American doctors, short of time and squeezed by hard-bargaining health plans, are less likely to see patients who can’t pay than they were a decade ago, according to a study released last week.

A survey by the national Center for Studying Health System Change found that about two-thirds of U.S. doctors provided “charity care” – down from three-fourths in 1996.

The trend is alarming, the study authors said, because it comes as the number of uninsured or underinsured Americans is on the rise. The study also found that charity care received by people without insurance declined by nearly one-fifth during the decade.

The decrease in charity care – service offered free or at reduced rates – was seen across all regions and specialties, the study said.