Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Are physicians addressing the root causes of health problems?

Ricky Choi, MD
Physician
January 31, 2012
Share
Tweet
Share

While in residency, I took care of a toddler who was hospitalized following an anaphylactic reaction.  During a diaper change at home the child suddenly developed lip swelling and severe difficulty breathing for no apparent reason. The child was urgently brought to the hospital by ambulance and initially treated in the emergency room. By the time I met her on the inpatient floor her breathing and swelling had significantly improved. The first thing I noticed, however, was the child’s bumpy and irritated red skin which was covered with a thick layer of ointment. While I examined her she would claw and scratch at her skin with little relief. She looked miserable. Her mother had been suspecting food allergies and described a frustrating process of selective food avoidance and various skin treatments with little to no improvement.

Keeping in mind that eczema and allergic reactions are in the same family of disease, it was not surprising that this child was more prone to anaphylaxis. While her symptoms improved and she was sent home, the trigger for the severe reaction remained a mystery.

About 6 months later I ran into the child’s mother in clinic. The mystery behind the life threatening illness made this child memorable so I asked how her daughter was doing. Mom was happy to share that her daughter had not had any further allergic reactions and that the skin problems had nearly resolved.

So how did they cure her disease?

They moved.

After countless visits to specialists and various drugs that were not addressing the primary cause of her problems, one day the parents opened an infrequently used closet in their home.  Inside they found the closet saturated with mold.  Shortly after moving to a new mold-free home the child’s eczema immediately began to improve.

Its estimated that 70% of the factors that influence health are environmental and behavioral. It seems fairly obvious that food, access to transportation, and housing can affect health. But the health care system, and physicians specifically, are ill-prepared to address these social determinants of disease.

A survey of 1,000 American physicians conducted for the Robert Wood Johnson Foundation released recently showed that doctors know how important social factors are to health but feel unprepared to address them. 85% of surveyed physicians said that unmet social needs directly led to worse health. The same percentage of physicians said that a patient’s social needs are “as important to address” as medical problems. Of concern, 80% were not confident in their capacity to address their patients’ social needs even though it would improve the patient’s health.

Interestingly, if prescriptions could be written to treat social needs the way they could be used to treat illnesses, social prescriptions would represent one of every seven prescriptions the surveyed physicians would write.  The top social needs physicians said they would write prescriptions for included:

  • Fitness programs
  • Nutritional food
  • Transportation assistance
  • Housing assistance
  • Employment assistance

So what is to be done?

Are health care providers really addressing the root causes of health problems? How much incorrect treatment or unnecessary diagnostic testing occurs because these factors are not considered? Perhaps my patient could have been spared the the anaphylactic reaction had mold been investigated as a possible cause of her eczema.

How can health care professionals better address the circumstances in which we live, work, and play?

How can we structure the health care system to reimburse health care providers for addressing the behavioral and social factors that cause 80% of disease?

Ricky Y. Choi is a pediatrician who blogs at SFGate and reprinted with the author’s permission.

ADVERTISEMENT

Submit a guest post and be heard on social media’s leading physician voice.

Prev

Analyzing what the President said about health care

January 31, 2012 Kevin 3
…
Next

How adopting an EHR is like treating cancer

January 31, 2012 Kevin 31
…

Tagged as: Pediatrics, Primary Care

Post navigation

< Previous Post
Analyzing what the President said about health care
Next Post >
How adopting an EHR is like treating cancer

ADVERTISEMENT

More by Ricky Choi, MD

  • a desk with keyboard and ipad with the kevinmd logo

    What would you include in your perfect school lunch?

    Ricky Choi, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Dear Patient, great things are happening in health care

    Ricky Choi, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Our health problems will remain, despite how the Supreme Court rules

    Ricky Choi, MD

More in Physician

  • Why more doctors are choosing direct care over traditional health care

    Grace Torres-Hodges, DPM, MBA
  • How to handle chronically late patients in your medical practice

    Neil Baum, MD
  • How early meetings and after-hours events penalize physician-mothers

    Samira Jeimy, MD, PhD and Menaka Pai, MD
  • Why medicine must evolve to support modern physicians

    Ryan Nadelson, MD
  • Why listening to parents’ intuition can save lives in pediatric care

    Tokunbo Akande, MD, MPH
  • Finding balance and meaning in medical practice: a holistic approach to professional fulfillment

    Dr. Saad S. Alshohaib
  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • Why ADHD in women requires a new approach [PODCAST]

      The Podcast by KevinMD | Podcast
    • AI is already replacing doctors—just not how you think

      Bhargav Raman, MD, MBA | Tech
    • Why doctors must stop ignoring unintentional weight loss in patients with obesity

      Samantha Malley, FNP-C | Conditions
    • Why more doctors are choosing direct care over traditional health care

      Grace Torres-Hodges, DPM, MBA | Physician
    • Why hospitals are quietly capping top doctors’ pay

      Dennis Hursh, Esq | Conditions
    • Why point-of-care ultrasound belongs in emergency department triage

      Resa E. Lewiss, MD and Courtney M. Smalley, MD | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 3 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • Why ADHD in women requires a new approach [PODCAST]

      The Podcast by KevinMD | Podcast
    • AI is already replacing doctors—just not how you think

      Bhargav Raman, MD, MBA | Tech
    • Why doctors must stop ignoring unintentional weight loss in patients with obesity

      Samantha Malley, FNP-C | Conditions
    • Why more doctors are choosing direct care over traditional health care

      Grace Torres-Hodges, DPM, MBA | Physician
    • Why hospitals are quietly capping top doctors’ pay

      Dennis Hursh, Esq | Conditions
    • Why point-of-care ultrasound belongs in emergency department triage

      Resa E. Lewiss, MD and Courtney M. Smalley, MD | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Are physicians addressing the root causes of health problems?
3 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...