February, the month of Valentine's Day, stimulates expressions of love and romance among people. People share warm emotions and relate these feelings to the heart.

Intellectually, we know that emotions emanate from the brain. Culturally, we accept the heart as the seat of love. Fittingly, the American Heart Association dedicates February as "Heart Month."

Indeed, we dissect ourselves and apply the parts to the calendar. Think about the other days, weeks and months dedicated to specific anatomy--"Lung Health Day" or "Brain Tumor Action Week" or "Breast Cancer Awareness Month"--all published health observances. (See www.healthfinder.gov/library/nho.)

Reflecting on Heart Month and this practice reminds me of how we fragmented our profession.

Specialization offers patients the "best of times," through focused research and advanced technology. Specialization has enabled our profession to achieve miracles in the past 50 years. And when patient outcomes exceed expectations, accolades abound.

However, specialization also allows for the "worst of times." For example, in the current hospital setting, many specialists attend to the many diseased organs afflicting patients. In my primary hospital, the terms admitting physician, attending physician, consulting physician and primary physician evoke confusion. At different phases of a complex case, the role of each morphs, resulting in the question, "Who is my doctor?" When a patient deteriorates unexpectedly and has a poor outcome, which specialist accepts responsibility?

At the California Medical Association Health Care Leadership Academy in La Quinta this past fall, two experts on the economics of medical care disagreed on the question, "How should the United States fund healthcare?" They disagreed on many factors in the delivery of medical care. But independently, they reached the same conclusion. Since 1960, the U.S. healthcare system has provided more benefits to Americans than any other industry. The extension in life expectancy itself elevated the healthcare system to its status as the most beneficial industry. And physicians are the heart and soul of this industry.

In part, we achieved this through specialization. As the medical information and skills became too complex for one individual to absorb and retain, we specialized, applying intense study, analysis and focus on particular health systems.

The Orange County Register wrote a glowing article about House Call Medical Group. These doctors without offices attend patients in their homes. It was a call to a nostalgic time when the hometown "unspecialist" doctor would drive his buggy to his patient's home, bringing with him all the tools he had to do what he could do.

How does a house call physician practice without a laboratory, X-ray, scanner and a host of consultants? I suspect he uses his specialized organ systems: listening, visualizing, palpating and emoting. This method of medical care requires an hour of travel time between patients; therefore, he cares for just 6 to 8 patients a day. The story tugged at our heart as a compassionate way to deliver medical care.

However, most analysts recognize this as highly inefficient for the provision of routine medical care. Also in many cases, diagnosis and treatment dictated some form of testing unavailable in a home setting. Most patients need some form of specialty medical care.

While the doctors in the newspaper story were generalists, specialization has produced demarcating lines among physicians--the concept of "my specialty" and "your specialty." Even patients understand this concept of the organization of the medical field. They consult with an array of specialists, but may not identify with any of them as the physician who cares for them.

Most specialists perform procedures on patients. Most procedures and tests cause angst. Acknowledging the patient's discomfort--"feeling their pain"--may create the caring bond. Listening, touching and visualizing a patient's needs remain the hallmarks of compassionate care.

We physicians can deliver compassion with evidence-based, scientific medical care. Too often we label ourselves as our specialty. We say, "I am an ABC." But we should first think, "I am a physician." If we introduce ourselves, "Hi, I am Dr. XYZ, a physician specializing in ABC," perhaps we can bring back more caring and compassion in our daily work. We must love what we do as physicians first. This gets to the HEART of our profession.

Lytton W. Smith, MD, editor for the OCMA, is a physician practicing family medicine with the St. Joseph Heritage Medical Group in Yorba Linda. Dr. Smith welcomes feedback on his articles and can be reached at ocmaeditor@ocdoc.com.