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As healthcare organizations look for ways to reduce costs and improve quality, many are increasingly relying on allied healthcare professionals, and in particular, medical assistants, to supplement the work of physicians and other health professionals. Most often utilized in primary care practices, medical assistants often play an important role in part of healthcare teams. Given the enormous power, status, and income differentials between medical assistants and physicians, I ask what are some of the sociological implications of the increasing use of medical assistants? This paper draws upon qualitative data collected at a large healthcare organization currently undergoing a system redesign and explores some of the challenges and tensions that characterize the changing role of medical assistants in primary care settings.