Physicians Foundation builds on efforts to address health equity

Many doctors are frustrated with the short amount of time they have to spend with patients, and some physicians say that has an impact on assessing factors that could be affecting their health.

Gary Price, president of the Physicians Foundation, talks about the importance of assessing the social drivers of health affecting patients. (Photo: Physicians Foundation)

Hospitals and medical groups are paying greater attention to assessing the social determinants of health, such as food or housing insecurity, that can contribute to health complications and diseases. Six out of 10 doctors (61%) said they have little or no time to address the social determinants of health, according to a 2022 survey by the Physicians Foundation.

Doctors are spending much of their time on getting approvals for medication plans or treatments, siphoning their time with patients, says Gary Price, president of the Physicians Foundation.

“We have this conundrum with physicians, frustrated by their inability to address their patients’ drivers of health,” Price tells Chief Healthcare Executive®.

In a recent interview, Price talked about the foundation's efforts to help doctors address the social drivers of health, key elements on improving health equity and why he’s optimistic about the prospects of closing disparities.

• Read more: Health equity can’t be a ‘side hustle’

‘Let's take five’

The Physicians Foundation has recently launched a campaign to address the challenge, called, “Let’s Take Five to Address the Drivers of Health.” The campaign offers resources for physicians to start conversations with patients and to integrate patient screenings into the practices’ workflow.

The conversation starter can offer guidance to physicians who are struggling to initiate conversations about social determinants. Price said the tool offers “some helpful tips for practices and their staff to begin those conversations so that they do take place in a respectful, meaningful way.”

Some of the suggestions stress the importance of building rapport with patients by maintaining eye-contact and avoiding standing over the patient. In addition, physicians can also offer encouragement and comfort to patients who may be struggling, such as acknowledging their resourcefulness and strength in facing adversity.

• Read more: Making health equity sustainable: Helping patients and the bottom line

In addition to assessing social determinants, doctors also need to guide patients into getting assistance, including pointing them to agencies that could help with housing needs, utility bills, or domestic abuse.

“The last step and probably the most important one is being able to offer an immediate step to begin to address that problem,” Price says.

Some patients can be reluctant to talk about their struggles to pay rent or buy groceries, but Price says many patients appreciate the chance to discuss their problems with providers.

“It turns out that the majority of patients fully support being asked about them,” Price says.

Health systems and physicians should be especially mindful of the social determinants of health affecting children and get them assistance.

“I suspect that the impact of drivers of health are even more profound on children, because in the case of children, you're not only affecting their health at that point in time, but you're impacting their development and health habits and health conditions that might follow on through the rest of their lives,” Price says.

• Read more: Hospitals and health equity: Examples of novel strategies

Developing best practices

The Physicians Foundation played a key role in the development of new guidelines from the Centers for Medicare & Medicaid Services in assessing the social determinants of health. The CMS has adopted measures asking hospitals to report on screenings for the social determinants of health, as part of its 2023 Medicare Hospital Inpatient Prospective Payment System rule.

The Physicians Foundation also has launched a grant program for state medical associations to help doctors in screening for the social determinants of health. The foundation has awarded grants to the Arizona Medical Association, Center for a Healthy Maryland, Foundation of the Pennsylvania Medical Society, Indiana Medical Foundation and Maine Medical Education Trust.

Price says the goal is to identify ways to assess social drivers affecting patients and to develop effective referrals so they can get the help they need.

“There's going to be a lot to learn, a lot to report and share with others, so that we get to best practices for pathways that work the best in each area,” Price says. “So we have funded five of those societies to begin exploring those practical, on-the-ground solutions. And I'm actually quite confident that over the next year, we'll be funding even more.”

‘Room for innovation’

For health systems and physicians aiming to improve health equity, Price says it’s important to realize there are many different approaches that can be successful.

“There's lots of room for innovation and creativity, to find the best ways for these systems to work,” Price says.

“I think it's also critically important for physician practices to realize that they can't do this on their own,” he adds. “This has to be a collaborative effort between the practice, their hospital system, their community and the community's resources and the entities of finance in healthcare, both federally and private health insurers. I think all of those organizations have to work together. I think it will quickly become apparent that investment in trying to solve some of these issues of drivers of health will give the reward that justifies it.”

While physicians have known about the impact on the social drivers of health for many years, the COVID-19 pandemic generated new urgency to address health equity, he says.

“COVID shined a spotlight on this problem that we couldn't turn away from,” Price says.

While Price says he’s “not normally much of an optimist,” he says he’s encouraged by the increased attention he’s seen on health equity, including the CMS gathering data from hospitals and physicians about screenings for the social drivers of health.

He says he’s enthused about the growing recognition to invest more into addressing the social drivers that affect health and can lead to more costly hospitalizations.

“I'm really encouraged by the response and attention our healthcare system is giving to this,” Price says. “I really see this as a major inflection point, in the way we think about healthcare and the way we deliver it.”