Every year, medical errors cause about 44,000 unnecessary deaths. Some of these errors are made by trained physicians throughout the diagnostic process. We examined the experimental hypothesis that physicians within a certain specialty show a bias in diagnosing situations outside their own domain as being inside that domain, using error frameworks presented in the literature.
A cardiologist (heart specialist) nearly died of acute appendicitis because he and his colleagues were unable to accurately diagnose his ailment, according to a recent newspaper account. All he knew was that he was in pain someplace in the center of his body. His colleagues, who were heart disease experts, were absolutely perplexed by his symptoms. Finally, they admitted him to the coronary care unit for a suspected heart attack; a few days later, this specialist’s son, a general practitioner, paid a visit to his father. He took one lock and diagnosed appendicitis right away. They performed emergency surgery on him and removed a ruptured appendix. Any additional delay may have been fatal.
Of course, this is only one example. Most doctors, whether specialists or general practitioners, have a broad knowledge of diseases, but as the example indicates, specialization can cause the specialist to lose touch with topics with which he is not generally in contact. He knows far too much about one thing and far too little about another. He is overly specialized and completely powerless when dealing with things outside his specialty.
Thank goodness for general practitioners, also known as GPs. These GPs are not experts in everything; rather, they are jacks of all trades in the medical field. Every day, they may handle dozens of cases of various ailments, and as a result, they have the ability to recognize almost any common sickness that a person can contract. He will then be able to prescribe the necessary treatment. If he suspects a more serious problem, he can refer the patient to a specialist.
This isn’t to imply we don’t need professionals. They are also an essential component of the overall medical setup. No general practitioner has the skill or training to do a heart transplant. It can only be done by a very trained surgeon. Furthermore, no general practitioner has the time or competence to perform the duties of an orthopedic surgeon, gynecologist, pediatrician, or any of the other specialists available today.
Patients with many chronic conditions receive inferior care overall, and their disconnected treatment plans result in redundancies and inefficiencies that place an undue strain on our healthcare system. The field of the general practitioner is becoming increasingly confined in these days of specialization. In reality, there is some risk that the so-called general practitioner would eventually become a mere business representative of the specialists, acting as the local distributor for the patients in his neighborhood.
A general practitioner is a front-line clinician who treats patients first. Perhaps he can handle the majority of the little and not-so-minor problems that he has to deal with on a daily basis. Only in the most extreme circumstances does he recommend to a specialist, but the GP selects which specialist is required. As we can see, the GP is a critical figure.
In any situation of disease, it is best for the average person to consult a doctor first. He can then determine what action is required. Going straight to a specialist can put you in the shoes of the cardiologist discussed before. It is preferable to avoid such an occurrence.
Over the last 30 years, budgetary concerns have compelled even primary care, long considered the final stronghold of the generalist, to divide responsibilities between full-time hospitalist and outpatient practitioners. These divisions of labor, as Smith foresaw, cure singular diseases and handle routine care with quality and efficiency.
