“In the 1960s and 1970s it was assumed that physicians who also developed expertise in one of the fundamental sciences by obtaining a PhD degree would use their knowledge of the fundamental science to address problems in the clinical arena. In retrospect, this assumption was naive. The physician-scientists were being trained to be reductionists. The fundamental research approaches they were learning did not lend themselves to an understanding of human physiology or pathophysiology. As a consequence, physiology as a discipline atrophied. In many medical schools, it became extinct, as pointed out by Feinstein (8) in this issue of The American Journal of Medicine. Physiology does not readily lend itself to a reductionist approach. Indeed, by its very nature, it uses the tools of integration to understand complex processes. Thus, it would seem unlikely that scientists trained in a reductionist environment would develop research careers in the fields of human research. Rather, they would spend their time in the fields of the fundamental scientific laboratories in which they were trained, far removed from the bedside.”
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