What would happen if every doctor chose to specialize?

Only 2 percent of medical students said they planned to enter primary care internal medicine.

Hospitalist Chris Rangel offers an interesting analogy for that grim statistic, applying the specialization phenomenon to other fields.

“Imagine if only 2% of police academy graduates took jobs as beat cops while the rest became detectives, forensic specialists, or SWAT members,” writes Dr. Rangel. “Imagine if only 2% of nursing graduates became floor RNs and the rest specialized as ICU or surgical nurses. What would happen to the US Army if only 2% of recruits became infantry while the rest were allowed to become logistics specialists? . . . It’s not that we don’t need detectives, ICU nurses, or medical specialists. It’s just that there is no advantage to having them in huge numbers. Having thousands more detectives won’t necessarily improve our ability to solve crimes better than what we have now and will be much more expensive.”

It’s something to think about, especially when we’re seeing the American College of Surgeons mobilizing to protect their turf.

Make no mistake, specialist organizations are ready to throw primary care under the bus, with the opening salvo of implying that generalist doctors can be easily replaced by mid-level providers telegraphing their intentions.

Let’s hope that the ACP is aggressive in countering these tactics. It’s becoming clear that a conciliatory approach with specialist organizations may not be feasible, and more contentious, potentially confrontational, methods may be needed to be heard above the din.