I'm currently a resident (not in primary care), so I'm biased. But: * Nursing sucks. It's terrible work. On top of that, you have to deal with jerk doctors and

I'm currently a resident (not in primary care), so I'm biased. But: * Nursing sucks. It's terrible work. On top of that, you have to deal with jerk doctors and jerk patients. Not a single one of my many doctor friends would ever have considered nursing over med school. (Side note: if you meet a good nurse, thank them! Truly good nurses are rare.) * PAs generally do not know all that much about medicine. With very few exceptions, it was frankly terrifying signing out my service to them every night, and never fun cleaning up their messes in the morning. But with resident work hour rules, there is no alternative. * The bottom tier of medical students/residents aren't very good either. Pay doctors less and the smart ones will realize that maybe there is some other way to achieve life satisfaction, because money won't be a differentiator any more. Care will get worse but the general public won't notice or care. They will keep getting fat, diabetic, and ever sicker, insist on keeping their essentially vegetative elderly relatives alive at all costs, and then complain that healthcare is expensive.