"Millennial patients are the first generation of Americans to grow up with the Internet as a pervasive part of their lives. … They are amazed, bewildered, and ultimately angry with the inability to access their health care services in this way. They cannot understand, and they will not tolerate, this disparity in the ability to manage health care transactions as simply as they manage their financial transactions."
Those are the words of regular THCB contributor Scott Shreeve in an article he wrote for the April issue of MDNG magazine. Shreeve adeptly describes the next generation of patients, whom he calls millennial patients. All at once, he says, they are consumers, providers and partners in managing their health.
Then, he talks about what it means to be a millennial provider in a new technology-dependent world. Shreeve says the health care industry’s initial lag in adopting health IT can play out to its advantage — so long as it hurries up.
"By observing the wider technology adoption patterns in fast-adopting industries like financial services, we can reliably predict what trends will soon be impacting health care. We can also get a sense of how consumers, traditionally called patients within health care, will respond as they adopt—and push their providers to adopt — the technologies that will simplify their health care interactions."
Dr. Shreeve seems to focus on the (seizable) minority which has the intellectual, physical, logistical and financial ability to be alert and active consumers. He seems to overlook that the majority of patients may lack one of these factors (and some, believe it or not, may simply lack the motivation to be active patients, as I know from my own practice when I start discussing treatment options).
He is right that treatment costs are a component of medical decision making. I think that Dr. Shreeve did not really look at the ethical consequences of accepting cost shifting and countering the problem with consumerism (as he obviously suggests). The consequence is that patients who don’t have the resources will be excluded from meaningful medical treatments, while wealthy patients may consider spending Dollars on plastic surgery or Botox. I worked as a physician and/or resident in 3 different countries (Germany, France, US), and there is no doubt that the well off always and anywhere will enjoy one or the other form of preferential treatment … and I don’t find this horrible as long as the poor have a reasonable minimum standard, which Dr. Shreeve apparently does not consider.
I also noticed that, despite all the market analogies, the actual product is not defined (insurance? Doctor? Hospital? particular test or treatment? health care system?), and one can even argue that at least part of the consumer role belongs to the third party payor, or the employer).