Robin Osborn of The Commonwealth Fund and coauthors analyzed the results from the Fund’s annual international survey of primary care doctors in the United States and nine other industrialized countries. The study examined different aspects of primary care practice for patients with complex needs, including coordination of care, arrangements for after-hours care, and the use of secure e-mail as a means of expanding access to primary care. American primary care physicians stand out as being the most critical of their health care system (only 16 percent felt the system works well) and as having high levels of stress (43 percent) and dissatisfaction (34 percent) practicing medicine.
“Industrialized countries face a daunting challenge in providing high-quality care for aging patients with increasingly complex health care needs who will need ongoing chronic care management, community, and social services in addition to episodic acute care. Our international survey of primary care doctors in the United States and nine other countries reveals their concern about how well prepared their practices are to manage the care of patients with complex needs and about their variable experiences in coordinating care and communicating with specialists, hospitals, home care, and social service providers. While electronic information exchange remains a challenge in most countries, a positive finding was the significant increase in the adoption of electronic health records by primary care doctors in the United States and Canada since 2012. Finally, feedback on job-related stress, perceptions of declining quality of care, and administrative burden signal the need to monitor front-line perspectives as health reforms are conceived and implemented.”
Osborn, Robin; Moulds, Donald; Schneider, Eric C; Doty, Michelle M; Squires, David; and Sarnak, Dana O. “Primary Care Physicians In Ten Countries Report Challenges Caring For Patients With Complex Health Needs” Copyright 2016 by Project HOPE: The People-to-People Health Foundation, Inc., HealthAffairs, January 26, 2016, http://content.healthaffairs.org/content/34/12/2104.abstract