Healthcare has undergone many changes in the 21st century. With the advent of Covid-19, it may now be poised for even more radical changes. In the 20th century, doctors were exclusively in the drivers seat when it came to healthcare discussions. Like a taxi passenger, patients let the doctor take them to their destination. The patient journey has changed a lot in the past 20 years. And is poised for even greater changes starting now.
My career researching healthcare began in 2000, when the scales were heavily tilted toward the doctor. In a focus group I observed in 2002, one CNS doctor suggested that when it came to their health, patients considered him God. And the rest of the doctors agreed!
My how times have changed. Since then, DTC marketing has promoted patient involvement in medical discussions. And in many categories, this led to remarkable changes. At one conference, I debated Ralph Nader who disparaged DTC marketing as bad for the country. He claimed that DTC marketing increased costs and promoted the use of medications that patients do not need. I disagreed. As examples, I pointed out that DTC marketing changed the terminology of impotence to Erectile Dysfunction and demonstrated to patients that depression was based on chemical disorders that medication could treat. With stigma around these medications reduced, treatment increased dramatically. As patients learned more about treatment options available to them, the dialogue between patients and doctors improved. Patients knew more about the questions to ask and the symptoms to be discussed. They might even push back on doctors if the suggested solution did not make sense.
In most recent years, the Internet was a key source of information for patients. When you want to pick a new detergent, you can ask a friend. When you want to understand your health condition before going to the doctor, you go online. In 2017, when I was diagnosed with Stage 4 Throat Cancer, that is exactly what I did. My appointment with specialists was a week after I heard the bad news from my ENT. I certainly wanted to know more before that meeting. I went online and learned a lot. For one, I learned that 80% of patients with this condition were cured (wish the ENT would have told me this, but he didn’t). I also learned about my options for treatment. And got the best treatment. I was cured.
So patient empowerment has been happening for awhile. Then COVID-19 struck. If things were already shifting, this crisis has put the change into superdrive. Telemedicine, which has been growing recently became a standard of care during this time. It enabled patients to communicate with doctors from their homes, offering safety to both. Use of this approach skyrocketed. In this period, the call volume to doctors offices ballooned from 50,000 to 100,000 per day.
While this approach offered convenience, it left many gaps. With a lack of personal interaction, the doctor must rely on patient discussion and results from testing centers like Quest. More than ever, patients need to come to their doctors knowing the questions to ask. They are learning to research their conditions better.
Patient portals allow patients to review information from their tests and communicate directly with their doctors between visits. Lesley Kadlec, director of health information management practice excellence at American Health Information Management Association indicates that patient involvement through portals is revolutionizing the way that HCPs interact with patients. She says that consumer engagement is “a high priority” for healthcare today”, and one “likely to increase as health information technologies, like portals, continue to evolve.”
These shifts lead us into a world where the balance between patients and doctors is more even. Doctors will always be in the drivers seat. However, the patient is no longer a passive passenger. The patient has moved from the back seat to the front passenger seat. The patient can interact with the doctor to make certain that they are getting to the right destination. The journey is improved.
An important implication for Healthcare providers, Insurance companies and Pharma companies is that they must provide access to the right information. This is both an opportunity and an obligation. By offering such information, these parties can help patients to properly discuss their condition with healthcare providers. They can also draw attention to new brands and improvements in patient care. This can lead to both improvement in patient care and also adoption of the latest therapies. In this way, everybody benefits.