Date of Defense


Date of Graduation



Health, Physical Education, and Recreation (to 2011)

First Advisor

Denise Bowen

Second Advisor

Eric Vangsnes


The implementation of the concept of mid-level providers in healthcare has undoubtedly contributed greatly to the solution of the physician shortage. This shortage of physicians had posed a problem in the delivery of health care for decades, particularly in rural areas. Nurse Practitioners and Physician Assistants as we know them today may not have existed without previous groundwork and inspiration. The introduction of the nurse clinician concept by Frances Reiter in 1943 led to the later development of a masters nurse clinician program at Duke University by Dr. Eugene Stead and Thelma Ingles. Despite the denial of accreditation of the program, leading to its demise, interest in a healthcare worker of this type still remained with Dr. Eugene Stead. The fundamentals of the nurse clinician program, combined with the proven success of military corpsmen with relatively little training, inspired the creation of a Physician Assistant program at Duke University. The program faced many obstacles and criticism during its conception and early years from other healthcare professionals, particularly the American Nurses Association. These obstacles were overcome and criticism has been suppressed as the Physician Assistant career proved to be a successful role in health care, increasing the availability and affordability of healthcare.

Access Setting

Honors Thesis-Open Access