0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Brief Communications |

Support for Physician Deception of Insurance Companies among a Sample of Philadelphia Residents

G Caleb Alexander, MD; Rachel M. Werner, MD; Angela Fagerlin, PhD; and Peter A. Ubel, MD
[+] Article and Author Information

From the University of Pennsylvania, Philadelphia, Pennsylvania; and Veterans Affairs Ann Arbor Healthcare System and the University of Michigan, Ann Arbor, Michigan.


Acknowledgments: The authors thank Kristen Lindeen and Tara Mohr for their research assistance and John Lantos, Ashwini Sehgal, and Matthew Wynia for comments on previous drafts.

Grant Support: Dr. Ubel is a Robert Wood Johnson Foundation Generalist Physician Faculty Scholar, recipient of a Career Development Award in Health Services Research from the Department of Veterans Affairs, and recipient of a Presidential Early Career Award for Scientists and Engineers (PECASE).

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: G. Caleb Alexander, MD, Robert Wood Johnson Clinical Scholars Program, University of Chicago, 5841 South Maryland Avenue, MC 2007, Chicago, IL 60637; e-mail, calexand@medicine.bsd.uchicago.edu.

Current Author Addresses: Dr. Alexander: Robert Wood Johnson Clinical Scholars Program, University of Chicago, 5841 South Maryland Avenue, MC 2007, Chicago, IL 60637.

Dr. Werner: Division of General Internal Medicine, University of Pennsylvania, Blockley Hall, 12th Floor, 423 Guardian Drive, Philadelphia, PA 19104-6021.

Drs. Fagerlin and Ubel: Program for Improving Health Care Divisions, Ann Arbor Veterans Affairs Medical Center and University of Michigan, 300 North Ingalls Street, Room 7C27, Ann Arbor, MI 48109-0429.

Author Contributions: Conception and design: G.C. Alexander, R.M. Werner, P.A. Ubel.

Analysis and interpretation of the data: G.C. Alexander, R.M. Werner, A. Fagerlin.

Drafting of the article: G.C. Alexander, R.M. Werner, PA. Ubel.

Critical revision of the article for important intellectual content: G.C. Alexander, R.M. Werner, A. Fagerlin, P.A. Ubel.

Final approval of the article: G.C. Alexander, R.M. Werner, A. Fagerlin, P.A. Ubel.

Provision of study materials or patients: P.A. Ubel.

Statistical expertise: P.A. Ubel.

Obtaining of funding: P.A. Ubel.

Administrative, technical, or logistic support: P.A. Ubel.

Collection and assembly of data: P.A. Ubel.


Ann Intern Med. 2003;138(6):472-475. doi:10.7326/0003-4819-138-6-200303180-00011
Text Size: A A A

Background: Some physicians seem to be willing to sanction deception of insurance companies. Little is known about public attitudes regarding this practice.

Objective: To assess public attitudes regarding physician deception of insurance companies.

Design: Cross-sectional survey using clinical vignettes.

Setting: Philadelphia County Courthouse, Philadelphia, Pennsylvania.

Participants: Convenience sample of 700 prospective jurors.

Measurements: Participants were asked whether, in response to restriction of health care, a physician should 1) accept restriction, 2) appeal restriction, or 3) misrepresent a patient's condition to obtain the desired service. The proportion of respondents reporting that the physician should misrepresent a patient's condition was determined.

Results: 26% of respondents sanctioned deception, 70% supported appealing, and 4% supported accepting the insurance company decision. Among the 27% of respondents believing physicians have inadequate time to appeal coverage decisions, 50% sanctioned deception.

Conclusions: Sanctioning of deception was substantial in this sample of prospective jurors. Preferences regarding insurance company deception are related to perceptions of physician workload and may further pressure physicians struggling to balance advocacy with honesty.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Opinions about Doctors Deceiving Insurance Companies To Obtain Health Services for Their Patients

The summary below is from the full report titled “Support for Physician Deception of Insurance Companies among a Sample of Philadelphia Residents.” It is in the 18 March 2003 issue of Annals of Internal Medicine (volume 138, pages 472-475). The authors are GC Alexander, RM Werner, A Fagerlin, and PA Ubel.

Read More...

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)