Observation of the assistants in six private pediatric offices (four registered nurses and two "medical assistants") for three days with a stopwatch to determine their work patterns showed an average of only 21 per cent of the work day spent "with patients." Nurses trained for three years performed the same functions as "medical assistants" trained for six months. Nurses are inefficiently used in private offices, a fact that should be remedied by more specific training in nursing school, and more appropriate task delegation by physician employers.