Abstract
Due to rapidly increasing costs in the US health care system, there is pressure on physicians at all levels to minimize the cost of treating patients. There is a risk that these pressures may lead to a reduction in the overall quality of care. This paper describes an investigation into the effects of resource pressure on physicians' perceptions of the level of care they are able to provide and their actual treatment decisions. The results generate questions that are critical to resolve for the future of the health care system. The first study demonstrated that correctional patients were provided less care than free patients across a range of treatments. These differences were magnified for treatments that require greater resources. The second study revealed that these differences may be linked to the pressure placed on physicians, especially in early residency, to conserve resources for patients that are seen as less likely to comply with the recommended regimen of care. There is also evidence that some explicit bias may be present.
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