"It all comes down to authority. Someone must be authorized to be the final arbiter of what is proper and correct when it comes to patient safety, medical ethics, and professional propriety. Sure, a technician could do a cholecystectomy under perfect circumstances, but there is still a need for supervision and direct involvement by the person who takes the responsibility for the outcome. As such, such 'surgeon-extenders' could creep into the current way of doing things, as long as it's a team approach involving physicians as those final arbiters."

The future of medicine is wide open, with a confluence of capitalism, socialism, evidence-based medicine, competition, and altruism. You can rest assured that the medical world will be quite different in 10 years than it is now. Whatever your thoughts, you want to come off as someone who is thoughtful, open-minded, and willing to go with the flow--that flow being, of course, what's best for the hospital: keep that in mind.

"Medicine is always changing, certainly. It's up to us as practicing physicians to assure safety with whatever comes long. I can see how it may be cost-effective to give technicians, nurse practitioners, and other ancillary persons more autonomy and responsibility, but that's agains the all-important barometer of patient safety. Always."