In conclusion, there are big differences in U.S. and U.K. rheumatology, with each having its own strengths and weaknesses. With commissioning of services and increasing involvement of private providers, the U.K. system may be moving more toward a U.S. style of healthcare. Ironically, with the passage of the Affordable Care Act, President Obama seems keen to move the U.S. system more toward an NHS system. Perhaps the best healthcare system lies somewhere in between!
Dr. Deighton is president of the British Society for Rheumatology and a consultant rheumatologist at Royal Derby Hospital, U.K.
