Influence of Patients' Socioeconomic Status on Clinical Management Decisions

A Qualitative Study

The role of socioeconomic status (SES) in physicians' clinical management of patients was investigated in this article.

Researchers conducted in-depth semistructured interviews with 18 primary care physicians. The interviews focused on physician perspectives on the impact of SES on clinical management. Codes were ascertained from line-by-line analysis of interviews that yielded a number of important themes.

Key Findings:

  • Some physicians asserted that SES should not matter in treating patients while others stated that SES did make a difference.
  • Physicians reported modifying clinical management with low SES patients in the interest of their patient, such as prescribing generic medicine in order to be mindful of patient finances.
  • Some physicians believed patient outcomes were not impacted by modifications in clinical management with low SES patients, while others thought patient outcomes might be compromised.
  • Tension arose in personal and financial arenas for physicians who worked with low SES patients. For example, physicians cited stress in the areas of not wanting to look as if they provided lower-quality care to low SES patients and how performance measurement was influenced by treating low SES patients.

Acknowledging the impact of SES in clinical management might positively influence standards of care and potentially bolster the number of physicians who work with low SES populations.