Comments on More Sub-Subs Are Coming!

We read with interest Drs. Dalen and Ryan’s recent commentary in The American Journal of Medicine regarding increasing subspecialization within the medical community.1 They did an excellent job detailing the history of subspecialization, especially within the context of the failure of expanded medical school training slots to fill a primary care physician gap, with most graduates now entering specialty medicine. Where this commentary falls dramatically short is the final conclusion, erroneously stating that the answer to primary care physician shortage is simply the replacement of the primary care physician with nurse practitioners and physician assistants and that primary care may be better served in a retail clinic.