This question was originally posted on Quora.com and was answered by Amy Chai, MD, Internal Medicine, MS Epidemiology I am going to go out on a limb and suggest that “primary care” doctors are disliked by other doctors. Or, perhaps not actually disliked, but rather, “looked down upon” which is worse than dislike. Why do other doctors look down on their primary care colleagues? First of all, we are looked down upon due to money. PCPs do not make a lot of money, and in our society we value money above all else. We admire people who make lots of it, and we despise those who make less of it. This is simply a moral failing of society, not unique to the medical field. Doctors are guilty of idolizing the wealthy as much as anyone else! So, we are the, “poor cousins.” Second of all, we are looked down upon due to the fact that we do not know as much about the specialties as specialists do. For example, the specialist will ridicule the primary care doctor for asking a “stupid” question that is “easy” for them. Well, maybe it is easy for them because it is literally the ONLY thing they do ALL day, EVERY day, while the PCP must know every specialty. Well, yes, that is why they pay specialists the “big bucks” to know a lot about a single topic. When you think about it, it is a lot harder to have to know everything, and sometimes we do not have access to all the latest thought about their specialty. There are multiple specialties, and I will wager that the specialists know much less about the other specialties than the PCP must know. Thirdly, we are looked down upon because we are seen as “less well educated” or “people who were not good enough to be orthopedists.” While it is difficult to get accepted into orthopedics, that does not mean that those who chose primary care are less well educated or less capable. I chose Internal Medicine because it used to be “the thinking person’s specialty.” It was the most cerebral specialty. Also, women tend to choose non-surgical options because we can’t get up to go to the hospital at 6am when we have kids. So we go for the 8am professions. Fourthly, we are looked down upon because we need to make a lot of referrals. Well, that isn’t our choice. Most of us are employed and we are not allowed to admit our own patients, and we are not allowed to do certain types of tests or procedures. Also, because our payments are so low, we do not have the TIME that is NECESSARY to complete our “procedure.” Our “procedure” is thinking deeply about your problem and creating solutions. Insurance does not pay for “thought” it only pays for tests and procedures. So we are forced to over-order them. Finally, the PCP is the closest you can get to a “caregiver” in a professional role. Everyone looks down on caregivers, which is why misogyny is so rampant in our culture today. People with sharp tools who can cut things are respected, people who are caregivers are not respected. Many women think that the answer is to get sharp tools and start cutting. However, I think the answer is to give caregiving and caregivers the respect that they deserve. Source
