It is not a question of how well each process works, the question is how well they all work together.1
Everyone likes a good game. It seems that even professional societies in the field of medicine also like to compete, as there is continued publication of reports of specialty comparisons on quality of care. If you believe the numbers, it seems like the subspecialists are beating the generalists. Even among generalists, there is competition. One might argue whether the playing field can ever be fair in the first place, but a more important question might be why are we playing this game at all? One thing is clear, our patients are certainly not gaining anything by this type of comparative research when there are larger health care delivery problems on which the performance of any specialty is intrinsically dependent.
O’Malley PG, O’Malley AS. Studies Comparing Quality of Care by Specialty: Valid, Relevant, or Neither? Arch Intern Med. 2007;167(1):8–9. doi:10.1001/archinte.167.1.8
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