Generalists and specialists caring for patients with heart disease: united we stand, divided we fall.

The quality of care provided by generalist and specialist physicians has been the focus of many comparative studies during the past two decades, motivated in part by health insurers’ efforts to contain the costs of care by limiting patients’ access to specialists1. Physician-directed medical groups have also begun to implement similar limits2, designating primary care physicians to serve as gatekeepers who control their patients’ access to specialists and other medical services. (February 15, 2000)