Mythical & Modern Medicine (cntd) 3/25/2021 8:11:53 AM
Academic medicine.-At universities and teaching centers professors and teachers were employed by the organization. These were practicing physicians also teaching and doing research. They noticed that they were making less than their colleagues in private practice. This lead to some leaving academic medicine for private practice. Several combinations were tried, allowing them private practice , combination of employee and private practice and others. The focus changed from teaching and research to doing both and making money. They became experts for pharmaceutical companies giving lectures all over the country and touting drugs and devices. Their research, hereto, done for the benefit of medicine and free for universal use, changed. Now they had patents for their discoveries. Their researches were subsidized by pharma. They organized seminars on diseases and their treatment at their centers and charged a hefty some for the courses. There they invited their friends to teach at their seminars, who reciprocated when they held their own ones. They dominated specialty societies and organization. A doctor practicing in the community somehow was now looked down upon in undeclared condescension as at a slightly lower tier. This was supported in articles and journals citing statistics. (Statistics can be made very elastic). No one in medicine had doubted their expertise in fields which the community practitioner was not much exposed to. But medicine practiced in the community was not inferior medicine.
As medical knowledge advanced, no one could be an expert at all that medicine offered. Inevitably specialization resulted. Originally you were supposed to know most of medicine and then in addition know more of one particular field and become a specialist. This gradually morphed to the present 'super-specialization' where a doctor dealt only with one area or even part of an area of medicine and practically disregard the rest. I got a lesson of this in my training . I took a just done chest X-ray of a patient to a radiologist for a verbal reading so the patient could go for emergency surgery. When I put up the X-ray and asked his opinion for a verbal 'reading', he told me he was a neuro-radiologist and that I go find a general radiologist. I was floored. I had seen the x-ray, it was normal, but a radiologist's say so was needed. I omitted it altogether. The surgery went through and the patient was fine. And this was in 1965! Where will this ridiculousness go? Specialization in the left eye or right foot only?
