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Objectives: To find the current situation regarding the relationship between Primary Care and specialist doctors. To find the defects in this relationship and to propose actions to improve the situation., Design: Delphi technique., Setting: Area Medical Directors, Medical Coordinators of Primary Care Centres, Hospital Medical Directors, Internal Medicine Service chiefs and Casualty directors from the entire Community of Valencia., Results: After a qualitative analysis of the replies given in the first and second questionnaires, the 10 most serious problems for the Primary Care/Hospital relationship were extracted, along with 10 possible solutions to improve this relationship., Conclusions: The main problems detected between Hospital and Primary Care concerned the professional and organisational areas. The solutions suggested mainly centered on the organisational area. Specific differences were found in the prioritization of the replies, both for problems and solutions, depending on whether the point of view was Primary or Hospital Care.

Objective: To find the opinion of asymptomatic HIV+patients about their Primary Care doctors., Design: A descriptive, crossover study with an 11-item questionnaire, filled in by the patient him/herself anonymously and analysing: communication of being seropositive, frequency of attendance, confidence in the doctor and their competence in dealing with the patient., Setting: AIDS Information and Prevention Centre, Alicante., Patients: Consecutive sampling of the first 100 HIV+patients who attended voluntarily during the first 5 months of 1993 (from January 3 to May 18 inclusive)., Measurements: 60.2% (C.I. 95%, 69.9%--50.5%) said they communicated their being seropositive to the doctor. Intravenous drug users communicated this fact more (72.9%), against 41% of the rest of the groups (p = 0.0016). 25% had little or no confidence in their doctor and 44% considered him/her incompetent or barely competent, with these two variables being related (r = 0.42; p = 0.0001). Communicating their condition to the doctor is only related to more frequent attendance at the clinic (p = 0.0001). The reasons for not doing so are due mainly to lack of confidence (30.8%) and "didn't think of it" (46.2%). The doctor's competence obtained the lowest points average, 2.6, with its Confidence limits sharing no value with frequency of attendance or confidence., Conclusions: An important percentage of patients do not communicate their condition, due basically to problems of confidentiality and rejection. There are doubts among HIV+patients interviewed about their doctor's competence, at the same time as they have little confidence in him/her.