America among lowest for primary care physician access among 11 wealthy nations

Nation last for long-term relationships between patients, PCPs, study says

A new study reports 89% of American adults had a regular doctor or place of care – the lowest percentage among 11 wealthy nations measured.

The study, “Primary Care in High-Income Countries: How the United States Compares,” by the Commonwealth Fund, measured the availability of primary care in the United States and 10 other countries.

In the United States, 89% of adults had a regular doctor or place of care. That ranked below leader Norway, where 100% of adults had a regular doctor or place of care, and behind the Netherlands, U.K., New Zealand, Germany, France, Australia, Switzerland and Canada.

Only Sweden ranked lower, at 87%, the study said.

Primary care providers (PCPs) serve as most people’s first point of contact for health care and can develop relationships with patients.

“But in the United States, decades of underinvestment and a low provider supply, among other problems, have limited access to effective primary care,” the study said.

Among possible solutions, the study suggested narrowing the U.S. wage gap between PCPs and specialist physicians, along with subsidizing medical school tuition, to incentivize medical students for primary care practice.

Expanding telehealth, continuity of care and communication between patients’ providers all were suggested as improvements for U.S. health care.

Other findings included:

  • The United States was last in the group with 43% of adults having longstanding relationships with PCPs, meaning five years or longer. The Netherlands and Germany tied for the top measure at 71% each.
  • The United States ranked lowest for access to home visits, with 37 percent of PCPs making home visits frequently or occasionally. Canada was second lowest at 70 percent, while the Netherlands topped the list at 100 percent and the U.K., Norway, Germany, France and Sweden all scored 95 percent or more.
  • The result may stem from low numbers of PCPs, along with lack of financial incentives, time and training, with possible safety and liability concerns, the study said.
  • American patients were least likely to visit a PCP after regular office hours, with 45% of those physicians reporting after-hours arrangements. Germany led that list at 96%.

The study by authors Molly FitzGerald, Munira Z. Gunja and Roosa Tikkanen examined results of 2019 and 2020 surveys of PCPs and adults.

In 2021, the Commonwealth Fund made national headlines with a study that found the United States spent more for health care than other high-income countries, but ranked last in access to care, administrative efficiency, equity and health care outcomes.

The New York-based foundation last year also published its scorecard outlining racial and ethnic disparities in health care around the 50 states.