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Social determinants are threatening patient outcomes, burnout is a scourge but opioid scripts are down, physicians say

Majority say social determinants pose major threat to patient health and burnout threatens three-quarters, but patient relationships are a big boost.

Beth Jones Sanborn, Managing Editor

A majority of physicians say social determinants of health are seriously threatening their patients health, that overburdened and burned out physicians are becoming the norm instead of the exception and some gains in changing opioid prescribing habits are all part of a somewhat startling snapshot of today's physician landscape, according to the 2018 Survey of America's Physicians, conducted by Merritt Hawkins for the Physicians Foundation.

The survey was based on responses from nearly 8,800 physicians, as well as written comments from roughly 2,470 physicians. The margin of error was +/- 1.05 percent.

Most notably, 88 percent of physicians reported that some, many or all of their patients are affected by social determinant including poverty, unemployment, lack of education, and addiction, which represent serious barriers to their health, well-being and eventual health outcomes. Only one percent of physicians reported that none of their patients had such conditions.

"It is distressing that such a high number of patients are dealing with one or more social situations that are detrimental to their health," said Walker Ray, MD, chair of the Foundation's research committee. "These challenges directly impact a physician's ability to deliver effective care, and the cost implication of these issues is enormous."

Physician burden and burnout continue to pervade the medical landscape producing sobering statistics with serious implications for physician well-being and by extension, patient care, as 80 percent of responding physicians said they are at full capacity or are overburdened and almost the same number, 78 percent said they often or always experience feelings of burnout. Results showed a major culprit behind those frustrations was the inefficiency of electronic health records.

One thing clearly fueling physicians' motivation is their relationships with their patients, as 79 percent of physicians reported that patient relationships continue to be their greatest source of professional satisfaction. This proves the urgency of reducing administrative burden to clear the way for more interaction with patients not only to boost care quality but physician morale as well, something else that is sorely suffering, with 62 percent of physicians saying they are pessimistic about the future of medicine and 55 percent saying their morale is somewhat or very negative. Also, 46 percent said they planned to change career paths, the reality of which stands to feed an already threatening physician shortage in the coming 5 to 10 years.

Gains are being seen in the battle against opioids though, specifically physician efforts to affect change in some of the trends that fed the onset of the epidemic. It has been widely reported that doctors and hospitals are changing operational and prescribing protocols to cut down on the amount and frequency of opioid use and it's working, as 69 percent of responding physicians said they are prescribing fewer pain medications because of the opioid epidemic.

Twitter: @BethJSanborn
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