A new CMA document provides physicians with practical ways to help patients deal with social determinants that can affect health, such as housing and income.
The document, Physicians and Health Equity: Opportunities in Practice, outlines seven steps doctors can take to help patients counter social or economic barriers to good health. Delegates who attended the CMA's General Council meeting in Yellowknife last year, when social determinants of health dominated discussion, expressed a clear desire for such a document.
"As physicians, we're not the experts in housing, early childhood development, income equality or any of the other social determinants of health, but we see every day the impact these factors have on our patients," said CMA President Anna Reid. "If we want our patients to truly be well, we sometimes need to look beyond their symptoms and consider the broader context of their lives."
The new paper is part of the CMA's ongoing health care transformation initiative aimed at improving the health care system. Its focus is also reflected in the current National Dialogue on Health Care Transformation, which involves a series of CMA town-hall meetings where Canadians discuss the impact of these determinants on their lives. The next town hall takes place in Charlottetown March 28.
The new paper is based on input from physicians who had been identified as leaders in health equity in their communities. The 32 physicians who were interviewed identified seven common areas where doctors can take action to improve health equity:
- by linking patients with supportive community programs and services
- by asking questions about a patient's social and economic circumstances
- by integrating considerations of social and economic conditions into treatment planning (i.e., the cost of medications)
- by advocating for changes to support improvements in the social and economic circumstances of the community (i.e., advocating for reductions in child poverty)
- by undertaking advocacy on behalf of individual patients (i.e., writing letters about the need for safer housing)
- by adopting equitable practice design (i.e., flexible office hours, convenient practice locations)
- by providing practical support to help patients gain access to federal and provincial/territorial programs
The document's key message is that physicians can take many steps to address issues they don't usually consider to be within their purview.
For example, CMA Past President John Haggie, who is quoted in the document, observes: "I had a patient who had major surgery and was no longer able to do her laundry by hand like she had always done. I wrote a prescription for a washer and dryer, and it was actually filled."
Reid said all health care providers, including physicians, "need to do what we can to can help turn the tide toward health equity - program by program, policy by policy, patient by patient."