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Joseph Mattana and James Gavin

The Nephrology Match yielded disappointing results again this year.

At the same time, the current state of medical practice as a whole continues to suffer numerous problems, which are well described and largely obvious. Among them is a progressive degree of compartmentalization: Outpatient physicians are abandoning the hospital as a practice site, and hospitalists are quantitatively dominating inpatient medical care, with abandonment of the outpatient setting. This has afforded many efficiencies and advantages, including apparently favorable impacts on hospital metrics. It has also allowed for a form of subspecialization, a supporting argument being that this may better facilitate mastery and