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Letters |

Specialization in Health Care

Michael M. E. Johns, MD; Haile T. Debas, MD; Robert H. Miller, MD, MBA
JAMA. 2012;307(19):2025. doi:10.1001/jama.2012.3625.
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To the Editor: Specialties are established based on scientific knowledge and technology, and they evolve as knowledge expands and technologies develop. It is the nature of progress.

Dr Detsky and colleagues1 do not distinguish between specialties and specialists. Physicians enter a specialty because of their interest, inspirational role models, and the characteristics of that specialty. While financial gain may sometimes play a role, we have observed that professional inquisitiveness and the personal satisfaction of having expert knowledge are the much stronger drivers for selection of any specialty, including primary care. Said differently, financial gain may sometimes be a reason for physicians choosing a specialty, but that is not the driver for the creation of specialties.

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May 16, 2012
Thomas Plochg, MSc, PhD; Niek S. Klazinga, MD, PhD
JAMA. 2012;307(19):2025. doi:10.1001/jama.2012.3582.
May 16, 2012
George F. Sheldon, MD
JAMA. 2012;307(19):2025. doi:10.1001/jama.2012.3617.
May 16, 2012
Allan S. Detsky, MD, PhD; Stephen R. Gauthier, BSc; Victor R. Fuchs, PhD
JAMA. 2012;307(19):2025. doi:10.1001/jama.2012.3655.
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