factors (increasing costs of health care, changing societal values, advances in treatment therapies, and many others), the delivery of health care services is undergoing rapid and important change (Hupcey, 1993, pp. 181-185). One of the more significant of the changes occurring involves the direct delivery of health care services by non physician health care professionals in team-based situations. There exists both substantial support for this trend, as well as substantial opposition to it. Nurse practitioners and clinical nurse specialists are among the most prominent of the non physician health care professionals involved in the direct delivery of health care services to patients through team-based structures.
The strongest opposition to the concept of delivering health care through multi-disciplinary teams comes from some individual physicians and from many physicians' associations (Hupcey, pp. 181-185). Physicians who oppose the nurse multi-disciplinary team concept for the delivery of health care do so publicly (most often) on the grounds that patient health care will suffer. There are strong suspicions, however, that such physician opposition is often rooted in other factors, such as the loss of some power and some income by physicians. Physician opposition remains strong but is weakening.
One of the charges made by opponents of the concept of health care delivery through multi-disciplinary teams is that application of the concept will lead to a lowering of the quality of health care services delivered (Trnobranski, 1994, pp. 134-139). Contemporary research, however, refutes such charges as baseless (Thibodeau & Hawkins, 1994, pp. 205-218).
Strong support also exists for concept of delivering health care through multi-disciplinary teams (Banjok & Wright, 1993, pp. 609-610). Support is strong within the public health community, where the use of multi-disciplinary teams in the delivery of health care services is vi...