--I try to avoid primary care physicians as much as possible. It's nto thtat there aren't some good ones out there, but many of us here are such unusual cases by their standards that they are in over their heads with us with little idea how to handle our symptoms. (Not that specialists are necessarily more knowledgable either. I think the best way for most of us to go, if we can, is with clinical practices in tertiary centers or teaching hosptials that also do research and have more possibility of being on the cutting edge.)

I do feel for people who have insurance plans that REQUIRE them to go to primary care physicians first in order to even get a referral to a specialist--in our cases, rather than saving money in itsr gatekeeping, the practice tends to cost all of us money in the long run--doctors, patients, and insurance companies.