Jack, I have three PAs who work with me directly. One is with me for 30 years (she and I were awarded the 2014 AAPA Paragon Physician-Partnership Award), and the others for about 14. They are invaluable and allow my expertise to be delivered to many more patients than I otherwise would be able - even when I'm away. They know as much as some of our colleagues and manage expertly our team of patients. Our entire practice of 14 rheumatologists and 22 advanced practitioners (PAs and NPs) is the model by which we all operate. As my partner Paul Caldron says, a highly competent APC is like having an excellent fellow who never leaves. JT