Family physician Risheet Patel, M.D., said a lack of emphasis on primary care is one of the key reasons the US spends more on health care than other high-income countries but has the widest gaps in care quality. “If we want to change the direction of our health care system, we need to put more emphasis on primary care along with screening and prevention as opposed to costly testing and treatments,” said Patel, who leads a direct primary care practice in Indiana.