Episode 97: Adapting to Consumerization in Healthcare

Patients have different expectations of their healthcare providers than they did in the past. The desire for consumer-focused healthcare has continued to grow over the years, and the pandemic has only accelerated this push among patients. While consumerization may force practices to change their normal processes, those that can adapt can improve patient interactions, build trust, and create long-lasting relationships with patients.

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Full Transcript

Announcer: It’s time to think differently about healthcare. But how do we keep up? The days of yesterday’s medicine are long gone and we’re left trying to figure out where to go from here. With all the talk about politics and technology, it can be easy to forget that healthcare is still all about humans. And many of those humans have unbelievable stories to tell. Here we leave the policy debates to the other guys and focus instead on the people and ideas that are changing the way we address our health. It’s time to navigate the new landscape of healthcare together. And here’s some amazing stories along the way. Ready for a breath of fresh air? It’s time for your paradigm shift.

Michael: Welcome to the Paradigm Shift of Healthcare. And thank you for listening. I’m Michael Roberts, here today with my co-host, Scott Zeitzer. This show is focused on the many ways that healthcare is changing and how the consumerization of healthcare is affecting practices. We talk about this topic on a regular basis a p3practicemarketing.com, and we invite you to be a part of that conversation there. So healthcare is becoming more and more like other consumer-focused businesses, even though we all know there’s some striking disparities between those two concepts. So, this pandemic has only continued to accelerate the push for consumerization and while consumerization can present challenges to practices, those that adapt have the opportunity to create a lot of positive interactions with patients and foster trust and loyalty among their patient base. Patient expectations are changing and practices that don’t adapt may ultimately get left behind.

Scott: I’m seeing this, it’s just COVID has exacerbated, for the better and for the worse, a lot of things. And I’ve had a lot of conversations with friends of mine who’ve been in practice for a while and when I say “consumerization of healthcare,” you get this pained look on their faces on some of the people and then some other people you get this wide-eyed “Yeah.” Both will require some heavy lifting. There are changes to be made. And with habits, habits can be great and habits can be tough to break. And this is a lot of that. So patients, to your point, Michael, they are calling for more consumer-focused experience. That’s a fancy way of saying I don’t think you need to treat your patients like you’re at Nordstrom’s, but we all know everybody that everybody listening to us knows that we’ve been to see a doctor where you’ve waited for three hours because of X or maybe you had to wait, but why couldn’t they have called you?

Orthopedic surgeons, neurosurgeons, et cetera. Sometimes the surgery lasts a little bit longer, but it’d be nice if I was told. I hear that a lot. There is a study by SymphonyRM, 50% have higher expectations, we’re talking about patients, for their doctors since COVID-19. 50%. And 23% say their opinion of the doctor changed since COVID-19. That’s a lot. The next one is nearly 20% are considering changing their doctor based on how they handled COVID-19. I want to warn everybody out there, I’ve had a lot of conversations with docs, I’ve got two more bullets to bring up here, that it’s really hard to track those that you’ve lost. A little bit easier say for the dentist or for the endocrinologist who’s seeing a patient all the time then all of a sudden they’re gone. I get it. But when you talk about practices like an orthopod or a neurosurgeon, it’s usually hey, you’re going to get them to come in and you’re going to take care of them, hopefully fix them, and they’re on their way.

And you’re not going to know that they decided not to come back or that they’ve left because you’re either busy or you just never knew. So keep that in mind as you smugly go, “Not me.” Third bullet is patients are feeling that their doctors should have made a greater effort to communicate and felt left behind when they felt they did not receive enough information. So, that’s always been the case. Docs are always trying to get in and out, see all their patients, take care of everybody in the same day. Now it’s even worse because not only are they in pain, but they’re afraid of getting COVID and that always comes back to, Michael, you and I talk about this all the time, over communicate.

Michael: Just because of the business that we’re in, we’re focusing on how are you getting out to on your website, on your map listings and all of that kind of stuff, how are you making things easier for patients that are coming in, that are just getting started? But a lot of this has to do with not just that kind of communication, but also all the stuff that’s happening in the portal, all that person to person communication. A lot of this stuff that we’re talking about is like a broadcast approach, put it on your website, put it on your map, listing, put it on social media, that kind of stuff. But that person to person interaction is so critical here too. So just to give a window on where we’re at in the world as we’re recording this particular episode, Scott you’re in New Orleans, I’m in Tennessee right now, all of us dealing with the aftereffects of Hurricane Ida that came through.

And so you talk about consumerization, the types of experiences that we’ve had, that my family and I have had just since leaving New Orleans and being in different places, how convenient it’s been to communicate with hotels and whatever remotely, and to be able to do all that stuff online. And these are the experiences that people are having and then comparing to their doctor appointments because, well, if I can book all this stuff, if I can do all this stuff. So I’m talking to a family member that’s up here in Tennessee and they were just talking about how well, I don’t want to go down to see this doctor in this particular city because hey, there’s a bunch of cases down there, there’s a bunch of COVID happening down there, I’d rather stay away.

So they’re coordinating their care between the big city hospital and some smaller clinics that are further away. So, again, this type of coordination and communication. And they’re talking about how great that is, but all of the gaps that are arising, well, I didn’t hear back from this person, well, I didn’t hear from this. And so all of that normal communication problems that people have, it’s now extra because it’s not just going to one facility all the time. There’s multiple clinics involved, there’s all these different moving pieces. So the process is getting harder. I think, to very much advocate for all the practices and the hospitals and all that stuff, the bar has definitely moved. It’s gotten harder, but everybody’s expecting that everybody’s keeping up. And so, fairly or unfairly, patients’ expectations are growing pretty substantially.

Scott: That’s the thing. So as you’re talking to me about this, I’m thinking about all these different practices where they’re working so hard. So I do want all the patients who are listening to this, practices, they’re working hard. They really are. Whether that’s the surgeon or whether that’s the front office staff, et cetera, man, they are just trying to see patients and take care of them as safely as possible. And to all of those practices, I say, I get it, I get that you’re pressured but if you slow down long enough to figure out what you can do a little bit differently to help this whole movement along, it will help you so much and save you so much time. And I will warn you that if you don’t, your patients are going to go somewhere else where they are doing it. It is happening.

I talked to a surgeon who basically said, “I get it, my patients have to work hard sometimes to see me, but I think I’m worth it and I think that ultimately they come to see me. And my response to that surgeon was, “I hope you’re right, but I can guarantee you that there are five or six that left.” And usually that five or six that left, quite frankly, are the people with better paying insurance. So you got to bear that in mind. I always warned all of my customers and friends, value over volume, value over volume, is it going to be a critical win for the health of your practice? And if you’re treating everybody just from a value perspective, I get it, man, you’re trying, but I think you’re going to end up failing. And I think that’s a critical thing to think about, especially when you think about it from the perspective of where, as you’re saying, Michael, patients are coming from. They’re so scared, COVID’s changed that habit. “I’ll do whatever the doc tells me.” Nah, not anymore, man. I’m too afraid.

Michael: Whatever the reasoning may be, that recognized authority that doctors have had historically is definitely changing and it’s just always, I think, more and more in question, some because of better information, some because of misinformation, whatever it may be. There’s just a variety of challenges that are really coming into that space.

Scott: So pre-COVID, that lessening of authority was certainly there and a lot of my surgeon friends were really rueing it, like, “Man, if I have one more person come in and talk to me about how magnets are going to cure their arthritis, misinformation. I can’t understand why they’re not doing what I told them to do.” It’s not a misinformation thing, you’re just not the authority. The changing patterns of primary care physicians and other referral patterns coming in to the surgeon, so pre-COVID all this existed. Now during COVID, because I used to say post-COVID, but that’s a wrong statement on my part, but now that we’re in this endemic, I see no reason as to why it’s not going to continue this trend at this accelerated level. So you got to be prepared for that.

Michael: Yeah, for sure. So let’s switch gears a little bit just to talk about some more data that came up. There’s an article from Fierce Healthcare, the article’s entitled “As Healthcare consumerization gains steam, organizations must balance convenient service and quality care.” So consumers are used to Amazon. They’re used to these kinds of other services where you can just order and you can see what’s happening and you can know what to expect and you can check on where your deliveries at the entire time and all of those kinds of things, all of that over-communication that we’re talking about, but that’s obviously a very different experience than what a lot of healthcare can be. So, again, I definitely want to talk through Amazon has in many ways systemized their approach. They’ve, I won’t say perfected it, but they’ve got a pretty darn good solution on how they’ve made these things come together.

It’s very repetitive. It’s very exact. It’s very obvious what the next step is going to be. So it’s clear when something goes off the track, how to fix it and how to get it back on. But so much of what practices are dealing with are…

Scott: It’s not Amazon. No.

Michael: Opening up this whole what’s the diagnosis, what’s the treatment option, what is the way that the patient’s going to respond, all of these different variables that come into this. So how do practices look at that process and start making things more efficient? I think the things that come to mind at first, it’d just be what are the processes and communication that they can give to patients to help them understand what to expect around that?

Scott: It’s interesting, as you were telling me that I was thinking, that article, it’s a lot about it’s an unfair comparison. So Amazon is very good at these repetitive things and the art of medicine, and it’s called the art of medicine for a reason, it does require people to slow down, some very smart people to slow down, take a good hard look at what’s wrong with the patient and come up with a game plan. And that’s never going to change. You’ve got to have, really, hardworking, intelligent people working with patients to take great care of them, it’s not going to stop. But the people that come up with some sort of system that helps alleviate the mundane repetition that really is there, those are going to be the ones where there are wins. It’s, I get it, you’re not going to process patients like Amazon. If you do you’re frankly probably not a good doctor.

But there’s so many things, and a lot of the things that hamper the surgeon, it’s like there’s a lot of processes that are built on sand. There’s got terrible EMR systems where no, no they’re good at billing people and they’re good at entering data, but they’re certainly not very good at helping you communicate with the patient, that kind of conversation. Or we can have an entire show just based on oh my God, why do EMR systems… Why are they so bad in general? And if any EMR sales person marketer wants to get on board and tell us why their system’s so great, give us an email, give us a shout out. In the meantime, I’ll say… But it does make a lot of those repetitive tasks hard, because a lot of the conversation is really, like we said, just communicate. I get it, man, I need to come in and get an MRI or a CT, how come I can’t see it? How come I don’t know what the next thing is? Why do I need to call back three times just to get information? These are the things.

Michael: Absolutely.

Michael: So if you’re just joining us, this is the Paradigm Shift of Healthcare. I’m Michael Roberts, talking to here with Scott Zeitzer. We’re talking about just adapting to consumerization in healthcare. It is here, it is happening and I really wanted to dig in on some of these specific points around what does consumerization mean today in the middle of everything going on with COVID-19, in the middle of so many consumer-facing services just getting more and more convenient all the way through. It is interesting because we’re talking that fair or unfair comparison that people make with something like healthcare and Amazon, there are still so many businesses other than healthcare that requires some sort of diagnosis process.

There are other industries that do require custom work every single time that people can look to and can learn from. What are those other things? Are there architects who are doing a great job of communicating? Are there lawyers who are doing a great job of communicating? Are there all these different kinds of industries that have still found a way to be very personalized and very attentive along each step of the way? We’ve talked to some people on the show here before, and we’ve talked to Ira Kirschenbaum around how he’s organized the clinic, going to get a chance to talk to him again. Coming up for our hundredth episode.

Scott: 100!

Michael: Coming up on a lot of episodes. But getting the chance to see hey, this is how physicians are already doing this, they are already adapting to these kinds of things. There are people that do excel at making this stuff happen, but it is so intentional when they excel at it. Dr. Green, Dr. Smith, who works in pediatrics, these physicians that we’ve talked to that truly excel, it’s not something where somebody gave them the existing system where it was already flawless and all they had to do was go and implement that, they each made choices to intentionally go out of their way to make this more convenient.

Scott: This is this thing where, I say it over and over, you got to slow down enough to do a better job. So if all you’re doing is coming into the hospital at the crack of dawn, rounding on your patients, doing your surgery, going to clinic and then at the end of the day going, “I don’t understand why people are actually mad at me, why I’m not making as much money as I should.” All those things happen. And I go down to slow down, and I think what I want to do is instead of making it so negative, why don’t we talk a little bit about how it can help a practice financially?

Michael: Absolutely. This can be a very trying thing if it comes from the sense of “I’m just not enough, I’m not getting enough things done, here’s five more things I have to add to my day.” I’ll definitely say that in Dr. Kirschenbaum’s experience in particular, it’s not just him.

Scott: No, it’s his whole team.

Michael: It really is this team coming together. So in terms of who’s responsible for it, how does this thing actually happen, all of that kind of stuff, but I do want to really emphasize that it’s whole clinic, a whole practice shift in mentality, not just “Work harder doc, good luck.”

Scott: Absolutely important point to make here. Whatever the plan is that you come up with, it’s got to be done as a team. There’s an office manager in there who probably has a lot of ideas and there’s a group of MAs and PAs and everybody else on the team. And you got to get that group together, whoever you trust, in that room together, maybe for dinner, maybe just block out an extra hour. I get it. It’s costly to say, “I’m going to run clinic for one hour less this whole week. Man, that’s a lot less patients to see,” but maybe because you do that, you actually come up with a system that allows you to see so many more patients. I think, Michael, I couldn’t agree more.

If only you come up with the plan and you don’t tell anybody else, destined for failure. So let’s talk a little bit about consumerization and what it can mean to a practice financially. There are challenges, we’ve been talking about that, but I think that practices that embrace consumerization may be more likely to grow and make more money. This goes back to that volume versus value conversation I keep bringing up. There was a recent article in Medical Economics that explains how embracing the consumerization of medicine could affect a practice’s bottom line in a positive way. There we go. And when consumers purchase goods and services, they know the pricing upfront. Not in medicine, this is not the case with healthcare. Patients usually don’t know the cost of the service until they get the bill and it may affect the practice’s ability to get paid.

This is something that has been talked about quite a bit in the newspapers and et cetera, et cetera. The article quoted a survey that found that when patients are given a cost estimate at the time of service, 65% said they were more willing to at least make a partial payment. Now, it’s a really touchy conversation here because a lot of, that specific thing, I think a lot of practices… I remember talking to an office manager Terry up in Ridgewood, she would love to tell you what the price is if she could ever figure it out herself, because she deals with so many different insurance companies and just trying to figure out how to get something approved, let alone what the cost is. But it’s an important point. If, if you could try to understand the system better and work with your billing team, I think that’s helpful.

On the other hand, when the bill ends up being higher than they thought it should be, patients understandably get upset. And in these cases, most patients don’t pay anything. And then of course they diss you online. I do think that’s just one little subsection there, Michael, where consumerization can get messy. The billing process is so dissimilar, as so many other things are, that these are one of those things that really need to be looked upon about, how do you ameliorate that? I don’t think you’ll ever wipe it out, but do you ameliorate it?

Michael: There’s been this big push for pricing transparency.

Scott: No doubt.

Michael: And then there’s been these ridiculous ways that hospitals are getting around it. Yes, there is a page on my website where it has it and it’s just literally just a block of text with numbers and it’s not in any sort of chart, it’s just as difficult as it can be. And it’s interesting, some of the different guests that we’ve had on, there’s a lot of different folks that we’ve connected with on LinkedIn through this nearly 100 episodes that we’ve recorded, but some of them really go to task on a lot of these organizations that list their prices that way. If you’re going to make it as hard as it possibly can be for us to understand what pricing is, they really dig in and go look, here’s the range of prices for this particular joint replacement or this particular procedure or this whatever it may be. And so obviously that’s a big, hard challenge and nobody’s solving that problem today. That’s a lot of legislation that’s involved. That’s all that kind of stuff. There are so many pieces to that. But there is obviously a hunger to have more transparency.

That’s the key, it’s people want to know more. So ways of going after that, we’ve got people that we work with that are more about cash pay for their procedures and orthopedic surgeons…

Scott: Concierge-style medicine. Yes, absolutely.

Michael: It’s not just oh, that’s something just for pain management or something, it’s no, here are people that are doing that. And I get that it’s not for everybody and all that kind of stuff, but acknowledging that people are trying to understand costs, they’re willing to talk about it. They’re willing to acknowledge it, but yet it’s big and it’s hard and it’s messy. Sometimes I feel like every time one of my kids ends up going to the doctor it’s like taking the van and you have some service repair, I don’t know what’s going to happen, but it’s going to be at least a couple hundred bucks. I look at it like every time the van has to go in the shop, I’m like, “Yep. It is a couple hundred bucks, at least. I’m just hoping it’s that.”

Scott: So a lot of this has the opacity conversation and difficulty. It’s not the surgeon’s responsibility to sit there trying to figure out what every procedure he does. But an 80/20 rule might be helpful. If he’s doing a particular procedure more often than not at two or three different hospitals, maybe taking the time to go figure out just, about on average, what it costs for your top tier so you could have a better conversation. What if part of the conversation when you’re talking to the patient is, “Hey, we can do the surgery at A hospital or B hospital, and from what I understand. And we can confirm this or, or you can confirm this, it’s cheaper to get the procedure done at this hospital or at the ambulatory surgical center, et cetera.” I think at least being aware somewhat of what some of these costs could be would be helpful, but, I’m telling you, for all the patients listening in, surgeons would love to know what some of these prices are and it is a maze out there and it’s a hard one to overcome. It really is.

Michael: And since we’re talking through all this, to kind of put this in perspective, look, Scott and I are not economists and I’m very happy to not have that job. I had to take a few courses in it and it was not my favorite coursework that we had to do, but here’s why we’re bringing it up. Here’s why we’re tying it into this episode and why it does affect more than just the billing department for your practice and for your hospital. Another study from Medical Economics found that a positive patient experience is associated with increased profitability, while a negative patient experience tends to have the opposite effect. And this is something we talk about with the way that people leave reviews, Scott. As we’ve got different customers that are working with reputation marketing and helping solicit reviews from their patients and going through all that experience, the more opacity and the more surprises there are, the harder it’s going to make it on the patient, the more likely that patient’s going to leave a negative review, all of those kinds of things.

So yes, it is a billing problem. Yes, it is a financial issue. Yes, it is an economic thing. But also it’s a marketing thing, because consumer experience, patient experience, all these kinds of things are the way that the practice is perceived. We talk a lot about word of mouth and what that means for a practice nowadays and how that shows up now. It shows up in reviews, it shows up in the way that people are talking about you on Facebook and all these kinds of things. So, there is this component where the more that practices can be aware of this and communicate around this, even if it’s something as simple as, “Here’s what to ask your insurance.” I’ve definitely had that experience before where, maybe the practice couldn’t answer the question, but they could give us the right questions to go ask our insurance. And so we at least understood hey, the dynamics here are this company is the one that’s gating the way here so can we at least get answers from somebody? But that extra step of being helpful made a world of difference in our experience with the practice.

Scott: I go back to over-communicate. And some of these issues are not going to be tackled alone. They really aren’t. My takeaway for everybody listening, if you’re trying to run a practice, really would be you’re answering the same questions over and over a lot of times, and they have nothing to do with the procedure. Start collecting that, start putting that somewhere. And when I mean that somewhere, I don’t mean just on your website, because I know you know we’re the online guys. I get it, yes, your website, Facebook, et cetera. I also mean start instructing your team. These questions are being asked all the time. I’m now going to go over how to answer those questions. So it’s not just me. So it’s not just a technology issue, being kind. Technology can certainly help you communicate. It certainly can. But you’re going to have to slow down enough to figure out what we’re going to over-communicate a bit.

Michael: And going back to, pull in the right people, I don’t think we can stress that enough. Including the practice administrator, the people at the front desk, all of those different folks, tying those bits of information together is going to make a really big difference. Because, again, how the word of mouth about the practice is shaped includes all those people. The more that they have buy-in and see the opportunity to contribute here, it’s definitely going to matter. So all the way through this, we’re talking about positive patient care experiences. It works in your practices favor. We’re talking about word of mouth. We’re talking about financially.

We’re talking about a lot of different things that go into this, but working to create efficient quality care experiences and sometimes really going overboard on compassion wherever you can creates word of mouth and creates patients that are willing to stick with you. Thank you so much for listening today. This is Scott Zeitzer, and I’m Michael Roberts, please feel free to reach out and connect to us on LinkedIn, different ways to connect with us around the show. It’s definitely been a pleasure to get to know folks from the show and guests and all of that good stuff along the way. So, as always, we appreciate you listening and wish you a great week.

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