"The American College of Physicians has a long-standing commitment to improving health care in the U.S.," said J. Fred Ralston, MD, FACP, chair of ACP's Health and Public Policy Committee, and an author of the paper. "A recent survey by the Commonwealth Fund of adults in seven industrialized nations indicates that Americans share ACP's view that the U.S. health care system is inefficient and could be greatly improved by providing access for all Americans to a primary care physician for continuous, comprehensive, coordinated care."

The Commonwealth Fund survey found that U.S. patients are more likely to report experiencing medical errors, go without care because of costs, and say that the health care system needs to be rebuilt completely. As medical care becomes more specialized and complex, adults in all seven countries said they place high value on having a relationship with a primary care or personal physician who is accessible and coordinates their care.

Patients with this model of care - a patient-centered medical home, which ACP proposes - reported significantly more positive experiences, including having more time with their doctors, more involvement in care decisions, and better coordination with specialists and hospitals. They were also much less likely to report medical errors, receiving conflicting information from different doctors or to encounter coordination problems, such as diagnostic tests or medical records not being available at the time of care and duplicate tests.

In an accompanying editorial, Harold C. Sox, MD, MACP, editor of Annals of Internal Medicine, notes that the paper "recommends that the country seriously consider a single payer system as one way to provider universal access to health care. Countries have achieved universal access with pluralistic systems, not unlike our own. Both can achieve the greater end that should be our highest priority: equal access to basic health care for every citizen."

"Achieving a High Performance Health Care System with Universal Access: What the USA Can Learn from Other Countries" and the editorial will be published on the Annals of Internal Medicine Web site (www.annals.org) on Dec. 4, 2007, and will appear in the print edition of the journal beginning on January 1, 2008.

The American College of Physicians (www.acponline.org) is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 124,000 internal medicine physicians (internists), related subspecialists, and medical students. Internists specialize in the prevention, detection, and treatment of illness in adults.

Published by ACP, Annals of Internal Medicine is one of the most widely cited peer-reviewed medical journals in the world. The journal has been published for 80 years and accepts only seven percent of the original research studies submitted for publication.

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