Well, as I get older I am definitely less tolerant. And, I am so tired of being considered a second-class physician, merely an "accessory" in the care of my patients. Specialists by-pass me all the time. I retaliate by then by-passing them. Gone are the days of keeping my mouth shut and simply letting them walk all over me. I will very eagerly explain to a patient why I prefer to refer to one specialist over another. One of the oncologists in town now regularly refers patients on to other specialists, without even calling me to discuss it or to find out if this has already been done. He now no longer sees new referrals of mine. But, this is a whole other topic and I could go on and on. I will leave it at this. Primary care is at a crossroad. We are at war. Not only with insurance companies but with many of our specialist "comrades". If we do not come out of the trenches and begin firing back we will dessimated. I can no longer sit back and watch the grenades hit all around me and wonder if I will be next. I have to pick them up and throw them back. I graduated second in my medical school class. I am not a stupid idiot internist. I chose Primary Care as my "specialty". I did not end up here by default.
Leslie, who is heading to the coffee pot
