The Future of Physicians’ Specialization
By the eighteenth century, medicine was grappling with rapidly expanding knowledge and technologies (Williams, 2000). So that multiple standards of care for the same condition were not in conict, specialties based on physician affinity developed out of generalist practice. By the late twentieth century, nations diverged in a number of specialties earning official recognition, but a singular trend of growth in specialization was unchanged. Specialization may seem to be ornamentation that denotes technical prowess and knowledge advancement, but it is essential in that it alters workforce self-organization and delivery of care, and channels patients into more finely distinguished pathways of care.* Specialization legitimates medical professionalism in the public eye, especially when physicians validate the importance of generalists. In 1999, major medical organizations promulgated a “Charter on Medical Professionalism” that espoused professionals, including specialists, as activists in healthcare reform.