Specialization

“Why was there the divorce within the medical profession between the organizational and the educational implications of specialized medicine? Such a divorce there certainly was by the 1940s. The specialties had come of age educationally, as the burgeoning process of residencies and specialist certification testified. Yet specialization was still being discussed as if new forms of organization and financing were irrelevant. The identification of national health insurance with other New Deal welfare programs was clearly one prevailing fact; health care financing moved into the congressional limelight, while specialist regulation did not. Professional self-interest was another factor. . . More broadly, there was the question of a profession’s responsibility for self-regulation. It was not clear in the growing confusion of health services of the 1930s and 1940s how far professional dicta should also govern the way in which medical practice is organized; this was to be an increasingly important issue in the 1950s and 1960s (Stevens, 288-89).