The nonphysician medical educator will never replace the physician educator. However, as team training, interdisciplinary education, and the general competencies become the norm, the need for the nonphysician medical educator will increase. The authors believe the use of nonphysician medical educators offers a way to improve the quality of physician clinical education while controlling costs. They also recommend areas for future research.

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bladder. They have been plucked from the gall bladder percutaneously or reduced to tiny fragments with extracorporeal shock wave lithotripsy. But cholecystectomy has the unique advantage of removing the organ in which gall stones form and therefore of providing a lifetime cure. A compromise method is to perform minilap cholecystectomy, but this tends to combine the worst of all worlds and compares unfavourably with the endoscopic method.4In England, over 30 000 cholecystectomies are performed each year.' If all these were performed by laparoscopic methods the saving resulting from a reduction in bed days alone would amount to £2 Im. In these days of strict financial and medical audit endoscopic cholecystectomy will inevitably become the only method for routine cholecystectomy. It is an innovation that has the virtue of being advantageous for both the customer and the community.

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