of skin issues without making the patient wait months for a derm appointment.
Pretty much all FM residencies at this time have those as requires before you can graduate, in order to cut back on referrals, some docs probably jump the gun, but they know what they should do.
I doubt that many NP day one can do all that, especially nowadays. Maybe back 10 years ago when standards were in place, but these online places sure aint gonna set you up in a clinical site that throws all that experience at you in 800 or so hours.
Its really scary people think they know it all day one after NP school. Goodness its like the laborers who make fun of engineers, mostly because they are jealous they make more money...
I am not even anti-NP, yet I can at least see reason.
Need more parameters than just BP and HLD to determine quality of care. At least recent studies. They will never be able to perform a study that is purely NP vs MD with no allowed consultations though since that would be dangerous to the patient in some aspects. I have seen a few that say "little consultation between NP and MD in these patients occurred." How much proof/help is that statement lol!
Its gonna be a sad day for patients when walden and kaplan grads work in solo rural health centers and these poor patients trust them with their lives.