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August 10/24, 1998

Comparing Apples With Oranges

Arch Intern Med. 1998;158(15):1591-1592. doi:10.1001/archinte.158.15.1591

Can't live with ‘em and can't live without ‘em— Woody Allen, Annie Hall

DONOHOE'S COMPREHENSIVE and scholarly review1 of generalist and specialty care is welcomed as both sides have lined up and traded volleys regarding their own abilities and the shortcomings of the other. The motivations for this are complex but involve egos and money (ie, marketplace share), a dangerous combination for rational thought. Herein I address generalism as it exists in the internal medicine model as I am less familiar with the other disciplines and types of generalists. I am well qualified to wax rhapsodic on this topic having been trained as a gastroenterologist in the 1970s and retrofitted as a generalist in the 1980s. As I reflected on Donohoe's article in this issue of the ARCHIVES, my comments are based on several assumptions derived through observation.