This is why i think it will become essentially necessary to do fellowships outside of the Norman reasons people do then. Like:

Anesthesia -> critical care -> cardiac anesthesia (or pain management, peds anesthesia etc)

IM -> cards -> interventional / EP / HF&transplant etc

1) get so specialized you can’t be replaced

But you can in your contract as an attending state whether you want to supervise mid-levels, sign their charts, accept students etc. and I know for anesthesia there are hospitals that only hire MD/DOs - so they’re out there you just have to find it.

If you do go into FM and have your own clinic, hire only PAs (if you have too) because at least in their schooling are taught on our model and with collaboration in mind.