Primary Medical Practice in the United Kingdom and the United States

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Abstract
Comparisons between the United Kingdom and the United States reveal definite differences in the style and content of primary medical practice. In the United States emphasis is on diagnosis. In the United Kingdom emphasis is on continuity and homebased care supported by a nationwide network of paramedical and social services. In both countries more is known about what discontents physicians than what satisfies patients. Medical practice and physician-patient relations are profoundly affected by external factors, including social attitudes, privileges, tradition, personal expectations and, above all, economics. The American medical profession is the more exposed to external criticism, and future conflict and preoccupation with survival is largely an American phenomenon. Little is known in either country about the long-term outcome of different forms of medical care. In Britain patients appear to value kindness above applied medical technology. (N Engl J Med 297:188–193, 1977)