Managing Patient Expectations: Are Physicians Becoming Less Relevant?

April 26, 2012

Three fundamental developments - the Internet, medical reporting, and technology - have shifted patient perceptions from who makes them better to what makes them better.

Three fundamental developments have shifted patient perceptions from who makes them better to what makes them better. And they have taken permanent root as influencers of patient perception:

1. The Internet
2. Medical news reports and advertising
3. Technological advances in diagnostics, medical devices, and pharmacology

Patients’ perception that technology has evened the playing field, making clinical skill less of an influencing factor, ranks second on my list of 10 new patient expectations, and it isn’t just patient perceptions that are at play here.

1. The Internet
Most website professionals correctly state that people overwhelmingly go to the Internet to find products and service providers, implying that people look for healthcare providers the same way.

They do not.

A recent Google study estimates that the vast majority of people conducting healthcare-related searches on the Internet are seeking information, not providers. To test that claim, I conducted a Google Adwords analysis to see how many people searched for “diabetes doctor” and all of its top 100 iterations. Of the 6.96 million monthly average U.S.-only searches, less than 215,000, or 3.1 percent, were for any kind of diabetes doctor. Internationally, less than 1.7 percent sought doctors on nearly 16 million searches per month.

And what did these searches yield? Lots of information and lots of diabetic testing products, from home testing technology and kits, to test parameters, to treatment products, and even Colgate toothpaste touting itself as an effective preventative for diabetes related gum disease. A search for “best diabetes meter” delivered 184,000 results. “Best diabetes doctor” - 43,900.

The conclusion is obvious. People are seeking solutions on the Internet, and they are finding them from medical device companies and suppliers, not providers.

This is not to say that providers do not have websites, most do, but the content is all wrong. Those providers who convert their websites from digital brochures to information resources will be the most relevant not only to search engines, but to patients.

2. Medical News Reporting and Advertising
People still intuitively want the best doctor, but their general definition and ability to determine who qualifies as the best has changed dramatically under the influence of a multitude of external forces and input.

Advances in genetic research, stories of seemingly miraculous cures, new implants, diagnostic equipment, and human interest stories featuring techniques, procedures, and technologies regularly make the news; doctors with exceptional diagnostic, surgical, or treatment skills and outcome statistics do not.

The media, from blogs to business channels, overwhelmingly covers new technological advances of every stripe. When doctors are involved, they are explaining. In advertisements, they are either pitching or prescribing.

Either way, the media presents technology as the solution and the physician as the purveyor. The complex decision-making process that physicians use to match the best technology to the patient’s needs is diminished.

This all makes the decision for many patients not who they will go to, but who they will keep, which is increasingly influenced by their out-of-pocket contribution to their care. Technology comes at a price. Patients that are confident that their care and pocketbooks are in good hands stay and refer. They predominantly change physicians who provide poor service not because they are inconvenienced by it, but because they infer that their care is equally inferior.

3. Technology
Technology in any form is a tool, and matching what patients want or expect to what they need has always been a challenge. This is especially true today because patient demands include explaining not only what needs to be done, but why, including a cost and benefit rationale.

Relevance is what physicians make of it. Those who choose to be accessible by demonstrating their relevance as representing a solution rather than a set of credentials will do well. Success in the face of changes in patients’ attitudes, perceptions and expectations, however, requires understanding them and adapting services without compromising what is in their best interest.

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