Overspecialization

Back on April 6th I mentioned the problems with overspecialization. With the compartmentalization and guild mentality keeping people from doing jobs that they are trained well enough for, but who have not been over-trained for.

I mentioned the death of Natasha Richardson, the fact that doctors had a CT in their hands within 2 hours of her accident--a CT which would have shown the bleed. Instead of a doctor knocking a hole in her skull, they waited around, dithering, because they were not overspecialized neurosurgeons. Their timidity in the face of crossing the specialty barrier cost her her life.

Here's a counter example of a doctor doing the same procedure that Richardson needed, without waiting for a specialist--or any equipment beyond a hardware-store bought power drill:

[ Daily Tele ] The astonishing procedure took place after Nicholas Rossi, 13, fell off his bike in the small rural town of Maryborough in Victoria and hit his head.

[...] The boy was kept under observation, but one hour later, he started drifting in and out of consciousness. Dr Carson recognised the problem as internal bleeding in the skull and noticed that one of Nicholas's pupils was larger than the other, another sign of bleeding that was placing pressure on the brain. The injury was the same that recently led to the death of actress Natasha Richardson after a skiing accident.

[...] In scenes reminiscent of a television medical drama, Dr Carson realised he had minutes to save the boy's life and there was no time to transfer his patient to a hospital with a dedicated brain surgery unit. Instead, he telephoned Dr David Wallace, a neurosurgeon 105 miles away in Melbourne, to help talk him through the operation - which he had never attempted before.

But there was one problem. The hospital was not equipped with a surgical drill. Instead, Dr Carson had to use the next best thing - a household drill found in the hospital's maintenance cupboard. He disinfected the drill and, under Dr Wallace's guidance, used it to bore into Nicholas's skull to release the blood clot.

Which was exactly my point a month ago: any GP with a power drill should have been able to save Richardson's life. She died because her doctors were to worried about crossing into their colleagues turf.