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Skip to main content asks a question all of us should answer.

How Good Is Your Primary Care Physician?

Everytime I hear or read that the U.S. health care system is the best in the world, I wonder why we wind up so low on so many basic indicators like longevity and infant mortality. A study out today that focuses on primary care — that first interface with the health care system — helps explain why.

A Commonwealth Fund survey published in Health Affairs asked 6,000 primary care physicians in the U.S., U.K., Germany, Australia, New Zealand, Canada and the Netherlands about their practices.

Primary care doctors in the U.S. are less likely . . . to be able to offer patients access to care outside regular office hours or to have systems that alert doctors to potentially harmful drug interactions. U.S. primary care physicians are also less likely to receive financial incentives for improving patient care.

Only about a quarter of primary care doctors in the U.S. (28%) and Canada (23%) use electronic medical records, compared with a large majority of primary care doctors in the Netherlands, (98%), New Zealand (92%), the U.K. (89%) and Australia (79%).

Thank you, Merrill Goozner,

Allow me to answer Merrill’s question for a number of my clients in Florida over the past 35 years. Unfortunately, some primary care physicians appear to be lax or disinterested. Some are extraordinarily pro active and knowledgeable. But, some seem to be sleepwalking their way through the medical lives of some of their patients.

I do not have an easy suggestion for improving this situation. A significant part of the problem is the extremely low reimbursement rate paid by insurance companies for primary care office visits. Then, there is the coverage grief frequently encountered when a primary care doctor wants to pro actively undertake a series of expensive tests. For example, just how many times will a primary care physician go to bat for an MRI or CT Scan after losing a couple of three month battles with a health insurance company.

Maybe we can add to Merrill’s question a second one: How Good Is Your Health Insurance Company?

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