As a recent trainee in pediatrics at the University of Colorado, it was with considerable interest that I read the article by Drs. Silver and Ott and the commentaries that followed.1-4 During my training, I had the opportunity to observe and participate in the education, training, and evaluation of both child health associates and pediatric nurse practitioners. As one interested in the problems of health care delivery, I have followed the development of these programs (CHA and PNP) with special interest and in relationship to my own experience as a recent pediatric house officer.