The authors declare that they do not have any competing interests.
The observational study by Rosen and colleagues described the proportion and characteristics of individuals who do not visit their primary care physician regularly. Overall, they identify a very low rate of non-attendance, high rates of visit frequency, and describe predictors of non-attendance. In this study of 421,012 individuals, only 6,217 (or, 1.5% of the study population) did not visit their primary care physician over the four-year study period. Multivariate analysis showed that the strongest predictors of non-attendance were being male, being a new immigrant, and the presence of fewer chronic diseases. This study raises important questions about why patients seem to be so engaged with primary care in Israel, whether this engagement explains part of the Israeli health system’s success, and ways to best structure primary care services in the future.