The major effects of specialization were bound to affect the position of the general practitioner, no matter in what social structure or payment sys­ tem he found himself. The number of specialists was increasing, and the number of hospital junior staff was increasing even faster. The specialist needed to spend more of his time in hospital, less in his office in the com­ munity. The main advances in medical science were being made in the teaching hospital centers, not in general practice. Hospital care was becom­ ing more expensive year by year as specialized staff and equipment costs expanded faster than overall price and salary levels. Society itself had be­ come specialist conscious, not only in medicine but in all fields of endeavor. All these results, singly and severally, tended to relegate the general prac­ titioner to the back seat.