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Wyoming Physicians Are Significant Providers of Safety Net Care

From the Rural Health Research Center, University of Washington

Correspondence: Corresponding author: Sharon Dobie, MCP, MD, University of Washington, Department of Family Medicine, Box 356390, Seattle, WA 98195-6390 (e-mail: dob{at}u.washington.edu)

Background: This study describes the contributions of family and general practice physicians from Wyoming to the health care safety net.

Methods: We surveyed family and general practice physicians in Wyoming about provider demographics, practice composition, and policies for treating the underinsured or uninsured. Two-tailed ² tests and limited logistic regressions were used to test for differences among characteristics of safety net providers.

Results: From a 50% response rate, 61% made less than the national mean family physician income ($130,000), and women are less likely than men to make this mean income, even when controlling for hours worked (OR, 0.09; CI, 0.009, 0.862). Close to two thirds claimed bad debt of over $10,000, and 29.3% noted forgiven debt of over $10,000. Physicians with less income than the prior year were more likely to decrease their charity care.

Conclusions: Wyoming family and general practice physicians provide significant amounts of informal safety net care, which is threatened by income loss. Thoughtful public policy is needed to ensure that vulnerable rural Americans have access to care that is not tied to the financial well being of their health care providers.