@jeffmarc You nailed it with "be able to ask technical questions"
Routine follow up is one thing, but specific difficult issues requiring a judgement call based on knowledge and experience is another. There should be very clear guidelines determining the limitations of NPs or PAs. Complex patients with changing conditions should be followed by the Physician Specialist to avoid harm to the patient. I suspect people don't know that much about their condition and required treatment etc. It requires considerable investment of time to develop a real knowledge of one's condition.