specialization
as we know it today has a history of little over 150 years. Its progress, achieved against the determined opposition of the established profession, was at first slow but in exorable. By the end of the 19th century a handful of specialties were recognized but constituted a very small element in medical care. Their role was enlarged by technical advance or medical ambition, by rising public expectations, and by increased spending on healthcare. At present, hospital medicine and most of private medical practice in the developed countries of the western world is irreversibly specialized. The European Union currently lists some 70 specialties for which a postgraduate training period is prescribed; in practice, some of those listed are already extensively subspecialized. Paradoxically, general practice, with its specific training program and defined aspects of operation, must for many purposes now be considered a specialty.... ...
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