Is there a doctor Hertzler in the house?

The Pharos/Autumn 2012 The author (AΩA, University of Pittsburgh, 1969) is Emeritus Professor, Department of Preventive Medicine, and Senior Fellow, Center for Medical Humanities, Compassionate Care, and Bioethics, at the Health Sciences Center School of Medicine of Stony Brook University. He is a member of the editorial board of The Pharos and one of its book review editors. Among his honors are the American Academy of Hospice and Palliative Medicine’s humanites award and the Davies Award of the American College of Physicians for “outstanding contributions to humanism in medicine.” When I attended medical school during the late 1960s, I learned that primary care was well on its way to extinction, soon to be replaced by a matrix of organbased specialties and subspecialties. General practitioners had recently begun to fight this trend by creating the specialty of family medicine, but my medical school scoffed at this seemingly unscientific development and for many years resisted establishing a department of family medicine. Health policy at that time dictated that the way to improve America’s medical care was through training large numbers of subspecialists, who would then evenly distribute themselves in small towns throughout the country and bring the blessings of specialization and new technology to populations that had relied only on general practitioners. While medicine still honored the tradition of the compassionate generalist doctor, the beau idéal no longer represented state-of-the-art care. In fact, some aspects of traditional practice were considered a waste of time, if not actually harmful. House calls were a notable example. Once the core of American medical practice, home visits were now deemed inefficient, unproductive, and possibly dangerous. If a patient was too sick to Dr. Arthur E. Hertzler.