Very true, I’m old enough to remember when you did house calls, though that was at the end of the era of that practice.
Now we have to fear FDA approve meds as much as we do incompent or under educated practioners. I resent a APN trying to Play ENDO, GASTRO, and NEUROLIGIST and counter what they advise, that is not there Education level or experience. And you don’t send a multi health patient who sees 4 main line Specialist to a APN for a Primary because you are to CHEAP to hire another Internist when 2 leave a 3 person practice, you just promoted the APN instead. Time to look for a new Internist practice. Technically they run blood labs and keep scripts the Specialist write currentas not to waste a Specialist time for a script renewal and routine small medical issues.
It has been quite an experience to see things change. When I was in Med School our Clinical Med professor was a fat old German who went to Med School in Germany during WWII. He insisted that clinical medicine did not require any labs or radiology studies. A clinical physician could make any diagnosis with the tools attached to his body, hands, eyes, ears, etc. and the most powerful tool was the one between the ears. I fear today medical students learn only who to order tests and follow algorithms.
The surgeons I learned from were maestros of skill and Michaelangelos in flesh. Their skill produced results today’s technicians cant emulate because today we produce technicians who can only reproduce “average” results.