Meeting at the American Academy of Family Physicians (AAFP) 2010 Scientific Assembly in Denver, the group’s Congress of Delegates requested that the AAFP fund a study comparing the practices of primary care physicians and nurse practitioners (NPs). Specifically, delegates adopted a resolution calling on the organization to fund research to evaluate the quality of existing studies that compare the groups in terms of health care outcomes and cost effectiveness. Several prior studies have compared the relative cost effectiveness of NPs and primary care physicians. However, many of those research projects have focused on differences in pay and ignored other factors, such as ancillary services, referrals, and total expenditures. Alternate Arizona delegate William Thrift, MD, told the Congress of the necessity of such research. "No matter what we find out, we need to know," he said. "We need to have our own data." Nurse practitioners need only 600 hours of clinical practice to practice independently in his state, he said, compared with 12,000 hours for primary care physicians. "Yet in Arizona," he said, "they can do the same work." Said another delegate, "We need to have our own data because I can assure you the nurse practitioners are going to have their own.” "We're in competition nose-to-nose with independent nurse practitioners," added yet another delegate. "In states like mine, nurse practitioners can hang their own shingles with very little clinical experience, and the public doesn't understand that."