Physicians say social determinants of health are not their responsibility

Physicians know behavior, physical environment, social context and economic factors play a major role in patient health, but many physicians say they are neither capable of nor responsible for addressing these issues.

Salt Lake City-based healthcare intelligence firm Leavitt Partners polled 621 physicians between June 2017 and July 2017 to better understand their attitudes toward social determinants of health.

Most physicians agreed patients could use help managing various social determinants of health. In particular, 75 percent of respondents said patients would benefit from assistance finding information about costs of care and insurance, 66 percent said patients would benefit from assistance arranging transportation, and 54 percent felt increased income would change patients' health. Fewer physicians felt their patients needed assistance with food access (48 percent) and affordable housing (45 percent).

However, physicians generally do not believe providing this assistance is their responsibility. For example, 69 percent said it was not the responsibility of the physician or the insurer to provide transportation assistance, and 91 percent said it was not their responsibility to help patients find affordable housing.

Physicians who felt they should help address these issues said they probably weren't in a position to do anything. For example, 48 percent said physician offices were not capable of helping patients find affordable housing. Other issues cited included lack of compensation for providing assistance and lack of time during the appointment.

The survey findings indicate the fee-for-service model, which incentivizes physicians to treat sicker patients and keep appointments quick, is still a significant constraint to addressing social determinants of health. Yet physicians in value-based care models have also been unable to address patients' social determinants of health in a meaningful way. Considering physicians' existing administrative burden, efforts to address social determinants of health should incorporate a range of clinicians, community health workers and even employers, Leavitt Partners suggests.


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