The layman of the older generation, who has been disappointed in his medical experience and who feels that something has been lacking in the way of warmth, sympathy and understanding of his case as a whole, is very apt to hark back to earlier days. “What we need,” he says, “is a general practitioner! When I was a boy we went to see Dr. Brown if we had anything the matter with us and he always fixed us up. Nowadays there don’t seem to be any general practitioners, and we visit one specialist after another, trying to find the one who happens to know about our particular ailment.” Does this complaint merely represent the normal senescent yearning for those old times which always seem to have been so much better than anything that has come since, or does it rest upon some firmer basis and suggest a possible way out of our present difficulty? At any rate, the question raised is worth serious consideration. Why is it that the general practitioner is being supplemented by the specialist, and where does the responsibility for this shift in emphasis lie? Is the further development of this trend to be regarded as desirable, either from the point of view of the public or the medical profession, and if not what can be done about it? The fundamental factor in the present increase in specialism is without doubt the progress which has been made during the last two or three decades in the various sciences which underlie the art of medical practice. Researches in anatomy, embryology, physiology, physics, chemistry, pathology, and bacteriology have so extended our knowledge of disease processes in man that, in spite of a lengthening of the period of study, it has become quite impossible for any individual to acquire an intimate understanding of all the broad fields of modern medicine. In the four years’ course of the medical school the student can get little more than an introduction into the so-called premedical sciences, and he learns of them only what is necessary to enable him to grasp the basic facts on which medical practice rests. If he is fortunate enough to be able to pursue his studies for a period of years after graduation, he naturally devotes himself to some limited phase of medicine in which he is particularly interested, and attempts to develop himself as far as possible in this direction. Meanwhile it is quite impracticable for him to keep in touch with the details of other fields and he becomes, by force of circumstances if not by wish, a specialist in what is often a comparatively narrow sphere.