Table 3 Themes that emerged from focus group discussions around implementing a clinical poverty tool and select participant quotes

Health care providers recognize the importance and value of screening all patients for poverty

People who responded “yes I have trouble making ends meet” were people I wouldn’t expect. (FG3, neonatologist)

Someone living in poverty is going to be at much higher risk of a whole bunch of things that I’m responsible for than someone who isn’t. (FG4, Family physician)

Was a humbling experience (…) found out stuff about people that I had been seeing for five years. (FG3, NP)

Just because our patients have an adequate income range doesn’t mean they’re not having a hard time making ends meet. (FG5, NP)

People who replied yes I have trouble making ends meet were people that I wouldn’t expect (FG3, Nronatologist)

All of us who participated in the project understand the very real implications of living in poverty, and how that affects people’s health. (FG5,Family physician)

Individual, practitioner-level barriers to screening

I was shocked at how difficult it was to remember to ask it. For me it was to get into a new habit. (FG2, Family physician)

When I was seeing a brand new consult (…) I would remember to ask them because it would come up naturally to a degree. (FG3, Pediatrician)

Systemic and organizational barriers to screening

If I had some way of making a notation in the EMR (…) then it would get done. (FG4, Family physician)

It is not a question you can just ask and quickly move on to the rest of the clinical interview (…) it does take time, and sometimes that’s a barrier. (FG5, Family physician)

Contextual factors impacting screening

Family practice is the better place, I think. Because I have no specific agenda with anybody (…) I can just carry something on if I need to. (FG4, Family physician)

It was really awkward to ask someone who you’d known for five or six years! (FG3, NP)

HCPs’ lack of expertise and lack of effective interventions and available resources to offer patients who screen positive

I felt uncomfortable. I don’t think it was a bad thing to do, I just didn’t know quite how I would get over that. (FG4, Neonatologist)

I would be terrified they’d screen positive, because, what would I do? (FG4, Neonatologist)

And I think that even if we have a reasonable facility with some of the more common resources, people's individual needs vary, and I think it merits somebody who can do a deeper dive. (FG5, Family physician)

I don’t think any of us have the adequate resources. There aren’t adequate resources. And that’s really hard. (FG3, NP)

The reality is, I have a lot of people who are connected with everything under the sun, and it’s still not enough to live on for a month. (FG4, Family physician)