There's a reason why nurse practitioners (a degree which requires as little as 500 clinical training hours) are meant to be supervised by, and work in conjunction with vastly more experienced attending physicians who have completed medical school, residency, and possibly fellowship. This Twitter NP seems to be implying that his "plan" is good enough to not require any physician oversight. If this is truly the way he thinks, then I genuinely fear for the well-being of his patients. In any case, "I don't enjoy it" is a piss-poor justification for independent practice rights when patients' lives are literally at stake.