retired doc points to an article from the Annals:
Academic medicine is the carpenter that fashioned the coffin of internal medicine. Instead of reengineering internal medicine to accommodate changes, it cannibalized the discipline by reducing its worth, creating the hospitalist and ambulatory care internist. These were both nails that helped seal the coffin; the former reduced the influence of the internist in the acute care environment and the latter blurred distinctions between internists and those without medical degrees who practice in the ambulatory settings.
I have written in the past that one of the problems is how out of touch academia is with the real world.
