The Physicians Foundation is accepting applications for its new year-long fellowship program, aimed at next-generation physicians passionate about addressing social drivers of health.

On the second episode of Piecemeal, Dr. Lalita Abhyankar explores the policy issues that promote health care consolidation. She explores the fee-for-service payment model, various value-based payment models, the challenges of telehealth, payment reimbursement negotiations, and the complex balance of managing patient visits.

Workers at healthcare facilities all over the country are reporting similar emotions. Sixty-one percent of physicians said they often experienced feelings of burnout, a significant increase from 40% in 2018; more than half of physicians reported feeling “inappropriate feelings of anger, tearfulness, or anxiety because of COVID-19,” according to a Physician’s Foundation Survey of 2,504 healthcare workers conducted from May to June 2021.

The Physicians Foundation is pressing the Centers for Medicaid and Medicare Services (CMS) to adopt new measures for social drivers of health. In a recent interview, HealthLeaders spoke with Gary Price, MD, president of The Physicians Foundation, about his organization's work on social drivers of health. The following is a lightly edited transcript of that conversation.

According to a 2020 survey by the Physicians Foundation, 12% of all U.S. doctors either closed their offices during the pandemic or were planning to do so within the year. Some 59% agreed that the pandemic would “lead to a reduction in the number of independent physician practices in their communities,” and half agreed that “hospitals will exert stronger influence over the organization and delivery of healthcare as a result” of the pandemic.

Every day, our healthcare system spends $11 billion. As a practicing physician, it is clear that what our system measures and pays for – via diagnosis and billing codes, “allowable services” and myriad quality measures – is a reflection of both what and who it values.

Last month, the Physicians Foundation put out recommendations to address social determinants of health in patients. Apart from acknowledging that social and structural drivers determine 70% of health outcomes, the Foundation highlighted the burden physicians face when tracking them

Stress from the coronavirus pandemic has made the outlook even worse, at least in the near term. When the Physicians Foundation, a nonprofit research organization, surveyed 2,504 doctors in May and June, 61 percent reported “often experiencing” burnout associated with financial and emotional strain. Two percent said they had retired because of the pandemic; another 2 percent had closed their practices.

In February 2020, as COVID-19 began to emerge as a real threat to public health, Dr. Folashade Afolabi, a pediatric pulmonologist in Dallas, had one thought: “This is going to be really, really bad.” Afolabi, 44, had been a resident when the swine flu hit the U.S. in 2009, so she knew she had to start preparing to protect her patients from COVID-19. What she didn’t expect was the effect the pandemic would have on her own mental health.

Since March 2020, when the COVID-19 pandemic was first officially declared, doctors, nurses and other clinicians have stepped up and shouldered burdens they never anticipated. They rose to the challenge magnificently, caring for the ill while protecting themselves and their families.