Participant Feedback and Quotations on Theme 1, “Barriers to Routine Screening of Health-Related Social Needs [HRSN] in Primary Care,” from Focus Groups Conducted from September to October 2022 in a Primary Care Setting at a Texas Academic Medical Center
| Subtheme | Quotation |
|---|---|
| Time | “It's going to be us [clinicians] feeling like we're rushing through things that are very personal to them [patients].” |
| “It takes 5 to 10 minutes to just to find things [resources].” | |
| “I want to do something immediately to try to help [the patient]. And that will slow things down a lot in the clinic as well.” | |
| Workload burden | “Right now part of the difficulty is our clinical staff is also really overworked and busy, and they're trying to do a lot of things as well, too, which tires them out.” |
| “So with the workload that we [social workers] currently have, and—I can tell you, all of us are running ourselves ragged—common screening is going to dramatically increase our workload.” | |
| Emotional toll | Sometimes a patient situation “grabs ahold of your heart strings, and you just go home and you're like, ‘Did I do everything I could do? Was there something I could have done differently?’” |
| “If it's someone telling me, ‘I cannot put food on my table tomorrow,’ for me, that instantly triggers feelings of alarm and panic.” | |
| Fear of inadequacy | “If I ask them about it [HRSN], I feel like they’re going to want an answer from me on what to do about it, and I’m not qualified to give them that kind of answer.” |
| “If we're going to address these things [HRSN], then we have to be able to help [patients].” | |
| “If we just go, ‘Do you have this? Do you have this? Do you have this? Do you have that?’ And they say, ‘No, no, no, no.’ ‘Well, I can’t talk about it today.’ That makes them feel like, ‘I wasn’t heard.’” | |
| “It could negatively impact your relationship with [the patient] because they’re thinking you’re thinking of this as a very cavalier type thing and not a personal thing to them…” | |
| Patient-related factors | “’Do you know how to navigate the Internet? Do you have a smartphone?’ Because yeah, not everybody's got access to those things and they're like, ‘No, don't, don't send me anything because I don't have a printer.’” |
| “You have to have a relationship with the patient before they open up and tell about… especially partner violence or financial issues.” | |
| “They think, ‘Oh, well, someone is worse off than what I am… my lights are off, but I have food,’ …so, they don't recognize [their eligibility for assistance].” | |
| “Some of the patients are proud, and they don’t want to say that ‘I don't have food in the house.’ They wouldn’t say, ‘I can't afford this.’” | |
| “Patients don’t know that they can talk to us about issues like, ‘I don't have food.’ They are very accustomed to go to the doctor just for medicine.” | |
| “There's a big deficit in resources when someone's not a citizen, or in particular if they’re not here legally.” | |
| “A lot of this is personal, and patients aren’t even forthcoming sometimes when you ask them.” |