for instance aiming at increasing the proportion of oneday surgeries new surgical procedures have been added to those that may be performed as day surgeries in the high share of highly paid specialists and low nursetophysician ratios create cost pressures which could be aggravated if substantial increases in the wages of health care workers take place to retain them in the system although skillmix arrangements likely depend on productivity considerations health worker and patient preferences and other economic and social factors there is some evidence suggesting that certain tasks traditionally performed by physicians could be transferred to highly qualified nurses without undermining the quality of care indeed hungarian physicians tend to perform medical and administrative tasks that could be carried out by nurses and other support personnel gal et al orosz and hollo