According to the Physicians Foundation's survey of American physicians, 8 in 10 physicians believe that the United States cannot improve health outcomes or reduce health care costs without addressing the social determinants that affect patient health (SDOH, for its acronym in English). Additionally, although they are interested in addressing social determinants of health for patients, 61% of the 1,502 physicians surveyed said they do not have the time or ability to do so effectively. The survey, from February 2022, examined the current impact of SDOH on medical practice, well-being in their patients, as well as potential solutions needed to address social determinants.
“Over the course of the COVID-19 pandemic, there is no doubt that all doctors and patients have been affected, some worse than others. Part of what drives the magnitude of that impact is SDOH,” said Physicians Foundation CEO Robert Seligson. “The desire of physicians to adequately address SDOH is there. “We need to take the initiative to make changes, such as assessing patients to identify their social needs and creating financial incentives to help health promoters address the unique needs of their patients.”
Social determinants of health include factors such as socioeconomic status, education, community and physical environment, employment, nutrition and food security, access to health care, and social support networks. .
The survey highlighted the frustration resulting from not being able to address SDOH for their patients. “[It] is not for lack of try or effort: physicians face many barriers when addressing SDOH,” the Physicians Foundation report said. For example, along with limited time, 84% of physicians said they do not have a sufficient workforce to get patients to community SDOH resources. Similarly, although there are some useful resources for navigating SDOH factors, 77% of physicians reported that community resources were unavailable, inadequate, or difficult to access, and 77% said there is no adequate information about how to access community resources.
The impact of SDOH challenges is very real, and not just for patients. More than half of physicians reported that challenges cause them stress on a daily or weekly basis. They cited factors such as existing payer reporting requirements that take away time from discussing patients' SDOH (63%) and lack of reimbursement for detecting or addressing SDOH (57%).
To make it easier for clinicians to address SDOH, the survey identified multiple policy steps that could improve patient health outcomes while ensuring high-quality, cost-effective care. The top strategies were to reimburse physician-led efforts to address SDOH (86%), incentivize payers to invest in the availability and quality of community resources to address patient SDOH (84%), and provide greater flexibility for Medicare Advantage reimburses for addressing SDOH (81%).
“In 2021, The Physicians Foundation submitted the first SDOH measures to the Centers for Medicare and Medicaid Services (CMS), which are currently being considered for inclusion in federal payment programs,” Seligson said in the press release. . “If adopted, these measures could potentially impact reimbursement for physicians, as well as address SDOH in the way our country pays for and delivers care to improve patient health.”
Psychiatric Times Vol 39
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