An item in "For the Record" (March 29, p. 14) cites a study that showed physicians who were involved in managed care and practiced in areas of high managed-care penetration provided less charity care. I take exception to the use of the term charity care, which suggests that physicians provide care without charging for it.
In fee-for-service offices, charges for such care are distributed among the paying patients. If physicians see mainly HMO enrollees, the treatment of indigent patients actually cuts into their profits, making it truly charity care. This is not a popular activity.
Data outcomes manager
Kaleida Health/Children's Hospital