Or that the big example with which they conclude the story is about a patient who went to the E.R. to get cysts treated on her ears because if she just showed up at her family doctor’s office he wouldn’t have put her treatment ahead of all of his patients with appointments. Something that has nothing to do with a shortage of primary care physicians.

The root of the “primary care physician” shortage in the U.S. and Canada seems to emerge in no small part from the trend toward specialization and subspecialization – which in most fields of medicine seems to be the path to higher income and greater prestige.

It isn’t. Thanks for a balanced view. No country in the world has a system working perfectly, and people who point to weaknesses elsewhere while saying ‘there is nothing there that we can use here’ are being really disingenous.

The problem about generalists that you point out is common in most systems. I think it has to do not only with the larger health care bureaucracy in all these countries but also with the way medicine itself is changing from within, as well as remuneration issues. In the US, another important factor is litigation.