How many specialists?

The need for specialists cannot be adequately assessed on the basis of current practice and an estimated case-load (based on prevalence/population ratio). Specialists should declare which patients can or cannot be expected to benefit from their treatment, and they should consider the consequences of underprovision of specialist services. Specialists should also decide how much of what they normally do might equally well be carried out by generalists using the knowledge of specialists. Only then can the appropriate level of provision for various specialties be assessed, and effective deployment of the resources provided ensured.