Why Doctors Hate Treating Consumers

Or, why shopping for health is now a 'thing'...

Photo by Shalone Cason on Unsplash

LIVING IN DENIAL
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I have a confession to make.

As a doctor, I used to secretly grit my teeth when I heard patients being called ‘consumers’. And my blood pressure would rise sharply if I heard clinicians being called ‘health care providers’.

Why? Maybe it was because it felt as if the recognition of nine gruelling years of medical training were being reduced in some way. That the complexities of delivering personalised, holistic healthcare might be simply dissolved into discrete, saleable commodities. 

Within doctor circles, I know that I have not been alone in this thinking.

Image by Steve Buissinne from Pixabay 

HOW PATIENTS SEE THE HEALTHCARE SYSTEM
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However, in viewing healthcare as a patient, I started to realise that the terminology wasn’t exactly incorrect either.

It's easy to argue that a patient makes choices and consumes services, with a freedom that is on the rise. And like it or not, anyone providing a health service is being appraised for more than just their clinical acumen. Patients are increasingly sharing feedback on third party sites including social media. Their posts then influence the next person's choice to use that service. For instance, a survey commissioned by Binary Fountain revealed:
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• 70 percent of Americans believed online ratings and review sites had influenced their choice of physician, and
• 41 percent said they would still check a doctor out online, even if referred by another doctor.

Just for fun, let's consider 30-year-old Natalie who badly twists her ankle while playing netball one Sunday morning. Sensibly, she takes the home remedy option (rest, ice, compression, elevation, a good swear and some painkillers). She decides to ring her GP in case it’s more than a sprain. But it’s a Sunday morning, appointments are all booked out.

So she looks online for appointments at other nearby clinics – a benefit that we are lucky to have in Australia. Or she could attend the Emergency Department and risk a long wait to be seen. Or Natalie might drive with her one good leg to the private Emergency Department 10 kilometres away.

Hang on. We’re not out of options yet. She might attend the Urgent Care Clinic run by GPs next to the Emergency Department. She might Google the local private orthopaedic surgeon, orthotist, or physiotherapist. And not to forget she has telehealth up her sleeve (maybe not the best option for a musculoskeletal issue).

In the end, Natalie decides to drive by the supermarket for frozen peas and the pharmacy up the road for an ankle strap. Don't worry, she makes a full recovery.

Image by 3D Animation Production Company from Pixabay

MONEY TALKS
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Patients are migrating away from traditional models of health care because they are dissatisfied with it for various reasons. Some of those reasons may include a cultural and societal campaign for wellness and desire for increased personal responsibility. So even in the traditional setting of the family doctor giving a referral to their patient, choice still can take place afterwards.

​Carrie Liken is head of industry for healthcare at Yext, a U.S. company that has helped multiple health organisations manage their digital presence. During her time working at Google, she found that many patients receiving a referral from their doctor would often search for alternatives after leaving the office.

I have no problem with that. I think the days of the borderline paternalistic consultation directing the compliant patient are coming to an end, and that is a good thing. And with the digital age, patients should be able to research and select beneficial services.

My main concern is that factors such as cost-saving or misinformation, may come to replace the ethical, family-orientated evidence-based management of traditional clinical practice.

Image by Tumisu from Pixabay

​In true dialogue, both sides are willing to change.  Thich Nhat Hanh​

CARE TO CONVERSE?

I recently listened to a conversation between David Shifrin of Health:Further, and Patrick Spear of Global Market Development Center (GMDC). For more on the concept of self-care, ‘patients-as-consumers’ and how U.S. healthcare and retail industries intersect, you might like to check out their fascinating podcast. 

I am no longer gritting my teeth, but experiencing a deep curiosity about where Australian healthcare is heading. 

It sound a little clichéd to say that we should stop competing and start collaborating. But realistically, health care providers need to begin an urgent exchange with one another. Only by doing so we will be able to provide health treatment options that are (a) in the patient’s best interests and (b) within the patient’s personal preferences. 

Things will never be the same again. They might even be better.


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REFERENCES
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Binary Fountain 2018, Healthcare Consumer Insight & Digital Engagement Survey Results Unveiled, accessed 10 May 2019, <https://www.binaryfountain.com/news/second-annual-healthcare-consumer-insight-digital-engagement-survey-results-unveiled/>

Shifrin, David (2018, October 23). Optimizing the Patient Journey | Carrie Liken | Yext [Podcast]. Retrieved from https://pca.st/o3RA

Shifrin, David (2019, May 1). A patient in the morning is a consumer in the afternoon – Patrick Spear of GMDC [Podcast]. Retrieved from https://www.healthfurther.com/the-future-of-health/2019/05/01/a-patient-in-the-morning-is-a-consumer-in-the-afternoon-patrick-spear-of-gmdc/

@AliceLamWriter @GMDCorg ‏ @HealthFurther ‏
#PrimaryHealthCare #gp #familydoctor #generalpractice #healthcare #patientexperience #patientempowerment ​#collaboration

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