Is the arrogance of general practitioners a universal phenomenon?

It sounds a bit like you've taken the same attitude toward medicine that many of us Americans have. The was I see it, specialists (like neurologists) are for cases that are difficult to manage or diagnose. Yeah, epilepsy is a serious condition, but it's a serious condition that can be well-controlled with relatively simple medication regimens in many. It doesn't necessarily take a specialist to be up to date on current guidelines and start off with the grade I-A recommendations. If those initial therapies don't work, then yes, it might be time to get a specialist involved. But once a definitive diagnosis is made by a qualified medical professional, long-term maintenance can often be accomplished by a GP very, very well (actually there's good evidence that pharmacists can also handle it). Being able to afford a specialist's care is not the same as NEEDING a specialist's care. Over-utilization of specialists results in a highly fragmented medical care model and drives up costs. Hence the big push for patient-centered medical home models...