Medical Fads and Fancies 27 
refer themselves on their own idea of the nature of 
their ailments or in a smaller percentage of cases, to 
whom they are sent by practitioners or fellow special- 
ists. Disadvantages of this system are that examina- 
tions are inadequate in lines other than that in which 
each specialist is expert; that there is a tendency for a 
widening of the field by each intensive worker to in- 
clude conditions with which he is not adequately fa- 
miliar; the over-accentuation of conditions falling with- 
in the specialist’s field and the cost to the patient. The 
great advantages are that the patient has the benefit of 
a skill and judgment that cannot as a rule be commanded 
in a group and he also derives a personal attention, 
moral support and the security of a responsibility on 
the part of his physician not available in any group. 
The arrangement is highly satisfactory to the physician, 
affording him independence and stimulation to put forth 
his best efforts through which he may anticipate in- 
creased professional reputation and financial reward. 
Certainly this method of practice has to date proven 
the most generally satisfactory, though far from ideal, 
as exemplified by the ophthalmologist, the surgeon, the 
nose and throat specialist, and so on. In the future it 
Seems not improbable that in addition to the elevation 
of the family physician, and working in conjunction with 
him, we shall have very small groups of the one-man 
type limiting themselves, though less restrictedly, to 
certain lines of work, and spending a much larger pro- 
portion of their income in laboratory work, technical 
and non-medical support; anticipating adequate return 
through the ability so developed to do a much larger 
amount of work at a lower cost to the patient. 
The entire medical fabric is in a flux of reconstruc- 
tion—there is so much one feels like discussing. I had 
