By Christopher Cheney
Physicians view social drivers of health (SDOH) as critically important in the health of their patients and they want to do more to help address SDOH, a new survey report has found.
SDOH such as food insecurity, housing instability, and transportation problems can have a pivotal impact on health outcomes, with a far greater effect than clinical care alone. “Physicians know that reducing total cost of care and achieving health equity are only achievable by addressing SDOH. Despite the well-documented impact of SDOH on health outcomes and costs of care, our current healthcare system does not operate in a way that includes addressing them,” the new survey report says.
The survey was conducted by The Physician Foundation from Feb. 2 to Feb. 11. Data was collected from more than 1,500 physicians. One-third of the physicians who responded to the survey practice primary care, which was defined as family medicine, general practice, internal medicine, or pediatrics. The remaining survey respondents practice in one of two dozen specialties.
The survey report includes several key data points:
- 99% of physicians reported that at least one SDOH affected the health outcomes of all or some their patients
- Financial instability (34% of patients) and transportation problems (24% of patients) were the top two SDOH experienced by physicians’ patients
- 61% of physicians reported having insufficient time and ability to affect the SDOH of their patients
- 87% of physicians reported wanting more time and ability to affect the SDOH of their patients
- Physicians reported that the top three reported obstacles to addressing their patients’ SDOH were limited time during patient visits (89% of physicians), inadequate staff to connect patients with community resources (84%), and the lack of community resources or difficulty of accessing community resources (77%)
- 83% of physicians reported that addressing the SDOH of patients contributes to physician burnout
- 68% of physicians reported that addressing the SDOH of patients has a major effect on physician mental health and well-being
- 80% of physicians reported that addressing SDOH is essential to improve health outcomes and decrease healthcare costs
Interpreting the data
Physicians are willing to do more to address the SDOH of their patients, Gary Price, MD, president of The Physicians Foundation, told HealthLeaders. “It’s clear physicians recognize how critical it is for our patients and our country’s healthcare system to address SDOH—and they are very much eager to play a more proactive role in this work. In fact, our survey found that nearly nine in 10 physicians (87%) indicated that they would like greater time and ability to effectively address their patients’ SDOH in the future.”
Physicians have a key role to play but they need partners to address the SDOH of their patients, he said.
“We physicians know that reducing total cost of care and achieving health equity are only achievable by addressing the SDOH. We must remain central to this discourse and decision-making as we’re closest to these issues and our perspectives are critical to improving patient outcomes. But we cannot do it alone. Addressing SDOH requires a holistic approach, including comprehensive coordination among individual physicians, medical societies, health systems, social service systems, and policymakers. A Physicians Foundation grant partner, Health Leads, is a great example of cross-sector community collaboration to enact systemic change in integrating SDOH in healthcare delivery,” Price said.
The link between physicians working on SDOH and physician burnout is concerning and should be addressed, he said.
“Physician burnout is a complex challenge and according to physicians surveyed, multiple factors contribute to physician burnout rates—from administrative burdens to prior authorization requirements. However, eight in 10 physicians (83%) reported challenges in addressing patients’ SDOH contribute to physician burnout rates. Additionally, six in 10 physicians (68%) believe managing patients’ SDOH has a major impact on physician mental health and well-being. Much of this is due to lack of resources. More than half of physicians reported experiencing stress or frustration on a daily or weekly basis because of limited time during patient visits to discuss SDOH, insufficient workforce to navigate patients to community resources to address SDOH, existing payer reporting requirements taking time away from being able to address patients’ SDOH, lack of reimbursement for screening for or addressing SDOH, and community resources unavailable, inadequate or difficult to access,” Price said.
There are several changes that can be made to support physicians in their efforts to address the SDOH of their patients, he said. “In our survey, multiple SDOH policy steps were identified by physicians as important to improve health outcomes and ensure high-quality, cost-efficient care for all. These steps included reimbursing physician-directed efforts to address SDOH, incentivizing payers to invest in availability and quality of community resources to address patients’ SDOH, providing greater flexibility for Medicare Advantage to reimburse for addressing SDOH, and integrating SDOH into payment policy.”
Christopher Cheney is the senior clinical care editor at HealthLeaders.