Private physicians and the provision of contraceptives to adolescents.

Abstract

Data from a national sample of private physicians show that 86 percent of obstetrician-gynecologists, general practitioners and pediatricians are willing to prescribe contraceptive methods to adolescent women. However, only 59 percent are willing to serve unmarried minors without parental consent. The obstetrician-gynecologists are more likely to provide contraceptives than the other two specialists, and are likely to have fewer policy restrictions. Although pediatricians are the least willing to prescribe contraceptives (only 32 percent say they would do so for a 15-year-old patient), they are the most likely to refer such patients to other sources of care (61 percent of those who will not provide primary contraceptive care do so). The parental consent requirements that physicians set for contraceptive services are somewhat related to state policies. Seventy-five percent of physicians who provide contraceptive care for adolescents and who practice in states that clearly authorize minors to give their own consent for family planning services will serve unmarried minors on their own consent, compared with 62 percent in states without explicit minor consent laws. Physicians practicing in the Southwest are the most likely to provide contraceptive services to unmarried patients younger than 18, while those in the North are least likely to do so (88 and 67 percent, respectively). Ninety percent of private physicians who prescribe contraceptives for adolescent women will prescribe the pill, but smaller proportions will make the diaphragm or IUD available (61 and 23 percent, respectively). Among the physicians surveyed, the average fee that an adolescent would have to pay for an initial contraceptive visit, including laboratory tests, is $37. Of those who accept teenage contraceptive patients, only 53 percent will accept Medicaid reimbursement and only one percent indicate that they will instead provide free services to adolescents who cannot afford to pay the fee.