Even in good times, primary-care physicians dedicate a certain percentage of their practice to caring for patients unable to pay their bills. So we wondered what will happen to such care as the recession broadens and deepens. Our current poll question has generated some interesting commentary. After you read what your colleagues have to say below, leave your own thoughts in our comment box.


“As our long-time patients go through hard times, we are going to figure out ways to help them through an empowerment approach. We may give samples of one product if they agree to a cheaper generic on something else. This engages them in the solution to their problems and they go out thinking they can make it. The key is to get them involved in steps that remove their powerlessness over the situation. In the long run, this builds long-lasting relationships with our patients.”

 

--Eric G. Johnson, MD, Rock Hill, SC

 

 

 

“As a rural physician, I have a fair number of patients without insurance. And they are not just patients—they are my neighbors, people I see in town every day, at church on Sunday, waving to me from their tractor. We don't see it as ‘charity' when times are tough. We are just taking care of each other.”

 

--Paul G. Wilhelm, MD, Kiowa, Kan.

 

 

“As a family medicine physician in Michigan, a state severely impacted by the recession, it is difficult not to increase charity care. Long-term patients have lost jobs and lost insurance coverage. We are trying to help by reducing fees, working out payment plans, scouring the Internet for prescription aid programs (such as www.needymeds.com) and converting patients to lower-cost medications that are affordable. (For instance, some statin is better than no statin.) I am grateful for the large $4 formularies at Target, Walmart, and Kroger.”

 

--Nancy J. Rancour, DO, Livonia, Mich.

 

 

“I have more patients coming in without insurance, so I discount the cost of an office visit. I entered the medical field to care for patients, not to become a millionaire. These are also people who have always paid their bills—now I can return the favor.”

 

--Robert J. Sikorski, DO, Westland, Mich.

 

 

“I've already increased my charity care, trying to bridge people for the next six to 12 months until they are re-employed. We can all get through this together!”

 

--Michael J. Fremgen, MD, Geneva, Ill.