The Pediatric Nurse-Practitioner Program

To the Editor:— The pediatric nurse-practitioner, as described by Silver et al (204:298, 1968) continues the trend to use more and more nursing and paramedical personnel to carry out tasks that were formerly done by the physician. The article simultaneously continues the trend which says that "if it is new it must be good." This philosophy must be challenged by the burgeoning techniques of health services research. The philosophy that adding more and more personnel, or increasing the number of dollars expended, or doing more of anything will result in higher quality and more efficient medical care must be subject to critical evaluation. In the program described, there is no evidence to prove that the quality of care is better, the cost of care is less, (3) physicians' efficiency is increased, that patients are healthier, or that parents are happier. Innovations in the delivery of health services should now