Another shortfall of the American system that the survey points to is follow-up calls and care: 22 percent of Americans surveyed reported that they don’t always get a call back the same day when they’ve called with a medical problem, and almost 20 percent waited six days or more for an appointment. After hours calls and problems were worse, Osborn says, with 40 percent saying that they could not receive care after hours on evenings or weekends without going to the emergency department of a hospital.
“A lot of primary care doctors don't have the capacity or arrangements for after-hours care,” Osborn says. “That’s a point worth stressing.”
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Osborn points out that in the Netherlands, primary care doctors are required by law to have an arrangement for after-hours care, and so there are after hours collectives, where they can go from 5 p.m. to 8 a.m. “They didn’t always see their own doctors, but the doctors they did see had access to their medical records, and they send notes to the patients’ doctors,” Osborn says.
Grumet says that physicians, as a group, could become more politically active, and he believes that many physicians try to address these problems with their own population of patients. “We can’t change the numbers of the overall population, but we can look after our patients the best that we can,” Grumet says. “But if you really want to compete with these other countries, we have to streamline our healthcare system and get the business interests out of medicine. I don’t see that happening anytime soon. I think it is a systemic problem.”