title: Wyoming physicians are significant providers of safety net care.
abstract: BACKGROUND
  This study describes the contributions of family and general practice physicians from Wyoming to the health care safety net.
  
  
  METHODS
  We surveyed family and general practice physicians in Wyoming about provider demographics, practice composition, and policies for treating the underinsured or uninsured. Two-tailed chi(2) tests and limited logistic regressions were used to test for differences among characteristics of safety net providers.
  
  
  RESULTS
  From a 50% response rate, 61% made less than the national mean family physician income (USD$130,000), and women are less likely than men to make this mean income, even when controlling for hours worked (OR, 0.09; CI, 0.009, 0.862). Close to two thirds claimed bad debt of over USD $10,000, and 29.3% noted forgiven debt of over USD $10,000. Physicians with less income than the prior year were more likely to decrease their charity care.
  
  
  CONCLUSIONS
  Wyoming family and general practice physicians provide significant amounts of informal safety net care, which is threatened by income loss. Thoughtful public policy is needed to ensure that vulnerable rural Americans have access to care that is not tied to the financial well being of their health care providers.
authors.affiliation: Rural Health Research Center, Department of Family Medicine, University of Washington, Box 356390, Seattle, WA 98195-6390, USA. dob@u.washington.edu
authors.forename: Sharon A
authors.initials: SA
authors.lastname: Dobie
authors.forename: Amy
authors.initials: A
authors.lastname: Hagopian
authors.forename: Beth A
authors.initials: BA
authors.lastname: Kirlin
authors.forename: L Gary
authors.initials: LG
authors.lastname: Hart
mesh_terms: D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D017057:Medically Uninsured; D008875:Middle Aged; D016134:Organizational Policy; D010820:Physicians / Q000191:economics*; D016079:Refusal to Treat; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D017664:Uncompensated Care / Q000191:economics*; D014959:Wyoming