Physician and Patient Satisfaction With Charity Care: The Case of Health Access Network in Utah

Abstract

In the United States, non-profit organizations and physician volunteerism play a significant role in providing health care to low-income, uninsured individuals. This deep-rooted tradition of charity care is consistent with the libertarian values that underlie the United States’ for-profit, capitalist health care system. Anthropological research is well-suited to study patient and physician perspectives on accessing health care in the United States within the context of charity care. This thesis examines physicians’ and patients’ experiences with charity care through the non-profit organization Health Access Network, which manages a volunteer provider network to offer specialty medical care to low-income, uninsured individuals in Adams County, Utah. Physician and patient satisfaction were explored at three levels of the charity care experience: at the individual level—within the clinical appointment itself, at the level of the organization—with Health Access Network, and at the systemic level—with the larger health care safety net in the United States. Results of this study suggest that most physicians and patients expressed overall satisfaction with their charity care experience at the first two levels: with the clinical appointment and with Health Access Network as an organization. However, both physicians and patients attributed most of their frustrations with the experience of providing or receiving charity care to failures of the health care safety net at the systemic level. Anthropological theoretical concepts are utilized to understand how both physician and patient agency to provide or access health care are constrained by structural obstacles within the health care system. Keywords: charity care; health care system; physician volunteerism; patient satisfaction; structural vulnerability; structural violence