• Seth A Berkowitz, Travis P Baggett, and Samuel T Edwards.
• Division of General Medicine and Clinical Epidemiology, Department of Medicine, University of North Carolina School of Medicine, 5034 Old Clinic Bldg, CB 7110, Chapel Hill, NC, 27599, USA. seth_berkowitz@med.unc.edu.
• J Gen Intern Med. 2019 Sep 1; 34 (9): 1916-1918.

AbstractHealth-related social needs, such as food insecurity, housing instability, and lack of transportation, are associated with worse health outcomes, and are increasingly the focus of health-related social needs interventions within healthcare. Adoption of health-related social needs interventions is often justified by the potential to reduce healthcare costs. However, this can present a conundrum to clinicians. Physicians are often more accustomed to justifying clinical innovation based on improvements in health, in accord with the fundamental values of the medical profession, which include using our knowledge, skills, and the resources at our disposal to improve both individual and public health. In cases where health-related social needs interventions improve health but are not cost-saving, these two types of justifications can conflict. We provide a framework for considering these issues, and an agenda for scholarly work on this topic. Ultimately, if promoting patient and public health are key values for our profession, then understanding when to emphasize values-based care, rather than simply value-based care, is crucial to fulfilling our professional duty.

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