Primary Care Physician Stress Driven by Social and Financial Needs of Complex Patients

A Society of General Internal Medicine Position Statement on the Internists’ Role in Social Determinants of Health

“…This approach allows patients to feel “seen” as people, rather than as a list of problems or diagnoses. 15 , 16 Including open-ended questions does not add length to the patient encounter 17 and lays a foundation for a therapeutic alliance which can make clinical decision-making more efficient and effective. Employing a person-centric approach increases patient satisfaction and reduces physician burnout.…”

“…Employing a person-centric approach increases patient satisfaction and reduces physician burnout. 17 Physicians must respect patient autonomy in approaching these conversations, explicitly identifying patient priorities and desire for healthcare system involvement in their social needs. Physicians should also engage in efforts to enhance self-awareness, including an examination of how their own background and life experiences influence their attitudes towards and interactions with patients from socially disadvantaged groups.…”

Capacity to Address Social Needs Affects Primary Care Clinician Burnout

“…Our study findings also help to explain other recent work linking burnout and capacity to address social needs. 22,[24][25][26] Having dedicated team members directly address social needs helped clinicians stay engaged and feel more connected with their patients, which is a major source of work-related satisfaction for clinicians. 39,40 The findings also highlight how structural challenges-including lack of reimbursement, inadequate integration between medical and social delivery systems, and insufficient nonclinical capacity to address social needs-presented key barriers to professional efficacy, an important component of burnout.…”

“…[22][23][24][25][26] One study showed that primary care clinicians reporting extreme stress were more likely to rate patients' social or financial issues as most relevant to patient complexity. 22 Lower satisfaction with resources for treating complex patients has been associated with more symptoms of burnout 23 ; conversely, practice preparedness to address social needs and ease of coordinating social services have been associated with greater clinician satisfaction. 24 Two other studies also have shown that greater clinician perception of clinic capacity to address patients' social needs is significantly correlated with lower burnout.…”

People with Pediatric‐Onset Complex Disabilities: Good News, Bad News

“…Internists report feeling ill‐equipped to care for this population—largely due to lack of training and the complexity of the psychosocial issues, and time and financing limitations . Another recent study of internists and family medicine physicians tied having complex care patients to provider distress, noting that 80% of these physicians report that caring for complex patients causes them moderate (47%) to extreme stress (32%) . The stressors are many, ranging from lack of accessible heath care environments (eg, weight scales, exam tables, and transfer and diagnostic equipment), insufficient reimbursement, and inadequate knowledge and training, to poorly coordinated care services that myopically slice and dice patients into organ systems rather than care for “whole” people.…”