I have as close to the 'perfect world' as we can have, I think.
My GP (the same as your PCP) acts as a central point - all my specialists send their letters through to him, and he relays anything through that needs to be done.
I also have something of a 'small world' situation too - my PM doctor knows my physio, my GP treats my physio's kids, my GI doctor initially referred me to my cardiologist, so they talk regularly.
Unless I'm starting a new medication that he's not familiar with, or not comfortable handling initially, my GP handles all my medications. He is always happy to prescribe my narcotic meds (oxycontin and oxcodone IR), but I do have a close relationship with him and he's known me for many years. He also likes to review at least once a month even if I'm quite well - just to make sure we're on top of things.
CRPS since 1999, diagnosed in 2005 and since spread to full body, spasms, dystonia & contractures, gastroparesis, orthostatic hypotension,bradycardia/tachycardia, bone spurs, bursitis, carpal tunnel syndrome.
On Oxycontin/Endone, Topamax, Mobic, Magnesium, Florinef, Somac, Cipramil. Have a spinal cord stimulator, intrathecal pump with baclofen & bupivacaine and doing physio.