Big Doctoring in America: Profiles in Primary Care

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by Fitzhugh Mullan, MD; Photographs by John Moses
Review by Linn Getz, MD

Spring 2005 - Volume 9 Number 2

https://doi.org/10.7812/TPP/05-005

The title Big Doctoring in America provoked my curiosity, partly because I am situated in Iceland--the geological and cultural bridge between Europe and the USA and a place from where the condition of American medicine is followed with great interest. The US system is widely believed to be the best in the world despite consuming a higher portion of the national gross domestic product than in any other country and despite a World Health Organization report1 ranking it as only 37th among the health care systems of 191 countries. Gro Harlem Brundtland (WHO Director-General at the time) acknowledged that "there is wide variation in performance, even among countries with similar levels of income and health expenditure" and asserted that "[i]t is essential for decision-makers to understand the underlying reasons so that system performance, and hence the health of populations, can be improved."2