Anyone who’s ever been downsized or otherwise lost a job knows the feelings: Personal loss (social, financial and routine), self doubt, and in some cases fear of what the future will bring. Unemployment and its cousin, underemployment, are not subjects that a lot of people are comfortable brining up in polite conversation — even with their doctor.
Given today’s tough economic environment, chances are that 15 to 20 percent of the people sitting in most doctors’ waiting rooms are out of work. Do you know who they are? You should.
Losing a job is a highly stressful event. For most employed adults, work is a central part of one’s life and identity and a major source of income. While job loss affects people differently, research suggests that loss of a job affects how many people feel -– emotionally and physically. Job loss, as well as job insecurity, has been linked to increased mental distress (depression) and physiologic responses such as a weakening of the immune system, increase inflammatory response which is associated with cardiovascular disease as well as an increase in blood pressure. Depression is also correlated with more physician visits, medical tests, medications, hospitalizations and decreased adherence among patients.
As I pointed out in an earlier post:
It costs twice as much to treat a patient with depression ($4,780) as it does to treat a patient without depression ($2,794).
Ask your patients what’s going on in their lives, including current or potential job loss and problems at home. Understanding the context of the patient’s life will allow you to provide true patient-centered care to patients that desperately need and want your help.
Cohen, F., et al. “Immune Function Declines With Unemployment and Recovers After Stressor Termination.” Psychosomatic Medicine 69:225–234 (2007).
Pearson et al. “Depression Among High Utilizers of Medical Care.” Journal of General Internal Medicine. 1999: 14:461-468.
*This blog post was originally published at Mind The Gap*