We live in Minnesota, and had never heard of the "PA" [[physician's assistant), or the "NP" [[nurse practitioner). We started going to a clinic in the small town nearby [[760 people). The doctor there always seemed more interested in rushing us out the door than listening to what we had to say. Once he was gone when we needed an appointment, and the PA saw us. She listened carefully, asked lots of questions, made good notes, and made sure we were satisfied with answers and had no more questions before she let us leave. She moved to another clinic about 35 miles away, and we followed her there. For personal family reasons she is no longer practicing. My husband now is being treated through the VA system, and the local outreach VA clinic has a PA and a doctor. The PA spends loads of time with us...the doctor seems to busy to pay attention to what we are saying to him. I actually think sometimes the PA's and NP's are more up to date on meds and new discoveries than the doctors are. There are still many, many family practice doctors here in rural Minnesota.