Sir.—In recent issues of AJDC, Bedrick 12 and Winter3 address the issue of residency work demands and the overburden in terms of hours and responsibility that hinder the effectiveness and humanity of the physician education process. They suggest that to hire more house staff to limit the number of resident working hours is not the answer to the problem. Likewise, expanding the number of residents in a given program to meet the ever-increasing service demands of the current tertiary and quaternary care centers will not meet service needs or optimize a resident's educational experience. Other practical ways are needed to address the problems associated with resident overwork and hospital care needs.
The use of nonphysician primary care providers in the inpatient hospital setting bears further comment. Before a solution is implemented, physicians should analyze the available data to ensure that quality of patient care is maintained. It is