A comparison of US and Canadian family physician attitudes toward their respective health-care systems.
OBJECTIVE
To examine how family physicians in the United States and Canada evaluate their respective health-care systems.


METHODS
The study design was a cross-sectional survey of 300 randomly selected US family physicians and 300 Canadian family physicians. Outcome measures included: attitudes about professional satisfaction and views on health-care delivery and government involvement in health care.


RESULTS
Sixty-one percent of the US sample and 67% of the Canadian sample responded. After performing factor and discriminant analyses, we were able to identify nine characteristics differentiating the two groups of physicians. United States physicians were more likely to be older, male, working in rural areas, conservative in their political thinking, and satisfied with their ability to obtain diagnostic tests. United States physicians viewed the health-care system as being in need of fundamental changes, less likely to advocate a central role for government, and more likely to report that litigation concerns influence their clinical decisions.


CONCLUSIONS
This study documents differences between Canadian and US family physicians, and suggests that US family physicians might not easily accept a Canadian-style health-care system. Policy makers implementing health-care system changes should be cognizant of the attitudes of physicians that might determine their acceptance or rejection of such changes.
Scanlan
A
A
School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA.
Zyzanski
S J
SJ
Flocke
S A
SA
Stange
K C
KC
Grava-Gubins
I
I
D000328:Adult; D001291:Attitude of Health Personnel; D002170:Canada; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000458:organization & administration*; D016002:Discriminant Analysis; D005163:Factor Analysis, Statistical; D005260:Female; D018166:Health Care Reform; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000458:organization & administration*; D010821:Physicians, Family / Q000523:psychology*; D018855:Single-Payer System; D011795:Surveys and Questionnaires; D014481:United States