Reasonable Choice

The American Academy of Family Physicians (AAFP) supports physicians and patients in making personal choices regarding their participation in the healthcare system as a fundamental principle.


Patients should have reasonable freedom to select their physicians and healthcare delivery system. Importantly, whenever making a choice, one must be well-informed on the options available and possible effects of, and responsibilities involved with, each option. To this end, all medical and pharmacy plans should, to the fullest extent possible, provide transparency regarding:

  • coverage;
  • network, including credentials and quality of care of participating providers;
  • restrictions on patient access to services or goods; and
  • price and patients’ financial responsibility (including premium, deductible, and copayments)

Special circumstances may render limitations on choice; however, such circumstances should be clearly explained and free from coercion (e.g., free clinics, Medicaid service limitations, drug formularies, etc.).


Physicians should have reasonable freedom in the context of patient values, evidence-based care, quality, and value options, to determine where and how to provide ethical medical care. Similarly, physicians should be free to determine, assess, and collect reasonable and appropriate fees for their services. In making such determinations, physicians should be mindful of the ethical precepts of the profession and individual circumstances of their patients. In some instances, physicians may opt to provide charity or courtesy care.

Public Policy

The AAFP notes that although it is proven that a strong primary care-based health system yields both better outcomes and lower cost, the current U.S. healthcare system has serious obstacles to changing to a strong primary-care based system. A variety of public policy incentives should be developed to strengthen primary care’s long-term viability. Such incentives should be adequate to create reasonable freedom of choice for those entering medical careers. In addition, all insurance networks should actively recruit most of the local family physicians in any given community to preserve and protect ongoing patient-physician relationships and reasonable access to primary care services. Further, insurance networks should not restrict or limit, on an arbitrary basis, family physicians from applying to or participating in any health care plan, nor limit services offered by family physicians. (1985) (2014 COD)