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I don't see this as a problem because 90% of doctor visits are for medical issues so simple they can easily be handled by nurses. Seeing a doctor for every medical issue is like seeing an engineer every time your car breaks down.

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It's a huge problem if you're in your theoretical 10%. Ask me how my chronic pain suffering spouse fairs. Six years without even an inkling of a diagnosis. They've had things cut out, things put in, bones fused. The medical system has crippled them more than we ever imagined (not an exaggeration) and we get a lot of "that's interesting" and "my part looks fine, tell me which new doctor I should forward this to." They've also had many comments that they're very complicated and then doctors seems to just fade away because the don't want to mess up their record.

The problem is that it's impossible for anyone to reliably recognise when they're working beyond their competence, particularly in a field as complex and uncertain as medicine. A lot of serious and life-threatening diseases have subtle symptoms and are easily mistaken for more common diagnoses. The decision to refer someone for urgent tests often relies upon half-remembered trivia from medical school or long-honed clinical instincts.

Replacing GPs with NPs will inevitably cause preventable deaths, the question is simply how many deaths we're willing to tolerate. That may be a perfectly reasonable tradeoff in health economics terms, but we have to be frank about it. I am hopeful that AI will go some way to bridging the gap between healthcare supply and demand, but at least in the short term we face a lot of difficult choices about how to allocate resources.

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