When in training, I had to rotate through each specialty before I could become board certified in internal medicine. I remember telling my new husband how much I loved learning about (fill in whatever my current rotation).
"So are you thinking of specializing?" he'd ask.
Never. My joy in medicine revolved around the challenge of putting all the pieces together and seeing the interactions between the various body systems and patients' panoply of medications. Being a generalist allowed me to do what I could to help patients deal with their life as a patient, as opposed to helping them with their "arthritis" or "kidney failure."
Such "generalism" had a cost, the price of which has only spiraled up since I left clinical medicine in 1993: Compared to what is known about each specialty, generalists know less and less about more and more.
As an example, when I was a medical student, internists admitted to the hospital their patients with heart problems, calling for a cardiology consult only for complicated cases. By the time I was in practice, it was routine for cardiologists to take over the hospital care of almost all heart patients.
Why? Because the science and technology behind cardiology care exploded. Cardiologists had specialized knowledge and skills that could minimize patients' heart damage and improve outcome beyond what generalists could do.
The challenge today is how to help patients benefit from the expertise of both specialists and generalists.