Using "paper patients" we compared the therapeutic approaches of general practitioners and rheumatologists to rheumatoid arthritis and to osteoarthritis of the knee. The mailed survey contained a mild, a moderate and a severe case of rheumatoid arthritis (RA) and a case of osteoarthritis (OA) of the knee. 111 out of 252 general practitioners and 78 out of 132 rheumatologists selected at random participated in the study. We found that rheumatologists would choose more non-steroidal anti-inflammatory drugs (NSAID), disease modifying antirheumatic drugs (DMARD), steroids and physical therapy. In case 4 (OA of the knee) rheumatologists would more frequently recommend analgesics, local steroids, occupational therapy, surgery and ortheses. Primary care physicians on the other hand prescribed more chondroprotective agents. Patients with RA and OA of the knee would be treated differently by primary care physicians and rheumatologists. In order to develop a more uniform therapeutical concept and therefore to reach a better management of the rheumatic patient, a close co-operation of the two physician groups is needed.