The Physician Assistant and the Nurse Practitioner have been successfully implemented in the Dutch health care system. The professionals provide good quality care, contribute to reducing the workload of physicians, and in most cases are cost-effective. The changing labor market, the increased demand for care and the way health care is organized will further increase demand. Within the labor market, we see several developments affecting the demand for PAs and USs; the need for physicians to have more work-life balance and the shortage of residents not in training ('anioses'). The increased and changing demand for care also requires additional staff, in this case PAs and VSs. In addition, it appears to be quite possible to have care performed by a PA or VS supported by the use of technology and guidelines.
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