Editor's note: This story was updated on June 13, 2018.
Doctors generally acknowledge that social determinants of health affect their patients—but an overwhelming majority of doctors say it is not their responsibility to address them, according to a recent white paper by Leavitt Partners.
For the paper, Leavitt Partners surveyed physicians between June 2017 and July 2017 to:
In total, 621 physicians responded to the survey. The sample population included
According to the paper, a majority of respondents said their patients would benefit from assistance with social determinants of health. In particular, researchers found:
However, few respondents considered addressing social determinants of health to be their responsibility, with:
According to the paper, respondents frequently said patients have other resources available to address their social needs. For example, more than 30% of respondents said there are resources for patients to get sufficient food.
Moreover, several respondents said their ability to address specific social determinants of health was limited. For instance, 48% of respondents said helping their patients get affordable housing was not within the capabilities of their physician offices. In addition, respondents said patient appointments are not long enough to address social needs and insurers do not compensate for such services.
According to the researchers, success in value-based payment models will increasingly require that patients' nonclinical needs are addressed. To facilitate the incorporation of social determinants of health into the clinical setting, the researchers said:
By Tomi Ogundimu, Practice Manager, Population Health Advisor, and Darby Sullivan, Analyst, Population Health Advisor
The headline data points in this survey—including that more than 80% of physicians don't consider tackling major social determinants of health to be part of their job—certainly sound alarming. The good news, though, is that the results aren't quite as worrying as they seem.
First of all, physicians are rarely in charge of their organization's community resource connection effort, especially if they are non-primary care physicians (who made up 65% of the study's respondents). While all health care staff, including physicians, should be conscious of the impact of the social determinants of health, the primary responsibility for addressing social needs is often held by non-physician staff who are involved in discharge planning, transition support, and ongoing care management. The RN care managers, social workers, community health workers, and others who typically own this task can tap into their relevant expertise and thereby help physicians focus their limited time on clinical care.
Still, it's concerning that many physicians don't realize that members of their care team should help in meeting non-clinical needs at all. This misconception can be especially worrisome coming from primary care physicians, whose teams are most suited to helping patients address the social determinants that impact their health. Our research shows that innovative community partnerships to address non-clinical factors work best when they're championed by engaged, respected clinical leaders—who helps obtain leadership buy-in and cascade culture change across their teams.
Population and community health leadership should therefore make sure that physicians are aware of the impact of social determinants and engage them in the cause. Need help knowing where to focus your efforts? Use Population Health Advisor's toolkit to build your strategic plan for non-clinical resources.
Employed medical groups must strengthen Medicaid patient access to physician services. This briefing summarizes the medical group’s three discrete—though not mutually exclusive—options for doing so.
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