Supporting Physicians to Address Drivers of Health

Ryan Lowery, MD | Texas

My name is Dr. Ryan Lowery. I’m a general pediatrician in Austin, Texas and the fellow for The Physicians Foundation for 2022 and 2023. 

So I’m a general pediatrician, working in a busy, federally qualified health center, and I get to interact with families every day. And I love being able to interact with families, and one of the things I love the most about being able to interact with families is getting to know the parents and the children and the things that are impacting their lives. What I have found, and what research has shown us, is that the things that are impacting their lives are mostly those things that happen outside of the clinic. 

About 70% of the things that are impacting their overall health and wellbeing are related to drivers of health – those include things like food, housing, transportation, the ability to pay their utilities, to name just a few.  

We know that historically, their interaction with the healthcare system or myself seeing them in the clinic really only impacts their health and wellbeing by about 10%. In my pediatric practice, I see this play out on a daily basis. Recently, I saw a teenage patient with her mother, and she was coming in for worsening ability to focus. She had poorly controlled ADHD and asthma. I know this family really well, and as I was able to dig a little bit deeper, I was able to find out that they’d actually been facing housing instability for the last four months and were at risk for homelessness in the last several days and had been living in a shelter for the last three days. It’s experiences like those as a pediatrician that are both humbling and frustrating because the tools and the training that had traditionally been given to me are unlikely to make a dent in this patient’s overall health and wellbeing in both the short and the long term. 

I think it’s important as a physician for healthcare to invest in social needs screening and systems to address drivers of health. It’s going to be important that they take into account community partnerships and availability of those partnerships, but also organizational innovation, so that we can start to impact that 70% of health outcomes that historically we have been unable to touch, and that will eventually lead to improved patient outcomes and population health. Thank you.  

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