Ancillary personnel have been effectively utilized in health care for scores of years, and are a constant feature of the physician's office and hospital clinic. For this reason, the use or nonuse of such personnel is hardly a subject for discussion. Their utilization in roles which were once the sole responsibility of the physician is a relatively recent, and still debated development, and it is this aspect which will be considered in this discussion.
The need for such assistants for the physician is based on the shortage of physician manpower relative to both perceived and unperceived needs of patients. Inequalities of distribution, especially in rural areas, place medical care beyond the reasonable reach of many who desire and can afford it, and in addition there are countless others who do not appreciate the need for such care or who cannot afford it. Even the wellto-do patient in a city with