Doctors team up to offset drop in free care

More physicians are turning to organized programs as a way to provide charity care to the needy.

By Damon Adams, AMNews staff. Sept. 17, 2001.

A new study by the Center for Studying Health System Change shows that the number of doctors doing charity care dropped 4% from 1997 to 1999.

Center analysts warn the decrease could mean trouble for the poor if the number of uninsured continues to rise while growth in physician supply slows to a crawl.

"If there's an increase in need, at the same time [the number of] doctors isn't growing, then it will make it more difficult for the uninsured or the poor to find care," said Marie C. Reed, lead author of the study and health research analyst for the center.

The study, released in late August, said the decrease from 76% to 72% may be related to changes in the medical marketplace during the 1990s, including an increase in managed care and a shift away from physician ownership of practices.

Three likely reasons for the drop:

• More physicians are employees of medical practices and are less likely to provide charity care.
• The financial strain from lower payment rates may lessen a doctor's willingness to treat patients for free.
• Administrative burdens leave less time for charity.

But many medical organizations encourage charity care.

"Our ethics manual says everyone should do their fair share to care for the uninsured," said Lois Snyder, director of the Center for Ethics and Professionalism of the American College of Physicians--American Society of Internal Medicine.

"We do believe historically that this has been the physician's responsibility," said Richard F. Corlin, MD, AMA president and a gastroenterologist in Santa Monica, Calif., whose practice does some charity care. [...]