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Drivers and Determinants

Jeremiah A. Barondess, MD

JAMA. 2000;284:1299-1301.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Specialization in medicine has been a virtually inexorable trend for many years. In the modern era it was heralded by the progressive separation from general practice of obstetrics and gynecology, pediatrics, internal medicine and surgery, and the surgical subspecialties. These movements began shortly after the turn of the century. The first US specialty board, in ophthalmology, was established in 1917, followed shortly by a dozen other specialties, including the American Board of Internal Medicine in 1936 and the American Board of Surgery a year later. The American Board of Medical Specialties added its 24th member board, the American Board of Medical Genetics, in 1991.

The growth of specialism and, more recently, subspecialism, has been, naturally enough, embraced by physicians seeking special expertise in various fields and recognition as well. Impetus has been added by status considerations, higher incomes earned by subspecialists, and the emerging need for . . . [Full Text of this Article]

Author Affiliation: New York Academy of Medicine, New York, NY.

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