Most Physicians Lack Ability, Time to Properly Address Patient SDOH

Although the majority of physicians recognize the role social determinants of health (SDOH) play in patient outcomes, many physicians do not have the time or resources needed to navigate patient SDOH, according to a survey by the Physicians Foundation.

Part one of the 2022 Survey of America’s Physicians reached over 1,500 physicians, focusing on the impact SDOH had on patients and physicians.

Barriers in addressing patient SDOH are not the result of minimal effort but rather are caused by several barriers hindering their capabilities. Challenges such as limited time during patient visits and insufficient workforce to navigate patients to community resources were cited as the most significant barriers by over 80 percent of physicians.

"Even before the pandemic, physicians knew that SDOH has a profound impact on not only the health of our patients but on the cost of care and our ability to advance health equity," Gary Price, MD, president of The Physicians Foundation, said in a public statement.

"Nearly ninety percent of physicians indicated that they would like a greater ability to effectively address their patients' SDOH in the future. To make this a reality, we need to institute change to lift the barriers that prevent physicians from addressing their patients' SDOH and contribute to physician burnout and build a broad-based understanding of the SDOH and their implications for patients and physicians."

Granted, community resources are available to assist physicians and patients with navigating SDOH, but 77 percent of physicians state that there is inadequate access to community resources and little information on how to access them.

"It is no surprise that this data has revealed that the majority of physicians want more time and greater ability in the future to effectively address their patients' SDOH,” Robert Seligson, CEO of The Physicians Foundation, said in the press release.

“However, even with this desire many still feel they cannot adequately do this due to lack of available resources, time, and capacity," added Seligson.

Almost all physician respondents indicated that SDOH impact their patient health outcomes, with financial instability and transportation being the top barrier for patients.

Six in ten physicians agreed that managing patient SDOH has a major impact on patient health and healthcare cost. Meanwhile, more than 60 percent agree addressing SDOH negatively impacts physician mental health and wellbeing.

Trying to navigate patient SDOH without access to resources contributes to the growing list of barriers for many physicians. Physician burnout has been an issue prior to the pandemic, but COVID-19 has worsened the situation; 8 in 8 surveyed physicians believe addressing SDOH contributes to burnout.

“It is imperative that physicians be equipped with the proper resources to address their patients' needs, which we know are impacted by SDOH,” noted Price. “As the data shows, when physicians cannot access resources to adequately address these challenges, it leaves room for feelings of hopelessness, stress, and burnout.”

Physicians need better support to address patient SDOH, the Physicians Foundation stated.

When asked about the top SDOH interventions needed to support physicians, the respondents identified community resource investment, better access to community resources, SDOH screening, financial incentives, and reducing administrative burdens as essential.

In addition, many physicians agreed that multiple policy steps are essential to improve health outcomes and ensure high-quality, cost-effective care.

Physicians believe policy solutions such as reimbursements for efforts to address SDOH, payer incentives to invest in availability and quality of community resources to address patients SDOH, and greater flexibility for Medicare Advantage to reimburse for managing SDOH are necessary next steps.

Patient navigators and social workers could be the added support needed to ensure SDOH are being addressed but not added to physician burden.

Clinics may consider having a licensed social worker or community health worker to facilitate social services referrals and patient navigation, as well as a dedicated staff member for entering SDOH data into the EHR.

With this assistance, the clinic team was able to successfully connect many of these patients with food and housing support.