IN THIS ISSUE of the ARCHIVES, the article by Tunkel and coworkers1 on the practice of pediatric otolaryngology focuses on the somewhat controversial topic of increased specialization. This topic is controversial in the sense that, although most have personal opinions about how much training and experience is required to pursue a field of endeavor, there are no absolute parameters available to make a determination. The various certifying boards, made up of qualified specialists, have developed guidelines for the currently accepted specialties and subspecialties. This topic is not limited to pediatric otolaryngology; indeed, it has been with us for nearly 100 years when physicians, led by the "eye, ear, nose, and throat doctors" of the time, limited their practice to a given organ system, formed organizations devoted to sharing the knowledge gained from their practices, and developed training standards and certification to be recognized as having expertise in a given field. Those opposed to certification suggested that this was merely an effort to "corner the market"–something that is forbidden by antitrust laws. Regardless, the general consensus is that specialization has improved the delivery of health care.