How physicians in different specialties explain their positions on tonsillectomy is explored using data based on in-depth interviews with 53 physicians. Justifications for and against particular indications, assessments of efficacy, and explanations of tonsillar function and pathology are presented. Clear specialty-specific differences exist, especially between pediatricians and otolaryngologists. Opposing specialty views rest upon radically different versions of cost/benefit assessment, whereas evaluations of efficacy are based primarily on conceptual reasoning and anecdotal accounts. Physicians' opinion of clinical trial results are specialty-dependent and are used to sustain specialty viewpoints. The implications of such specialty group differences for public policy are discussed.
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