European vs U.S. Primary Care: We Have Things Backwards

The status of primary care is dramatically different in Europe vs. the U.S.

While doing background reading, I was startled by the title of a book: “Primary care in the driver’s seat? Organisational reform in European primary care” The book was reviewed in the International Journal of Integrated Care .

Is primary care capable of taking a dominant role in running the whole health care system? This challenging question is what makes this book interesting and takes the debate one step ahead in the discussion of solely strengthening primary care, however important. In doing so, it affects the heart of integrated care; how to improve the clinical coherence and coordination that in the end leads to a patient led health service

What a contrast to the state of primary care in the U.S.!

While the question in Europe is “should primary care be in the driver’s seat”, the question in the U.S. is “Primary Care — Will It Survive? ” [New England Journal of Medicine; August 31, 2006]

And how are primary care physicians in the U.S. feeling about their status? Not too good, as documented in Merritt Hawkins & Associates 2006 Survey of Primary Care Physicians .

Q. 9. Relative to surgical and diagnostic specialists, which best describes primary care physicians in the medical hierarchy?

The dire situation of primary care in the U.S. is mind boggling to me. We have things totally backwards.