Medical Specialisation at the London Hospital

Book excerpt: The development of specialty skills in medical and surgical practice in the late 19th and in the 20th century transformed medical practice. For the first time, a patient could visit a doctor with the expectation of an accurate diagnosis and effective treatment. Disease prevention became a realistic proposition. Traditional practice methods became obsolescent, but a yearning for generalist medical wisdom and respect continued until the 2nd World War disrupted progress. In the 19th century, the London Hospital was remarkably open to new ideas, and the Chairman of the Board, Viscount Knutsford, was a master fundraiser. Investment in novel facilities and staff, including the establishment of special departments, and consequent changes in clinical practice led to a growing national and international reputation in clinical practice and education. Specialty skills defined innovations, both in hospital and family practice. More recently, merging St Bartholomew’s, the Royal London Hospital and other hospitals has reactivated the advance of specialism.