Focus On: Physician Burnout

Focus On: Physician Burnout

Source:

The Physicians Foundation 2022 Physician Survey. https://physiciansfoundation.org/physician-and-patient-surveys/the-physicians-foundation-2022-physician-survey-part-1/. Published April 5, 2022. Accessed June 7, 2022.

Disclosures: Price is president and Seligson is CEO of The Physicians Foundation.
June 08, 2022
3 min read
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Challenges in addressing social drivers of health are increasing physician burnout

Source:

The Physicians Foundation 2022 Physician Survey. https://physiciansfoundation.org/physician-and-patient-surveys/the-physicians-foundation-2022-physician-survey-part-1/. Published April 5, 2022. Accessed June 7, 2022.

Disclosures: Price is president and Seligson is CEO of The Physicians Foundation.
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Addressing social drivers of health is a critical aspect of a primary care physician’s job, but it is also contributing to rising levels of burnout and “has a major impact” on physicians’ mental health, according to The Physicians Foundation.

The nonprofit organization recently conducted a survey of physicians in America to examine how social drivers of health (SDOH) affect them and their patients. SDOH can include factors like food and housing insecurity, transportation problems, difficulties with utilities and interpersonal safety, according to the survey report.

PC0622PhysiciansFoundation_Graphic_01_WEB
Data derived from: The Physicians Foundation 2022 Physician Survey. https://physiciansfoundation.org/physician-and-patient-surveys/the-physicians-foundation-2022-physician-survey-part-1/. Published April 5, 2022. Accessed June 7, 2022.

Physicians have long recognized that “the conditions in which people are born, grow, live, work and age have a major influence on patient health” and the cost of American health care, Gary Price, MD, president of The Physicians Foundation, and CEO Robert Seligson wrote in the introduction to the survey’s report.

Of the 1,502 physicians who were surveyed (33% PCPs), nearly all said that their patients’ health outcomes are affected by at least one SDOH, with 23% reporting that their entire patient population was affected. The top two SDOH were financial instability (34%) and transportation problems (24%).

Although most of the responding physicians agreed that addressing SDOH is important, 61% also said they do not have adequate time or ability to effectively address the issues.

More than 80% of those surveyed said that, along with limited time, “insufficient workforce to navigate patients to community SDOH resources” was the greatest challenge impacting their ability to address SDOH. In addition, 77% of physicians also reported inadequate access to community resources and information.

The surveyors noted that female physicians were significantly more likely to be impacted by the top challenges than male physicians. They additionally wrote that Asian physicians were more likely than white physicians to report limited time (92% vs. 88%), insufficient workforce (88% vs. 83%) and challenges in accessing community resources (83% vs. 76%). Hispanic physicians were also more likely to report challenges in accessing community resources (86%) and inadequate information about community resources (86%) when compared with their white colleagues.

Most physicians — 87% — agreed they want more time and ability in the future to address their patients’ SDOH. But nearly the same number — 83% — believe that addressing SDOH contributes to burnout rates.

Sixty-three percent of physicians said they often have feelings of burnout when trying to address their patients’ SDOH; 68% reported that managing their patients’ SDOH has a major impact on their mental health and well-being; and more than half said they experience stress or frustration on a daily or weekly basis because of SDOH challenges.

Although eight in 10 physicians believed that the U.S. cannot reduce health care costs or improve health outcomes without addressing SDOH, “our current health care system does not operate in a way that includes addressing them” the surveyors wrote.

These factors are becoming even more important, as SDOH drove 70% of health outcomes even before the COVID-19 pandemic, which 89% of physicians agreed is “likely to exacerbate social conditions that cause poor health.”

PCPs are now seeing these effects as the pandemic continues. Patients who are returning to primary care offices and hospitals are presenting with conditions that were worsened by lost jobs and the struggle to afford rent, food and more, Price and Seligson wrote.

The physicians who believed that the U.S. must address SDOH said that the following strategies will be important in supporting their efforts:

  • investing in the community’s capacity to address patients’ SDOH;
  • investing in the technological and human capacity to connect patients to community resources;
  • assessing patients to identify social needs;
  • significantly reducing administrative burdens such as payer reporting requirements to allow time to address SDOH; and
  • creating financial incentives for physicians to address SDOH.

According to The Physicians Foundation, “physicians are held responsible for patients’ health through quality measures and financial rewards or penalties that focus almost entirely on clinical care, not including SDOH.”

To change this norm, physicians said that payors need to be incentivized to invest in the availability and quality of community resources; Medicare Advantage needs more flexibility to reimburse for addressing SDOH; and SDOH needs to be integrated into payment policy.

“As we continue building broad-based understanding of SDOH and their implications for patients and physicians, it is critical that physician and patient voices remain central to the discourse and decision-making,” the report stated. “It is through addressing SDOH that we can improve patient outcomes for everyone and ensure that the physician workforce is well supported and financially recognized for its partnership with patients.”