The practice of healthcare providers seeking binding arbitration agreements before agreeing to treat patients is becoming more widespread, according to a report in the Philadelphia Inquirer.

Nursing homes are ahead of most other providers in seeking signed arbitration clauses upon admission, a practice some consider controversial. But, the Inquirer reports, many acute-care providers, including ob-gyn specialists, have started to use the same tactic. Some deny service outright, and risking losing indignant patients, if an individual will not agree to seek binding arbitration instead of more common court options should a problem with treatment arise.

Doctors on the West Coast have led the acute-care push in asking for signed arbitration agreements, though the trend has started to grow among other providers across the country, according to legal experts cited in the Inquirer this week.

Proponents of the practice say it cuts through potential red tape and allows physicians to practice medicine without requesting as many costly, defensive tests or exorbitant insurance premiums, which can reduce the pool of available doctors in given areas. Opponents say the agreements favor the provider and do not allow for the creation of legal precedents.