Diagnostic scope of and exposure to primary care physicians in Australia, New Zealand, and the United States: cross sectional analysis of results from three national surveys

It is good to see that the authors have chosen to study the most
important and most accessible level of health services across the globe
ie, primary health care services. But it was disappointing to see that the
authors have left some important issues unaddressed. These issues are
important determinants of health care provided to people.

1. Primary Health Care infrastructure : Any study on Primary Health
Care is incomplete without studying the infrastructure, which is an
important determinant of the quality of health care provided.

2. Quality of Care : The numbers depicted in the results indicate
that the health care services have been accessed and that the pattern is
similar. But it is well known that differences in financing of the
Primary Health Care affects the quality of care provided. If the quality
is poor, then numbers become irrelevant.

3. Patient satisfaction : Should have been studied for the reasons
quoted above. Ultimately if the patients are not satisfied, Primary Health
Care makes little sense.

4. Doctors satisfaction : As the service conditions of the doctors at
the primary care level is not very encouraging compared to the corporate
hospitals, it is an important issue that has been missed out by the
authors.

Competing interests:
As an Epidemiologist and Primary care physician I am involved in provision of Primary health care services in rural India