January 16, 1991

Outrage Corner: Generalists More General; Subspecialists More Subspecial

Author Affiliations

Monroe, NH

Monroe, NH

JAMA. 1991;265(3):357. doi:10.1001/jama.1991.03460030063022

To the Editor. —  Given the increasing recognition of the role of the generalist physician, it is outrageous to read the following introduction to a recent book review in The Journal1: "Within an era of increasing specialization, time constraints, and fiscal accountability, the role of each medical practitioner logically narrows.... The consequence is a tendency for compartmentalizing of patient needs, and for failure of sensitive dialogue with each patient regarding the individual's perception of the problem." Logic demands nothing of the sort. Family physicians, general internists, and general pediatricians are trained and able to integrate efficiently and sensitively the varying needs of patients, and it is only subspecialists who illogically fragment patient care in the pursuit of "expertise." Those of us who care for the whole patient will continue to pay attention to the intimate realms of patients' lives. We will continue to learn from such academic treatises as