• G J Hayes, S C Hayes, and T Dykstra.
• Department of Health Sciences, University of Nevada, Reno 89557.
• Am J Public Health. 1993 Nov 1; 83 (11): 1544-8.

ObjectivesThe aim of this study was to examine the US and Canadian systems from the unique perspective of physicians who have practiced in both Canada and the United States.MethodsQuestionnaires were sent to 355 Canadian physicians who graduated from US medical schools and 347 US physicians who graduated from Canadian medical schools.ResultsThe overall response rate was 59% (65% of US-graduated Canadian physicians and 54% of Canadian-graduated US physicians). Thirty-six percent of the respondents were "dual experience" physicians; that is, they had practiced medicine in both countries after completing their medical training. Physicians who left Canada were more likely than those who left the United States to indicate dissatisfaction with the health care system as a reason for leaving. Respondents expressed greater professional satisfaction with their current country of practice, but overall, dual-experience physicians in the United States favored that system only slightly more than the Canadian system, whereas those in Canada rated the Canadian system significantly better than the US system.ConclusionsThe comparatively weak rating of the US system by dual-experience physicians underlines the need for health care reform.

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