General practitioners with special interests: Risk of a good thing becoming bad?

• There is a long tradition of some general practitioners developing areas of special interest within their mainstream generalist practice. • General practice is now becoming increasingly fragmented, with core components being delivered as separate and standalone services (eg, travel medicine, skin cancer, women's health). • Although this fragmentation seems to meet a need for some patients and doctors, potential problems need careful consideration and response. These include loss of generalist skills among GPs, fewer practitioners working in less well-remunerated areas, such as nursing home visits, and issues related to standards of care and training.