The head of the senior doctors' union is urging hospital doctors to work much more closely with family doctors.
Dr Jeff Brown of the Association of Salaried Medical Specialists told doctors at their annual conference in Wellington on Thursday that those in primary and secondary care have to talk to each other if people are to get the best care.
Dr Brown said that integrating primary and secondary care is an increasingly important and challenging theme for hospital-based doctors.
He said "primary versus secondary territorialism" hinders innovation and consumes energy that's required elsewhere.
Dr Brown said patients expect their doctors to be the best, not second best, or worse.
But he said improvements require teamwork, which hospital doctors are well placed to lead because they make some of the most expensive spending decisions in health.