During the past ten years a growing number of physicians, the so called AGNIO's, have been working in mental health care as psychiatrists, although they are not qualified as such. This situation is discussed against the background of past and future developments in the medical profession in the Netherlands. Their tasks and additional education are discussed. Comparisons are made between the qualification and guarantee for quality of AGNIO's and psychiatrists. An estimation is made of the number of AGNIO's and their legal status is described.

The consequences for the quality of psychiatric care and institutions, the AGNIO's, the medical professions and psychiatry are described. It is concluded that logistic-economic motives played a major part in the present developments. The situation will worsen for all those who are involved.