The case for NP's is the same as the case for lap-children: the harms averted are greater than the harms created. This is nothing new: In the ER, you see a tr

The case for NP's is the same as the case for lap-children: the harms averted are greater than the harms created. This is nothing new: In the ER, you see a triage nurse before you see the physician. In the NP case, that means access to front-line medical care that might otherwise be inaccessible, vs possibly less capable care. That doesn't require a lot of training to resolve, I think: mostly along the line of making sure that the NP is professional about knowing when to pass the case on. The hard part may be creating a culture where this is considered a sign of competence, not the lack of it. There could be a counterargument, in cross-subsidy: the business of seeing a lot of patients, most with minor and easily dealt with issues, compensates/conserves/cross-subsidizes both the financial and the cognitive load for the one on Tuesday at 11.45 with something nasty.