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A hundred years ago, physicians were generalists, treating most medical conditions. Humanity didn’t have nearly as much medical knowledge and knowhow back then so that for the most part a single doctor could master what was known. That has changed.
Medical knowledge now far exceeds a single expert’s ability to master it. Medical students receive a general training and then they specialize, seeking to learn just one small piece of what we know about medicine.
Specialists have become essential because of the complexity of care. The more we learn, the more kinds of specialists are needed. Increasingly, however, it is necessary to have patients see multiple specialists for a single problem, which causes fragmentation and delays the necessary care. Furthermore—and critically—the interplay between multiple causes of a single condition, or multiple aspects of its treatment, makes it difficult for the separated specialists to address such complex problems.
What is the solution?
A human being is a single working system and specialists must be able to work together as an integrated unit for diagnosis and treatment. Specially constituted teams of physicians and other care providers who work together on a regular basis should address the more complex problems. The cost of having such a team in place might seem high, but for complex cases such a team will prove to be more effective and less costly than the alternative—the difficulties, delays, and costs inherent in multiple appointments. The challenge is making sure the teams can work together smoothly and efficiently, and with better results than specialists working separately.