How ‘screen and refer’ systems fail to help patients

We’ve all had the experience of a doctor or other health care worker staring at screen while asking us sensitive questions to fill out our electronic health records. But that frustrating experience is made even worse by a new trend in health care. As Sanjay Basu wrote in a recent First Opinion, hospitals are using so-called “screen and refer” systems to identify people with social needs, like those who are experiencing domestic violence or hunger. The idea is that workers ask patients about their needs, then refer them to organizations such as food banks that can help.

But according to Basu — a primary care provider, epidemiologist, and head of clinical at Waymark — these well-intended efforts are instead dehumanizing and ineffective for patients, and burdensome for the organizations buried by referrals.

“I’m an East-Coast-trained, tie-wearing physician who has learned to practice medicine with checklists,” Basu said. “But ultimately, seeing the impact on patients forced me to have a bit of correction, that we’re patting ourselves on the back, on the health care system side, for addressing people’s social needs.”

This week on the “First Opinion Podcast,” I speak with Basu about where these systems came from, a better approach to achieving their goals, and how to bring a bit more humanity back to health care.

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