>>The medical metaphor I used is pretty classic ... my cousin is a cardiologist and even there you have deeper specialties such as surgery, chronic heart failure, etc. and these specialties tend to fragment more and more.

Of course I agree that medicine increasingly involves subspecialization. But this is because delivery directly to the customer has expanded hugely. Medicine has not become more complicated to deliver the same stuff with a different packet; there are whole new modalities of care that impact directly on patients. Example: endoscopic surgery now is so detailed that there are sub-sub-specialties. The benefit for patients is that surgery that once needed days in hospital and a risky recovery period, now is done almost on a "drive through" basis. IOW the extra complexity for practitioners is mapping into significant new care options for patients. It's not simply more complicated to deliver the same result: they've done away with the abdominal incision completely and the patient gets to go home.