In your area are nurse practicioners seemingly taking over for doctors? In this area (northeast Alabama) they are opening more and more family practice offices, and if you go to a specialist office you might see the doctor on the first visit then after that initial visit you see one of their nurse practitioners. The specialist may have 3 or 4 working there. I guess there is a doctor shortage but it looks to me like a way to multiply the doctor's income by seeing more patients in a day. I guess we should be glad there is a medical office to go to as this area is considered rural and there are not enough people to draw a lot of new doctors.