The review by Donohoe1 regarding differences in generalist and specialty care lists mental illness care, with a particular emphasis on depression, as one of the major areas where studies show significant superiority in the knowledge base and quality of care provided by specialists. While the editorial by Johnson2 notes that the lack of studies on outcomes of care, rather than intermediate measures of processes of care, weakens some of these conclusions, neither this comment nor Donohoe's review adequately address the reasons by which the care of patients with depression is a remarkably poor example of the apparent superiority of the care provided by specialists over that of generalists.
Schwenk TL. Generalist and Specialty Care. Arch Intern Med. 1999;159(8):883-884. doi: