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Dr. Scott Gottlieb (2001) presents an array of negative results, from his medical perspective, regarding Nurse Practitioner and Physician Assistant utilization by Family Practice and Internal Medicine physicians.  He refers to many physicians as currently “managing a stable of physician extenders” to expand their practice.  They pass out the routine and monotonous check-ups and procedures to these practitioners, while saving the enjoyable and higher-paying work for themselves.  In Gottlieb’s eyes, this is causing these areas of medical practice to become less respected, and unnecessary, as non-physician clinicians move into these arenas.  In addition, Gottlieb (2001) states the care of “physician extenders” is “dumbed down” and “cheap.  Overall, he strongly infers that the medical community should move away from allowing NPs and PAs the level of practice and collaboration with physicians they have obtained. 

Gottlieb, S. (2001).  Low-cost extenders come at a high price.  American Medical News.  Retrieved November 10, 2009 from