Ameen, I agree that the country with strong primary health care have less problem with patients go shopping around. Theoretically, the health record of patients who needs specialist will send back to the primary doctor, but it might not have enough information or it might be delayed for primary physician to follow up. I think the second important thing after promoted primary care physicians is a quality of health record and the health record from specialists should be sent right back with the patients.
As a medical teacher, I try hard to teach our medical students to become a general practitioner. But Thai people preferred specialists over the general practitioner so that why we have a few numbers of primary care physician even our health systems support the tier of hospital from primary to secondary to tertiary care hospitals.