Why this UW doctor wants colleagues to ask patients if they are lonely

Medical professionals have started noting that isolation and loneliness are increasingly factors in health care, alongside smoking or exercise. One Seattle doctor urges his colleagues to ask their patients about it.

Dr. Sebastian Tong with UW Medicine noticed a trend emerging among his patients over the past few years. It prompted him to add a new question during appointments. After asking about exercise or smoking, he will now ask if they're lonely.

RELATED: Can writing letters help battle the loneliness epidemic?

"Increasingly, I saw people, and talked with people, who had very limited social contact, sometimes not even seeing anyone between when I saw them monthly," Tong told KUOW's Seattle Now. "Interestingly, I would see some people really dress up for their doctor appointments, because sometimes, my monthly appointment with them was the only time they had social contact with someone outside their apartment, in their life."

"So I really wanted to start engaging with people … about what being lonely, what being isolated, meant to them and how we could address that within a medical context.”

The issue has become so prevalent, Tong co-authored a paper in the Annals of Family Medicine, focused on the role primary care has in addressing loneliness. It's an issue the medical profession is increasingly talking about. U.S. Surgeon General Vivek Murthy was shining a spotlight on the problem before the Covid pandemic struck in 2020, causing people to isolate and go virtual in many parts of their lives. Loneliness was the top issue Murthy spoke about during a recent visit to Seattle, where he said that "healthy activities are being edged out" of daily life, and pointed to social media as a top concern.

There is no official medical diagnosis for loneliness. It's not something that can be put in a record or easily quantified. Still, medical care professionals are aware of its negative impact on health. It can mean chronic illnesses become poorly controlled, or people have less motivation to take care of themselves and take medication. Group settings can also influence exercise or healthy eating. Having a friend nearby can equate to a simple walk every now and then. It adds up.

Dr. Tong notes that he has observed the loneliness issue in three different groups.

• Older adults making life transitions, such as retirement, divorce, or being widowed may lack support systems or lifestyles to help make the next step.
• Also, immigrant and refugee populations who may lack local connections and have language barriers.
• Perhaps the largest group is younger people who have grown up in the pandemic era, permeated with social media.

It's a problem, Tong said, when people feel there is no one to turn to for help, especially if there is a medical emergency.

“I think it’s an increasing problem since the Covid pandemic," he said. "I think another contributor is the way we have structured our society. Social media is becoming a much bigger part of society, so people are interacting virtually, but not actually seeing people or talking with people in real time. I think another problem is that the way our society has evolved, people are moving away from where they grew up so they may lose those social contacts they had from before.”

RELATED: 6 steps to address America's loneliness epidemic

Now, Dr. Tong asks patients about their daily lives, if they have weekend plans, what their housing situation is like, or about their friends. He notes that doctors often have screening forms that patients fill out and that questions about loneliness could also be added to that process.

“I’m hoping that more primary care doctors will pay more attention and just ask questions," he said. "We may not have all the solutions, but I think getting to know the patients we work with, and getting to know the contexts, and how they are feeling, and how that might contribute to their health is important. I’m hoping it will also help everyone, when they go to their doctors, be more open about bringing it up.”

“I’ve seen people open up more. I’ve helped people plan to meet others and make plans for activities," he said. "It’s short term now, but I’m hoping, long term, it will have an effect on their health.”

Listen to Seattle Now's full conversation with Dr. Tong here.

KUOW's Dyer Oxley contributed to this article.