How to Talk About SDOH so Patients Will Listen

Ryan McWaters, Vice President, Product Development

These days, social determinants of health are one of healthcare’s hottest topics. Payers, providers, and researchers are extolling the benefits of addressing a patient’s social determinants of health to improve care and bend the cost curve. Yet for all the literature on this topic, very little exists that considers how to talk to patients about these critical influences on their health.

As providers who deliver medical care and treatment in the homes of healthcare’s most vulnerable populations, we often observe and address the social determinants of health that prevent patients from following the doctor’s orders. Through our experience, we’ve developed 5 ways to talk about these issues. (Hint: don’t call them “social determinants of health”)

  1. Use colloquial words and phrases.Industry jargon in confusing; use common words that have universal meaning. Personalize the conversation to the patient by asking about their daily routine to understand any significant barriers.
  2. Find the root cause(s).The natural inclination for someone struggling with social determinants of health (SDoH) is to be either optimistic or purposefully disassociated with the barrier, so be prepared to ask follow-up questions. Listen respectfully and provide an opportunity for the patient to freely discuss their situation (which you will translate to barriers to optimal health).
  3. Align recommendations with a patient’s priorities.Recommendations for well-being improvement should be personalized. Find out what is most important to the patient and offer recommendations tied to that. Expect to coach and explain how and why the recommendations are beneficial.
  4. Solve for immediacy, not policy.Make the next step a simple one to build confidence and trust. When one simple step follows another, it creates an intuitive path for the patient to achieve better health. Recognize when a greater value is placed on something now rather than the future. For example, “Do
    this now to get this now” instead of “Do this now to get the reward next month.”
  5. Praise, don’t pity.Be empathetic, not sympathetic. Small steps lead to big changes; focus on commitments and offer praise for the completion of tasks. Behavior change takes time and reinforcement; there is no such thing as “one and done.”

Addressing social determinants of health in a meaningful way begins with one-on-one conversations with patients. Words matter. Make yours count.

Published: 11/17/19