(HealthDay News) — Compared with their international peers, physicians on the front lines of U.S. medicine feel they are not prepared to treat the sickest patients, according to the results of a survey published in Health Affairs.

The new survey collected data from more than 11 000 primary care physicians in Australia, Canada, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States. 

Nearly 1 in 4 U.S. primary care doctors said their practices are not well-prepared to care for patients with complex medical needs. In both Germany and the Netherlands, just 12% of primary care doctors reported that their practices were not well-prepared.

Only 1 in 3 U.S. doctors say they are always notified when a patient is discharged from the hospital or seen in the emergency department (ED). The Netherlands leads all nations on those measures, with 2 in 3 doctors saying they hear from the hospital or ED. 

In the Netherlands and Great Britain, more than 80% of doctors frequently make home care visits; in the United States, only 6% do so. 

Fewer than half of U.S. doctors feel prepared to manage patients with dementia (47%), those needing palliative care (41%), and patients needing home care (46%). 

Primary care doctors in the United States are least likely to feel the healthcare system works well, needing only minor changes.

Positive U.S. findings are related to uptake of electronic health records. Fifty-seven percent of U.S. primary care doctors said patients can communicate with them by email. Sixty percent — substantially more than in any other country — said patients can access their medical records electronically.


  1. Osborn R, Moulds D, Schneider EC, Doty MM, Squires D, Darnak DO. Primary Care Physicians In Ten Countries Report Challenges Caring For Patients With Complex Health Needs. Health Aff. 2015;34(12):2104-2112.