Wyoming physicians are significant providers of safety net care

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. ( J Am Board Fam Pract 2005;18:470 –7.)