Modern medicine has adopted technology and pushed the boundaries of science in impressive ways. We see this in the use of high-tech imaging, advanced pharmaceutical agents, innovative medical devices, and recent advances in proteomics and genetics. However, in the actual delivery of care (how physicians interact with patients, manage health information, and pay for care), we still have paper records, we still hand write prescriptions, and we still have as much as 30–40% administrative overhead. This healthcare delivery “adoption lag” is predictable, and typically averages five to seven years, but may be as long as 10 to 20 years
. The automation of financial transactions, the movement toward electronic medical records, or even the adoption of Linux within the healthcare enterprise have all followed the predictable delayed adoption pattern seen in other industries.
However, this delay can be used to the strategic advantage of astute physicians and healthcare entrepreneurs. By observing the wider technology adoption patterns in fast-adopting industries like financial services, we can reliably predict what trends will soon be impacting healthcare. We can also get a sense of how consumers, traditionally called patients within healthcare, will respond as they adopt—and push their providers to adopt—the technologies that will simplify their healthcare interactions. This millennial generation of patients will expect to be able to use Internet technology to shop, compare, chat about, purchase, and report their experiences just as they do with nearly all the other services they consume. Welcome to nextgeneration
healthcare and what I like to call the Millennial patient.The millennial patient
Millennial patients can best be defi ned by their behavior, rather than their age, sex, or demographic. Millennial patients are the first generation of Americans to grow up with the Internet as a pervasive part of their lives. They use the Internet in their everyday life to research information, purchase tickets, pay bills, and meet their personal, social, and professional needs. They are amazed, bewildered, and ultimately angry with the inability to access their healthcare services in this way. They cannot understand, and they will not tolerate, this disparity in the ability to manage healthcare transactions as simply as they manage their financial transactions. They are knowledgeable, intelligent, are typically prepared for their appointments, and inherently expect and demand a far higher level of service from their healthcare provider.
In contrast to the widely publicized TIME magazine article
by Dr. Scott Haig, most Millennial patients are not “Googlers” in the derogative way he uses the term. Most do not use this information as a weapon against their physician, but rather use it to become an informed participant in the delivery of their care. They value the trusted relationship with their healthcare provider and want to work together to optimize their health. Having used professional advisors in other areas of their life, they understand the need to have a relationship with their healthcare provider based on trust, mutual respect, and open communication. In order for physicians to most eff ectively engage the Millennial patient, it is import to understand the diff erent types of next-generation patients.Patients as consumers
The days of passive patients cowering under the commanding voice of their all-knowing physician are gone. The outsourcing of medical decision making will continue to wane as the outsourcing of fi nancial responsibility continues to be reduced. As the cost shifting returns back to the patient, the increased fi nancial accountability means that patients will be more involved with decision making, including treatment decisions, because these directly aff ect costs. The notion of “shared medical decision,” pioneered by Jack Wennberg’s team at Dartmouth, describes the collaboration that occurs in reaching an agreement about a healthcare decision. Part of these conversations will include discussions regarding the pricing of services, which will force providers to reconsider what they are willing to accept for payment for their services. How much does that treatment cost? What are the alternative therapies, and how much do they cost?
It is important for providers to realize that patient consumers are not asking these questions to challenge their clinical judgment. There is no plausible medical tenet or practice bylaw that states the patient “shall not” know the price they are about to pay for a service. Th ey are asking because they need this information to formulate in their own minds the value decision (outcome/ price) that will aff ect what they ultimately decide to do. While providers may believe that the patient will always choose the therapy that potentially leads to the best outcome, patient consumers may not be willing to pay the price to obtain the recommended outcome.