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When the patient does not pay: a survey of primary care physicians
Journal article   Peer reviewed

When the patient does not pay: a survey of primary care physicians

Neil J Farber, Charles V Roche, 3rd, Brian M Aboff, Virginia U Collier and Joan Weiner
Medical care, v 48(6), pp 498-502
Jun 2010
DOI: https://doi.org/10.1097/MLR.0b013e3181dbe932
PMID: 20473194
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

United States - epidemiology Primary Health Care - statistics & numerical data Humans Middle Aged Refusal to Treat - ethics Male Uncompensated Care - statistics & numerical data Practice Patterns, Physicians' - ethics Practice Patterns, Physicians' - statistics & numerical data Refusal to Treat - statistics & numerical data Adult Fees, Medical - ethics Female Primary Health Care - ethics Family Practice - ethics Family Practice - statistics & numerical data Ethics, Medical Attitude of Health Personnel Cross-Sectional Studies Uncompensated Care - ethics Physician-Patient Relations Family Practice - economics Aged Fees, Medical - statistics & numerical data Uncompensated Care - economics Primary Health Care - economics Population Surveillance Quality of Health Care
Despite ethical implications, there are anecdotal reports of health practitioners withholding services from patients who do not pay their bills. We surveyed physicians about their attitudes and experiences regarding nonpaying patients. A cross-sectional mailed survey. Three hundred seventy-nine of 1000 surveyed primary care physicians participated. We studied how likely participants were to withhold 13 services from hypothetical patients who did not pay the physician's bills based on a 4-point Likert scale. Respondents were asked whether they had actually ever withheld such services from patients. The effects of demographic data on the number of services withheld from hypothetical and actual patients were analyzed by analysis of variance and multiple logistic regression. Most respondents (84%) would have withheld at least 1 item of service from the hypothetical patient, with 41% having ever withheld care from their actual patients. Most services involved administrative actions, but many respondents would be willing to forego other types of medical care. Being younger (P = 0.003), believing that patients are not always entitled to medical care (P = 0.002) and being in an urban practice (P = 0.03) were associated with withholding medical care from patients. A majority of primary care practitioners responding to our survey would be willing to withhold medical care from patients who do not pay their bills; some have actually done so despite ethical and legal mandates to the contrary. Physicians should be educated about the importance of the patient-physician relationship and their ethical obligations to patients.

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1 citations in Web of Science
2 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Health Care Sciences & Services
Health Policy & Services
Public, Environmental & Occupational Health
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