Health Affairs April 19, 2021
Sachin H. Jain, Balu Gadhe

Whatever happened to the confident generalist? The physician working at the top of her license, who could diagnose and treat a myriad of illnesses. The internist with a broad knowledge of medications, who always seemed to know exactly what prescription to write. The family doctor who ordered tests and read the results himself. The primary care physician who, when unsure of what course to take, simply said, “Let me call a colleague and see what she thinks.”

Today, internists seem more like traffic cops than the knowledgeable, capable physicians they are—seemingly content to dispatch their patients to a cohort of specialists rather than treat their ailments themselves.

A study in the Archives of Internal Medicine found that, from 1999 to...

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