Bad medicine: specialisation

doi:10.1136/bmj.c4903

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Des Spence, general practitioner, Glasgow

destwo{at}yahoo.co.uk

“You’re too good to be a general practitioner,” someone once told me. I never knew whether this statement was a slight or a compliment. In truth general practice chose me, because of particular personality traits (faults), not the other way round. But generalism is in decline, with the assent of the specialists. Gone is the widely experienced general physician, and general surgeons are replaced by an ever expanding list of “ologists” who now seem to be almost single cell specialists.

This drive to specialism is mirrored across …