Patients these days are a demanding lot. They insist on the latest procedures, they expect more bang for their buck, and they'll gladly jump ship for a practice that can better accommodate their busy lifestyles. Indeed, as the healthcare industry evolves from a patriarchal system in which doctors did the talking to one that gives patients an equal voice, so too has the population it serves. Technological innovation, new models of delivery, and higher out-of-pocket medical costs have transformed the passive patients of old into consumers as never before.
That's a good thing, says Glen Stream, president-elect of the American Academy of Family Physicians, noting the push toward patient-centered care requires patients to become active participants in their own care. But it also creates challenges for providers.
"I think a lot of physicians of my generation, who have been practicing for 25 years, think, 'What's wrong with how we've been doing it?' The answer is that nothing's wrong with it, but the environment has changed, the tools we use to deliver care have changed, and our understanding of what patients want and need has changed," he says, noting those who fail to adapt risk alienating their patients in the exam room, or worse, losing them to the practice down the street.
With that in mind, we sought to profile the modern American patient — who he is, how he has changed, and what he seeks from the system. Our findings not only shed light on the people behind the patients, but pinpoint opportunities to strengthen the doctor-patient relationship and sharpen your competitive edge.
They want bedside manners
From their physicians, it seems, patients seek out a specific set of behaviors: character traits they have always prized but have elevated in importance in the consumer era of medicine. "Patients more or less assume that their doctors are competent clinicians until they're shown otherwise, but what is also important to them, and what is easier for them to judge, is their doctor's behavior," says Leonard Berry, a professor at Texas A&M's Mays Business School and coauthor of a 2006 survey published by Mayo Clinic Proceedings called "Patients' Perspectives on Ideal Physician Behaviors." "As consumers, we pick up on a lot. We see body language, mannerisms, a raised eyebrow, a shrugged shoulder; things the provider doesn't see and may not know he or she is doing."
According to Berry's survey, patients want their doctors to be "confident, empathetic, humane, personal, forthright, respectful and thorough." Within those categories fall such specifics as an "assured manner which engenders trust," compassion, a personal connection that shows the doctor is interested in them as an individual (by recalling details about their life), and speaking in "plain language" without beating around the bush. Strong interpersonal skills, Berry says, go a long way toward establishing trust between doctor and patient, a key factor in determining how likely your patients are to comply with their treatment regimens.
Not surprisingly, patients in the survey who described their "worst physician" experience, relayed mirror-opposite traits, especially "perceived insensitivity" and disrespectful behavior. Their concerns about poor service ranged from a physician's arrogance in dismissing their input, to disinterest in them as an individual, and impatience in answering their questions. They were equally bothered by callousness in discussing their prognosis, the survey found, and by physicians who seemed to provide excellent service in the original visit, but failed to meet expectations they created about speed or quality at follow-up appointments.
They want value
It's clear, too, that 21st century patients are price sensitive, partly a result of ongoing economic uncertainty, and partly due to higher insurance premiums and copays. The 2010 U.S. Survey of Health Care Consumers by the Deloitte Center for Health Solutions found that 13 percent of all consumers switched physicians in the last year, and 29 percent of them did so for cost-related reasons that include changing insurance plans, wanting a doctor who was covered by insurance, or wanting doctors who charge lower fees. "They want changes, see gaps in quality, and fail to understand how a system that costs so much can be so confusing and seemingly resistant to common-sense improvements," writes Paul H. Keckley, executive director of the Deloitte Center for Health Solutions, in the survey. "And they do not want to pay more than they currently pay out-of-pocket, if at all."
Indeed, cost and convenience are driving the use of retail medicine for primary-care services, especially among Generation X and Generation Y consumers, the survey found. Some 15 percent of all consumers said they used a lower-cost retail clinic like those located at mini-malls and discount drug stores at some point during the past 12 months. The Gen Y set did so the most at 19 percent, followed closely by Gen Xers at 17 percent. That compares with 13 percent of baby boomers and 10 percent of seniors who used retail venues. Collectively, though, some 34 percent of all consumers (regardless of age) indicated they would use a retail clinic if it cost them 50 percent or less than a private practice doctor's visit.
