Archive for March, 2005

Consumer-Driven Healthcare: A Lesson in Moderation

March 15th, 2005 by Melanie Matthews

Guest Blogger: Jennifer Millman

Healthcare consumers rightfully have grievances. But complaints of insufficient access to information are losing ground in today's healthcare environment. We fill out health risk assessments and survey data to equip physicians with personal knowledge prior to the first appointment. We reap benefits of e-health initiatives; online calculators assess condition-specific risk, suggest treatment regimens and approximate account balances from flexible savings to reimbursement. We have referral resources, program brochures and health plan representatives that remain connected through e-mail and company meetings – educating and ensuring that consumer-driven philosophy is maximized and understood.

We are liberated healthcare consumers, making treatment choices of our own volition, questioning the experts and fending for ourselves. Yes, consumers are driving healthcare. Yet, there remains one unresolved question that drives us away: Yes, we have the resources. But … what are we supposed to do with them?

If the consumerism movement intends to empower consumers through information, it appears to be succeeding. However, power is diminished when a more powerful confusion inhibits one's ability to use it.

As the saying goes: You can lead a horse to water but you can't make it drink. So too with healthcare consumers. Providers, professionals and policy leaders alike can inundate e-mail boxes, send mass direct mail and post calculators and decision-support tools online. But in doing so, they may overlook one vital point. Consumers aren't doctors. Many treatment decisions deal with patients' utmost vulnerability, somewhat limiting their capacity to make objective, rational choices, especially regarding the quality of their own lives. Consider this fictitious example:

Aside from an eight-year-old daughter, a husband of 22 years and a fulfilling career, 44-year-old Mary has stage-four metastatic ovarian cancer. After a hysterectomy and five rounds of chemotherapy, her doctors offer a bleak prognosis. A week later, her doctor tells her there is a nearby research group seeking volunteers for a high-risk experimental procedure that may help her condition. Complying with consumer-driven trends, the doctor gives Mary all the information – packets, statistics and related materials – and asks her what she would like to do.

Consumer-driven healthcare is a double-edged sword. Yes, we want to take charge of our healthcare decisions, choosing the treatment design that best suits our needs. Still, the era of consumer-driven healthcare is young. As youngsters tend to be, we're bold, vibrant, attending to account balances, driving down costs and engaging in more preventative measures. We want the information, we want the power, we want the choice … but we don't want to make the difficult decisions. That's when we need our doctors to hold our hands.

No two patients will have identical conditions, mindsets, or case histories. Some patients are enlivened by the freedom of consumer-driven healthcare; some are frightened and others are just frustrated. Since the healthcare system must have some structure, I would venture to guess -- and I suspect Aristotle would agree – that a moderate approach by providers would be most efficient. Give patients information; let them ask questions but if they neglect something important, tell them. If you, as a professional, have an opinion that could fuel your patients' ability to make a rational decision, let them know. Give Mary some advice. She's got the information. But she still needs support from someone who knows better.