Healthcare access looms as doctors' top concern, followed by substance abuse, racial disparities and gun control

U.S. physicians rank healthcare access, substance abuse and racial disparities as the leading social issues facing the country, followed closely by gun control and climate change.

A strong majority, 85%, cited healthcare access as their most important concern, followed by substance/opioid abuse (66%), racial disparities (54%), gun control (53%) and climate change (51%), according to a new Medscape survey.

Nearly all the doctors surveyed say they support gun background checks, and a majority are in favor of abortion access with some restrictions by trimester.

A total of 2,342 U.S. physicians representing more than 29 specialty areas completed the survey, which obtained their perspectives on a variety of issues including healthcare access, racial discrimination, reproductive rights, immigration and refugee policies, gender discrimination, domestic violence and LGBTQ+ rights. 

The survey was conducted between Jan. 22 and March 2 by Medscape, a leading source of clinical news, health information and point-of-care tools for healthcare professionals. This was Medscape’s first report exploring physician views on social issues.

“We recognize that physicians—and society as a whole—are struggling with so many tough and divisive issues, and we’ve heard from our audience that many of these changes are affecting their patients and their practice as well as affecting their emotional well-being,” Leslie Kane, senior director of Medscape's business of medicine site, told Fierce Healthcare. “We wanted to find out how extensive the impact truly is and how it’s affecting the medical community.”

She added that “there are so many troublesome social issues occurring simultaneously. It's interesting to see how people rank their concern over various issues.”

Almost half of respondents (48%) preferred a healthcare system in which the government is at least somewhat responsible for contributing to the cost, with 1 in 5 supporting a single payer system.

A majority (77%) of physicians indicated that they encounter patients with substance use disorders in their practice, while 42% said they frequently treat patients with alcohol or drug use problems.

Although more than two-thirds (68%) say the U.S. has made progress in combating racial inequality, 78% noted that disparities must be addressed. More than half (55%) said patients are treated differently because of race.

Nearly two-thirds (64%) of physicians said they are concerned or very concerned about gun control, and the overwhelming majority support background checks (96%) and limiting ownership to people 18 and older (90%); 70% noted that a psychological evaluation should be mandatory for gun buyers.

More than 70% of physicians stated that climate change should be the top global priority, with 67% reporting that it is a key threat to humanity. 

More than half of respondents (53%) said they are concerned or very concerned about reproductive rights, with nearly 1 in 5 doctors indicating that abortion should be accessible no matter the reason and regardless of trimester.

When the survey inquired whether LGBTQ patients receive different levels of care, 45% of physicians said no, while 35% said yes and 20% replied that they weren’t sure.

About 60% of physicians said they were concerned or very concerned with immigration but were divided on their views about current policy; 28% said policies are too restrictive and 34% said they are not restrictive enough; 20% said they were appropriate.

Meanwhile, about two-thirds of physicians report significant levels of concern about domestic violence, and only 8% think the U.S. sufficiently addresses this issue.

Concerns about gender discrimination differed substantially between male and female physicians. Female physicians were far more likely to say they are concerned or very concerned about gender discrimination (67%) versus male respondents (38%).

Medscape wanted to provide physicians with data revealing how social issues affect their peers and how their profession is dealing with these concerns, Kane told Fierce Healthcare.

“Many physicians feel alone and isolated and would benefit by knowing how widespread their feelings and challenges are,” she said. “We also hope that the survey will help create a community where physicians can exchange experiences and ideas.” 

Kane noted that physicians encounter a wide range of patients, which gives them the opportunity to see how social issues affect various segments of the population. “Physicians are caring people; that’s a large reason why they chose their career—to help others,” she said. “The fact that they’re very concerned with social issues is no surprise.” 

The survey also found that “a lot of doctors were active in helping to change things; many volunteered; many provided money to help the cause,” Kane said.