Abstract
Health care reform has engendered many debates. One that has captured the attention of physicians, nurses, and policy makers is the relation, and perhaps the competition, between physicians and advanced-practice nurses. Advanced-practice nurses are registered nurses with specialty training, usually at the master's-degree level, in primary care (i.e., nurse practitioners and nurse-midwives) or acute care of inpatients (i.e., clinical nurse specialists). The practice of nurse practitioners has been evaluated since 1965, when the role was developed by Henry Silver, M.D., and Loretta Ford, R.N. When measures of diagnostic certainty, management competence, or comprehensiveness, quality, and cost are used, virtually every . . .