The Royal New Zealand College of General Practitioners says some district health boards don't understand that primary care exists - much less that they are responsible for funding the sector.
The college was supporting criticism of DHBs by Health and Disability Commissioner Ron Paterson.
He told Parliament's healthselect committee on Wednesday that hospitals remained unacceptably unsafe, two years after he had warned that progress to remedy the situation was slow, patchy and uncoordinated.
He called for strong national leadership, better communication between health providers and open publication of hospital data on patient safety.
College chief executive Karen Thomas said feedback from members showed about a third of DHBs interacted well with primary care and general practice.
"A second third have heard of it, but the remainder act as if they have never heard of it - nor seem to care."
Mr Paterson identified the communication between primary and secondary care as one of the problems. "And we think so too," Ms Thomas said.
"Unfortunately, it seems as though DHBs have been so focused on getting their budgets sorted that they have not had the time to realise that primary care is where you deliver care in the 21st century. Do it properly in primary care and many patients don't even need to go to hospital."
She said the college wrote to all 21 DHBs about improving communication between GPs and hospitals and only one-third responded.
