title: Support for physician deception of insurance companies among a sample of Philadelphia residents.
abstract: 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.
  
  
  METHODS
  Cross-sectional survey using clinical vignettes.
  
  
  METHODS
  Philadelphia County Courthouse, Philadelphia, Pennsylvania.
  
  
  METHODS
  Convenience sample of 700 prospective jurors.
  
  
  METHODS
  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.
authors.affiliation: University of Pennsylvania, Philadelphia, USA. calexand@medicine.bsd.uchicago.edu
authors.forename: G Caleb
authors.initials: GC
authors.lastname: Alexander
authors.forename: Rachel M
authors.initials: RM
authors.lastname: Werner
authors.forename: Angela
authors.initials: A
authors.lastname: Fagerlin
authors.forename: Peter A
authors.initials: PA
authors.lastname: Ubel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D008192:Deception; D006801:Humans; D007344:Insurance Claim Reporting; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D010414:Pennsylvania; D010820:Physicians; D028743:Professional Misconduct; D011639:Public Opinion