There is a traditional antagonism between MDs and other credentialed practitioners, if competition occurs. At the hospital or large group level, using physician extenders is no longer a philosophical issue, however, but purely financial. As these specialists gain credibility and acceptance in the health care marketplace, you have to present yourself as being open-minded, because as the American Board of Medical Specialties expands (or at least the types of authorizations by state medical boards), these providers will no doubt end up beside you treating patients--with you or for your competition.