Specialization

I went on with my lecture, "Even for patients within the same department, the current trend is specialization rather than generalization."

"What do you mean?" My wife asked.

"For example, if a woman is under the care of a liver surgeon for gall stone, and, at the same time, she is also noticed to have a breast lump. Would the liver surgeon do the workup or refer her to a breast surgeon? There is nothing fancy about breast ultrasound, X-ray, or biopsy - all general surgeons should be fully capable. However, if there is any problem, his expertise would be challenged, and any pig-headed extraterrestrial would comment that the system never bar him from referring the patient to a breast surgeon."

"The attitude is wrong."

"Is it? I'm not entirely sure. On one hand we think generalization would save the trouble of multiple referral and improve the efficiency of the system. On the other, specialization certainly improves the outcome of many procedures - surgery, endoscopy, and what not. As Adam Smith said: The greatest improvement in the productive power of labour... have been the effects of the division of labour."