The Bigger Issue - Corporatization of Healthcare and AI
I've posted quite a bit about midlevels on this subreddit. I think there are things that should be done to protect the field. You can become involved in scope protection by looking at upcoming legislation and contacting your representatives/encouraging your colleagues to reach out to their representatives using this link: https://www.physiciansforpatientprotection.org/2026-legislative-sessions-calling-for-awareness-education-in-key-states/
The reality is individual midlevels are not the issue. These are generally well meaning people who just want to help patients. The laws written by these professional organizations and our corporations enable this scope creep to happen and cause the problems for our field. These laws must be amended.
The bigger problem ultimately is corporatization of care. Companies are incentivized to bring down costs by paying psychiatrists less and substituting them with cheaper alternatives. They push for the laws that enable creep. Patients don't see the effects of substitution on their bills, but the companies see it on their bottom line.
The other issue that is inevitable is AI. The CEO of the US's biggest public hospital said he is ready to replace radiologists with AI. Utah is letting AI prescribe psychiatric medications. Many psychiatry visits are "simple" follow ups with re-assessment and prescription of medications. As the US relaxes legislation and enables this corporate creep of AI into psychiatry, this may pose an existential issue for the field. We will need fewer psychiatrists, NPs, PAs, psychologists, etc. I'm not entirely convinced regarding the idea AI can provide the same quality of care as any of these professionals in such a relationship oriented field with such difficult assessment.