The frustrating part is that I've found many specialist clinics that will do a one visit intake appointment with an actual MD then pass you off to the NP for follow-up visits. The strange part is that the NP is billed at the exact same rate. I'd be happy if I was paying ~50 an hour for an NP versus 400 an hour for the specialist, but that isn't the case.
That's fine until $z-cost-of-service is > $some-number. I think we've reached that point in the United States where we can discuss reducing professional barriers to entry in order to bring down costs.
Any biopsy or test that comes back negative could be considered unnecessary, but we don’t know that in advance.
Is it worth testing for a 5% likely disease that would be serious if found? Not running it will save time/money 95/100. Doesn’t mean it’s the right approach.
Those with less training (nurse anesthetists to be specific) tend to get themselves into trouble and only then call on a MD trained anesthetist for assistance. Furthermore, hospital networks are able to more easily "push around" nurse anesthetists which in the end creates an environment where bad decisions can occur.
To make a distilled analogy, this would be the potentially niave junior dev, pushed by management to ship code / tech debt, despite the advice or mentorship from a senior dev, and only asking for assistance when production is on fire.
However the topic of cost management and profit tactics in US medical system is a broader topic, hospital system administrators and their C-suite management in the USA love cheaper alternatives that are directly employed by the hospital (think nurses, PAs, nurse anesthetists, etc). The hospital system can directly enforce efficiency metrics (think, more money for the hospital, not better care for the patient) and doesn't have to negotiate contracts with a group of specialist doctors.