The Connection Between Physician Engagement and Tackling Health-Related Social Needs

Today, there are various health-related social needs (HRSNs) that oftentimes go unmet—such as food insecurity, transportation challenges, housing instability, and utility obstacles—which can impact a person’s health. With healthcare being considered a shared responsibility that spans multiples sectors and contributes to enhancing both the health of the population and health equity, efforts—specifically in the United States—have been underway to design a system that utilizes social care to tackle HRSNs, while reducing health inequities.1

When it comes to physicians, addressing HRSNs in a clinical practice setting could include screening and connecting patients to social services,2 and interestingly enough, their engagement when it comes to addressing HRSNs has not been fully measured thus far. Keeping that in mind, a cross-section study published in JAMA Network Open sought to not only determine physicians’ engagement in addressing HRSNs, but do so while also examining its association with burnout.1 The study authors also noted that currently, there is limited understanding regarding how different subgroups of physicians spend time addressing these HRSNs.

The aforementioned study used the 2022 Association of American Medical Colleges National Sample Survey of Physicians (NSSP), which is a nationally representative survey of active, practicing physicians in the US that was conducted from May to November 2022. It measures various physician workforce characteristics.

The method for sampling was broken down into the following steps:

1. The process of including all eligible respondents from the NSSP 2019 survey
2. Filling the cohort through with the use of stratified random sampling, with strata consisting of physician gender, specialty group, age group, and rural status.

Overall, in the study totaling 5,447 physicians, the mean (SD) age was 50.9 (11.7) years, with 3,735 (68.6%) identifying either as men or transgender men. Also, 34.3% of physicians reported high HRSN engagement, with variability being based on physician characteristics. When being compared to no HRSN engagement, low to moderate HRSN engagement (adjusted odds ratio [AOR], 1.33; 95% confidence interview or CI, 1.03-1.72; P = .03) and high HRSN engagement (AOR, 1.72; 95% CI, 1.39-2.27; P < .001) were significantly associated with high burnout.

However, the study did present its share of limitations, specifically pertaining to its design. As a result of it being cross-sectional, the investigators were unsuccessful in finding a causal relationship between physicians’ engagement in addressing social needs and burnout. Another limitation included the fact that because physician-reported frequency of addressing HRSNs based on the 2022 NPPS item was used as a way to represent their engagement, the results may not necessarily reflect physicians’ involvement in addressing HRSNs in an accurate manner.

“ … We identified variability in physicians’ engagement in addressing HRSNs and found that a higher degree of engagement was associated with burnout, concluded the study investigators. “As growing numbers of health equity strategies are developed and implemented, our study findings offer insight into strategies for mitigating physician burnout and suggest the need for a thorough assessment of the potential unintended consequences of physicians’ engagement in addressing HRSNs on their well-being.”

References

1. Tabata-Kelly M, Hu X, Dill MJ, et al. Physician Engagement in Addressing Health-Related Social Needs and Burnout. JAMA Netw Open. 2024;7(12):e2452152. doi:10.1001/jamanetworkopen.2024.52152

2. Kreuter MW, Thompson T, McQueen A, Garg R. Addressing Social Needs in Health Care Settings: Evidence, Challenges, and Opportunities for Public Health. Annu Rev Public Health. 2021;42:329-344.