General psychiatry, primary care, and medical primacy

Nonmedical psychotherapists are able to present themselves to the public as psychiatrist-equivalents, except for prescribing drugs, because psychiatrists have neglected to emphasize the nature of medical responsibility, here called "medical primacy." Psychiatric identification with the psychoanalytic and public relations models is criticized. Three cases are presented to illustrate the functioning of the general psychiatrist as a primary care specialist. It is acknowledged that all psychiatrists may not be attracted to this role, which intersects certain transference and countertransference vectors.