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The Journey

Transforming the Patient-Provider Experience

Written, edited and curated by Loyale founder Dan Peterson, The Journey explores ideas and innovation to enrich the patient-provider relationship

Are Patients Now Customers Too?

Posted by Dan Peterson, Chairman and Founder on Mar 7, 2018 9:24:00 AM
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patients_customersIn 2015, nearly a quarter of employees with healthcare coverage had high deductible plans, up from just 4 percent in 2006. That means they’re paying for healthcare the way they pay for everything else … like a real customer. What does that mean for providers? I’m old enough to remember when Dr. Brooks came to our house to give me a penicillin shot for my annual case of winter tonsillitis. It never took long, and Washington DC’s weather could be nasty enough that he usually took a few minutes afterwards to chat with my mother over a cup of coffee while she rummaged through her purse for the $4 to pay him. Then he would repack his stethoscope and flashlight into that wonderful-smelling black bag he carried, pat my head saying, “He’ll be hungry by dinner time,” and head for his next house call.

In case you’re thinking that Dr. Brooks was some “bush league” discount pediatrician, let me just say that a few years after he stopped being our family’s pediatrician, he was tending to two kids name Carolyn and John-John who lived a few miles away in a big fancy house on Pennsylvania Avenue. But we had him first.

And we were loyal. Once my brother was sick while Dr. Brooks was out of town. My mother called his service to ask who was covering for him. My brother said, “Thank you very much, but I’ll just stay sick until he gets back.” You can’t buy that kind of loyalty.

Our relationship with him was complete … blending clinical and financial. And oddly enough, the completeness seemed to matter. Something about actually paying the doctor directly for the care you received made him yours in a way no “in network” declaration ever could.

Have you noticed how paying for something seems to have a profound effect on how we feel about it? If we’re given a free or cheap bonus gift (think CoPay) that turns out to be junk we say, “Well, what did we expect?” But if we’ve paid real money for something, it’s a very different story. If the waiter is rude or the checkout line at the department store is always a mile long, we’re less likely to return. Tell me honestly … given the choice do you shop at Macy’s or Nordstroms?

So what does this have to do with healthcare? One of the realities of healthcare is that the financial part of an episode typically lasts longer than the clinical part. Long after the physical pain is gone, the financial responsibility continues. Who wants the last taste of an experience to be a sour one?

I’ve spoken with dozens of healthcare providers who are dealing with the transformation of patients to customers. Some of them are realizing that this challenge has a silver lining – deeper, more satisfying patient relationships. They’ve also learned that getting there requires a different kind of patient engagement; one that blends the clinical and the financial. I think Dr. Brooks would be pleased.

Not too long ago, I had clinically outstanding shoulder surgery that made very clear to me why so many Americans say they are less than pleased with our healthcare system. By the time all was settled, I had a list of customer practices that I believe would be considered intolerable in any other industry. Here were my favorites:

  1. I had NO IDEA of how much I would wind up paying or why (the first Blue Cross EOB said they were paying $500 out of $98,000 … that was a thrill!),
  2. There was NO acknowledgement of, let alone advice regarding, payment terms or financing to help me plan or budget my responsibility,
  3. My payment options were, mail a check or credit card, phone tree… then repeat as necessary, because...
  4. You guessed it! There was nowhere to view the bills, balances or communications resulting from my procedure. They just kept coming … until they stopped. (See item 1).
I’ll bet you have a similar experience, either personally or through someone you know. Let’s take a survey. On a scale from 5 (amazingly incompetent) to 1 (I don’t care, what are you whining about?), please rate top four “winners” of my patient experience. You can do it right here on this page.

I’ll keep you up to date on the results in the coming weeks, and as always, I’d love to hear your thoughts, comments and suggestions.

Topics: patient experience, healthcare consumerism, patient affordability, patient consumer

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