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Physician patterns in the provision of health care to their own employees
R A Sansome1, L A Sansone, M W Wiederman
1Department of Psychiatry, University of Oklahoma, College of Medicine, Tulsa, USA.
Objective:
To determine the level of medical and mental health care that family physicians provide to employees.
Design:
Mailed survey.
Setting:
Family practices in Oklahoma.
Subjects:
Two hundred ninety-one of 735 physicians assessed via the membership roster of the Oklahoma Academy of Family Physicians.
Results:
The majority of physician respondents (55.6%) reported providing routine health care always or most of the time to employees. Rural practice sites were associated with the provision of broader medical services (Spearman's p = -.35, P < .00001); 51.7% of respondents reported providing routine health care always or most of the time to employees' families. Breast and genital examinations were more likely to be undertaken in family members (67.2%) compared with employees (50.0%). Only a minority of physician respondents (12.3%) reported providing mental health care always or most of the time to employees; 53% never or rarely provided this service. When mental health care was addressed, respondents provided counseling alone (28.6%), prescription of psychotropic medication alone (8.8%), or both (62.7%). Antidepressants (50.7%) and nonbenzodiazepine anxiolytic agents (36.2%) were most frequently prescribed. When asked about ideal conditions, a significant minority of physician respondents (41.3%) preferred to refer employees to colleagues for medical care, and 59.8% preferred to refer for mental health care.
Conclusion:
The majority of family physicians in this study reported providing medical care to their employees, whereas only a minority provide mental health care.