Table 2

Illustrative Quotes on How Resources for Social Needs Affect Clinician Efficacy, by Clinicians’ Burnout Risk (N = 28)

DP ScoreLow to Average EE ScoreHigh EE Score
Low to average17 clinicians (SDH score: mean = 6.9; range, 4-10)
“We have a social worker, a care support team. I’m often asking people to make phone calls for me. I feel pretty certain that they can do it. So, I feel good about the care that we provide.” (physician; average EE, low DP; SDH score = 10)
“I feel like [patients] have some responsibility in their own health care. I can give them all the options in the world, if they want to talk to a counselor or they want to go to a group. But if they don’t want to do any of the above, it’s not going to impact my ability to feel like whether I’ve succeeded or not.” (nurse practitioner; average EE, low DP; SDH score = 8)
8 clinicians (SDH score: mean = 5.9; range, 2-9)
“A lot of times there are things that you cannot help [patients] with. Some of our patients already are homeless. We are lucky enough to have a social worker, but what can she do? I mean, regular people can’t even afford to live in San Francisco.” (physician; high EE, low DP; SDH score = 5)
“Even if there is a behavioral health navigator, really, it all kind of falls on you.” (physician; high EE, average DP; SDH score = 6)
HighNo clinicians in this category3 clinicians (SDH score: mean = 7.3; range, 6-9)
“Realistically, half or more of the illnesses that we see are related to substance abuse, whether it’s illicit drugs, alcohol, tobacco. If you throw in other social issues—homelessness, immigration, stress of poverty in general—surely, well over 50%. The inability to address those issues is a source of frustration.” (physician; high EE, high DP; SDH score = 7)
“Even with a nice behavior health system, through social work and all that, I feel sometimes I’m helpless and powerless to give [patients] more. Sure, I can sign my name on and give them health services, but I don’t feel sometimes that’s what they need.” (physician; high EE, high DP; SDH score = 9)
  • DP = depersonalization; EE = emotional exhaustion; SDH = social determinants of health.