[bsder]

Yes and no. The buck needs to stop with somebody and that responsibility is on the GP. So, you need at least ONE visit to the main GP before you can access their assistants.

I agree that most of what GPs do is be a "router" than sends your packet to various specialists. But somebody actually has to do it.

[maxerickson]

NPs can practice independently in ~1/2 of states, they aren't relegated to being 'assistants':

https://www.aanp.org/advocacy/state/state-practice-environme...

Of course they will escalate some care to other providers.