ABSTRACT
The disappointing gap between aspiration and achievement seemed to have a more philosophical origin - a lack of clarity about medicine's purpose, scope, methods and terms of engagement. Medicine is often portrayed as a purely technical exercise, up there with flying a plane or mending a car. Medicine's accelerating success began when it, too, adopted a Newtonian view of how the human body functions. Medicine's prevailing paradigm remains predominantly mechanistic, with only a few fuzzy mavericks banging the drum for mystery. The science of which medicine is a subset is no longer the deterministic, atomistic, mechanical and predictable affair it once was. The specialist way of doing medicine currently dominates the profession's corporate mindset, not least because of its spectacular successes in treating the many diseases that yield to a reductionist approach. Medicine can be practised in a specialist way and in a generalist way. But it is perhaps best practised by doctors who can do both.
