There are some people that have both but it is extremely rare as the author points out. Being a hack or OK in design and development is not the same, many people can do that. I think he is pointing out the very small circle of extremely gifted individuals who can legitimately do both on a professional level.
As in any profession there will always be some extraordinary individuals that are heads and toes above the rest.
As in any profession there will always be some extraordinary individuals that are heads and toes above the rest.