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One of the most remarkable developments in the field of health care during the past several decades has been the rapid proliferation and growth of new health professions and occupations. Where physicians once stood virtually alone, other health workers now greatly outnumber them.  There is a greater need for primary care and in many cases these services can be effectively delivered by health care professionals other than physicians, such as nurse practitioners (NP), physician's assistants (PA) and certified nurse midwives (CNM).  Still, territorial and power conflicts endure.

This paper was originally a working paper for COGME_NACNEP in 1995, but was reprinted in a special issue of the Journal of Interprofessional Care in 2007. 

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