Physician patterns in the provision of health care to their own employees
R. A. Sansome, L. A. Sansone and M. W. Wiederman
Department 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.
