Milton Packer, M.D., writes in Med Page Today about the deep divisions between primary-care physicians and specialists. Among his remarks:
“So I asked primary care physicians about recent advances in diabetes and heart failure. I inquired about their knowledge of clinical trials or guideline recommendations. I wondered how they interacted with physicians who had specialized knowledge.
“‘You are joking. Right?’ I was told by one primary-care physician. ‘I hate specialists, especially cardiologists. They are so arrogant. They think that they know everything. And they think that I know nothing. They don’t really want to help people. They just want to make money. I hate referring patients to them.”’
“There was more: ‘Look. I don’t do procedures. I see dozens of patients a day, and it is an impossible challenge. I don’t have the time or the staff to fill out preauthorization forms. I hardly have the time to tend to the emotional needs of my patients. Specialists certainly won’t do that.’
“‘When I call a specialist because I want their advice, all they want to know is if the patient needs a procedure. If I ask them about the use of medications, they have no time for me. Maybe I’ll get connected to one of their nurses. In any case, it’s a terrible experience.’
“Family physicians do not like specialists. Actually, they detest them.”
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