That's a big question.
I think one of the first things that happened with midwives, as well as nurse practitioners—and I'll refer mostly to midwives because that's what I know best—is that this was the first time that some professionals in these two professions could work within the health care system as primary care providers, as autonomous, with hospital-admitting privileges in many provinces, an ability to prescribe medications and to order investigations without having to necessarily have permission from any other profession. It was a challenge within the health care system. We aren't doctors and we don't have to have doctors for certain situations where the client fits within the scope of practice of the midwife. The midwife then can carry on care without having to have permission that this client is able to come to a midwife—is able to stay with a midwife.
The scope of practice for the midwife is to know when things are coming outside of his or her scope and to move that client potentially into medical care. It may also be into care of a social services provider. We have created a partnership with physicians. We need them; they need us. It was a fairly significant challenge to the health care system to see health care providers who had that scope of practice, that level of responsibility, who weren't MDs.