Brown and Grimes (1992)2 compared the effects of nurse-provided care with physician- provided care in similar settings to equivalent clients on process of care, clinical outcomes, and cost-effectiveness in a meta-analytic review for the American Nurses Association. NPs achieved clinical outcomes equivalent to physicians on most variables. Patients of NPs demonstrated greater satisfaction with their health care providers and greater compliance with health promotion/treatment recommendations than did patients of physicians. NPs spent more time per visit with their patients than did physicians, although the average number of visits per patient was equivalent. Because care activities of the nurse and physician practitioners were under-reported, the content of these visits was not determined. It must be noted, however, that, unlike the well- designed Burlington Trial,17 few studies (n = 12) on NP care involved randomized research designs; therefore, some of the findings may be due to differences in acuity between nurse and physician patients.