We have a healthcare system that is provider-centric indeed. Why else would we call the consumers of their services “patients?” Perhaps because they have to be patient. Patient because they have to wait long after their appointed hour to be seen. Patient while waiting in the Emergency Room. Patient because the healthcare system is rigidly resistent to change. Patient because even the most advanced providers measure quality based on “best practices” rather than outcomes. Do you care about whether your physician employed best practices if your outcome was bad? Ummm, nooo.
So let’s rename patients right now. How about “consumers?” For sure they are, although in today’s dysfunctional healthcare “system,” they rarely pay the providers whose care they consume. But let us not hesitate over that anomalie, which may be slowly changing. Up to now, we as consumers of healthcare rarely even choose our providers. They are chosen for us by other providers. And if we want to be good shoppers and choose ourselves? How do we do that when we cannot determine how much a provider costs or how good he or she is?
Oliver Wyman’s Tom Main and Adrian Slywotzky got it right when they opened their superb article with the following observation:
“For many people, the word “consumer” sounds out of place in a discussion of healthcare. And indeed some of the woes of our system arise precisely from our (mostly ineffective) effort to keep commerce away from medicine. We thought we were protecting the autonomy of physicians, but inadvertently we created a system that rewards waste and failure and makes it difficult to deliver optimal care.
We need to flip that around and create a healthcare market that rewards success and penalizes failure, where no one benefits unless the patient does, and in which competition leads to falling costs and rising quality. That is not just a business aspiration but a cultural and ethical one as well, and it recognizes both the ambitions of healthcare professionals and the centrality of health in all our lives.” The Patient-To-consumer Revolution, p. 7.
What about this strikes you as right or wrong? My premise is that we ban the word “patient.” It is demeaning and represents all that is wrong with our healthcare system today, which is of poor quality, costs entirely too much, and virtually ignores the, ummm, consumer. Will you join me?
Jim Purcell is the former CEO of Blue Cross & Blue Shield of RI. He now helps large employers cultivate workplace wellness strategies that reduce premiums and increase productivity. Learn more at jamesepurcell.com.