Certainly a product of the current medical institution. NPs are being pushed by administration to become more clinically active, independent and productive since that means they can bill their own RVUs..... more $$ for the hospital/group. No longer just ‘physician-extenders’ but extra billers ultimately that can improve the bottom line the admin’s eyes.



That said obviously there is wide range in how they view themselves and i guess fortunately in that I’ve worked with terrific NPs and PAs. At least in my field they function as a useful part of the team and really defer to me as the fellow so usually it’s them staffing things with me and not the other way around (obviously ultimately they attending is in the loop).



As a resident early on in your career I can see where there is some room for you (collective) to learn certain aspects (clinical or procedural) from an experienced NP or PA. We learn things all the time from experienced nurses, this isn’t much different. I deal with industry reps in my field which is heavily technology oriented and there are always new gadgets, devices or techniques coming out where I actually learn a specific procedural skill or use of a device from the rep themselves.



Not to sound cliche but everyone has a role and there are things we can take from other people on the ‘team’. That said, if you’re routinely having to staff patients with an NP/PA then that’s an issue with the program. If you’re just signing out a patient to them for coverage issues then that’s not an issue in my opinion.