I agree that finding the right person is pivotal, not so much the degree perhaps. We have had midlevels that had totally different health care approaches than ours, and it really didn't work. If you hire a midlevel, he or she is an extention of your practice, unless for some reason you really want to fund an independent practitioner out of your office. That means, he or she needs to be willing to practice medicine your way... use the drugs you are familiar with, refer as you would refer, treat problems the way you would, etc. We have seen nurse practitioners who were not willing to do this, as they felt they had the license to practice independently, but if they accept your employment you need to be able to set the tone. Also, you need to set limits as to what things they see; there are procedures my PA's have done elsewhere that I do not do, so I can't supervise what I can't do myself.
