“Be mindful of the underdog, as the corporates legally and unethically exploit the social determinants of health.” — Dr. Adam Tabriz.

Utility of Social Determinants Of Health In Physicians' Practice

Physicians Realize The Significance Of Social Drivers Of Health, But What Are They Going To Do About It?

It is utterly apparent to global healthcare leaders, including physicians, that how we live, learn, work, and play directly and indirectly affects our health and well-being. Risks threatening the quality of our lives and the outcome of our health based on those today are more than ever recognized and influential. We know these factors as "Social determinants of health." They are also referred" to as "social drivers of health." Regardless, those determinants alone do not offer any solution to how we should make changes so everyone can live healthily and thrive.

Of course, some factors that adversely affect our well-being can also be part of our attitude. However, the latter, which we call "Personal Determinants of health," is a subject separate from the current theme of this piece.

Physicians have long realized how factors like people's collective mindset and culture can affect their way of caring for themselves. Or, Just like washing hands, today is part of almost every individual's culture to reduce the spread of destructive microbes by having access to quality education, same for Socioeconomic status, neighborhood, education, environment, career, nutrition/food security, healthcare access, and social support networks.

Physicians and healthcare leaders, in general, also realize that if we fail to address the social determinants of health, the already increasing healthcare costs will keep rising. That is, even if we eliminate the overwhelming monopoly and politics from the healthcare equation. On the downside, addressing the Social determinants of health alone isn't without a cost. Metaphorically it comes as a "Double-edged sword."

The Physician's Foundation's 2020 Survey of America's Physicians invests in that doubtful advantage. Indeed, 73% of physicians indicated that addressing social drivers like accessibility to healthy food and housing will eventually drive up the healthcare service demand. That, in turn, will also raise the cost. Nevertheless, that presumption is valid in the short term, but as people live healthier and lesser in need of acute or even chronic medical care, that cost will plunge with time. Therefore, a little fiscal coercion seems worthwhile, given we invest the money in proper healthcare delivery infrastructure.

The reality of tackling the social determinants of health deals with Patients’ Lives and Investment on a modern healthcare infrastructure.

Now That Physicians Recognize The Problem, What Will They Do About It?!

So far, our healthcare system has invested time and money to recognize the problem of dealing with social determinants of health.

Governments invest billions of taxpayer money in various infrastructures and their favorite lobbying corporations and foundations. But, none has, so far, been able to stop the waste of taxpayer blood earned money, physician burnout, and patient expectation.

But, why is that, and what is it that physicians must embrace themselves?

I want to bet on the wrong healthcare infrastructure, extreme government red tape for independent physicians' practices and their discriminatory safe harbor for corporations, and corporate monopoly, like the pharmacy benefit management (PBM) industry.

Some recommend efficiently addressing social determinants of the health insurance industry (another corporate system) and must integrate them into independent physicians' reimbursement policies. As they have already been doing the latter, federal and state policymakers and private insurance company partners have indiscriminately had independent physicians responsible for patients' health through various quality measures. They have done so through heavy-handed "measures" such as Carrot on the stick policies that they call financial rewards and fierce medicolegal mandates enforced by harsh penalties.

The Center for Medicare and Medicaid (CMS) also offers utilization and outcome measurements. The head their way was identifying the development and implementation of measures that specifically reflect social and economic drivers gap as a critical measure.

But, how much can we push physicians to perform without genuinly having them as part of the solution and not the agent of service?!

And, How long can we pretend that we are engaging patients in their medical care using physicians on the verge of burnout when all the policymakers are doing is opening the road to corporate profiteering?!

Independent Physicians Need To Adopt A Competitive Attitude!

Historically, fierce competitors have always riddled the healthcare landscape. However, the recent disruption of that industry by tech companies and healthcare leaders' ambitions to carry health equity to everyone by partaking in social determinants of health in their strategies have made that competitive landscape even harder for independent physicians.

Indeed, the one easy way is for independent physicians to give up their independent medical practices and seek employment at corporate systems like hospitals and managed care organizations.

The independent physicians' practice survival and adopting the realistic approach to upholding social determinants of health will require new medical logistics infrastructure. The kind of system offered renders them competitive against the big players at an affordable cost while ensuring their autonomy.

We can only achieve such a system by establishing a network where healthcare stakeholders can search, find, realize, share, exchange, and sell any service or product from any location.

Modern logistics must be a collaborative hybrid domain over which every player can freely interact in real-time; that interaction workflow follows the same process. In other words, whatever transpires in physical space (in-person experience), one can follow virtually and vice versa.

Offering medical care by incorporating social determinants of health through the said modern Logistic infrastructure is a labor-intensive task. That is something larger centralized corporate systems can handle. Because they possess fiscal and human power, they need to thrive. Nonetheless, for a small medical practice, that is hard without giving away at least some level of autonomy.

The decentralized nature of Independent physician practice logistics ensures individual independence while enforcing collaboration among them. It offers hands-on human support whenever needed and computer automation when necessary. The latter formation is the foundation for a system that provides more options to patients and reduces the burden on independent physicians. Furthermore, it engages patients and provides more resources to address social determinants of health without significantly burdening fiscal and human capacity.

Improvision of social determinants of health requires new thinking. It seems like physicians already recognize the value of social determinants of health. However, what physicians need to embrace is that they should avoid the trap of rhetorics and not follow the computer algorithms of their electronic health records like robots. Instead, they must choose a collaborative, transparent, decentralized, interactive system that offers selective, real-time, and hybrid automation.