Redesigning primary care is an integral part of health reforms in the United States and elsewhere. A new study, released today as a Web First by Health Affairs ^[1], reports the results of a survey of primary care doctors in the United States and nine other countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Switzerland, and the United Kingdom.

The survey, conducted between March and July 2012, found US and German physicians the most negative about their health care systems: only 15 percent of US and 22 percent of German practitioners thought their systems worked well. On the brighter side, the survey found that 69 percent of US doctors report the use of electronic health records, bringing use in the United States closer to the Netherlands, New Zealand, the United Kingdom, and Norway, all with near-universal capacity.

Other key survey findings:
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• A high share of physicians in all countries reported that they did not receive timely information about their patients from specialists or hospitals. For example, only in New Zealand (55 percent) and the Netherlands (59 percent) did the majority report being notified when a patient was sent to a hospital emergency room.
• Although 89 to 95 percent of doctors in Germany, the Netherlands, New Zealand, and the United Kingdom reported that their practices had arrangements to enable patients to receive after-hours care, only 34 percent of US doctors reported such a possibility.
• Fifty-nine percent of US doctors said their patients often had difficulty paying for care–significantly higher than any of the other countries.
• Over half (52 percent) of US doctors also reported that the time they and their staff spend on insurance restrictions on their treatment decisions is a major problem.

“There are opportunities to learn from diverse efforts underway in the United States and other countries that are designed to achieve shared health reform goals,” conclude Cathy Schoen and her coauthors at the Commonwealth Fund and Harris Interactive. “Listening to doctors on the front lines of primary care can help identify gaps and target reforms of health systems.”