Think of 1998 as the Year of the Patient.
It's a New Year's resolution we think all our readers should adopt: Vow that with every new idea floated, every mission statement adopted, every new program implemented, patients' needs must be at the core of the action.
Call it patient-centered, patient-focused or patient-friendly, whatever you wish, as long as you commit. And this pledge doesn't mean you have to give up the dream of your organization becoming an integrated delivery network or a provider-sponsored organization taking on Medicare risk. The important thing is to remember that the patient is your raison d'etre.
Public opinion polls consistently reveal the ugly truth about how patients view the service rendered by healthcare providers. They are convinced healthcare has become a profit-minded big business that is a nightmare to navigate. They see little, if any, value added from managed care or integration. To the patient, a seamless continuum of care is little more than the latest industry gimmick.
Hospitals and health systems first must concentrate on delivering efficient, quality care to the sick and dying. They need to offer this care in safe, convenient and comfortable settings.
Beyond that, healthcare providers should adapt the style of successful retailers. Clearly the best merchants are those who cherish customer service and repeat business. In the past, too many hospitals viewed physicians as their customers because the medical staff ordered the test and hospital rooms for patients. In recent times, providers have catered more to the wholesale end of the market-insurers, health plans and government programs.
Legendary Chicago retailer Marshall Field's motto was "give the lady what she wants." Healthcare providers should borrow the strategy by crafting marketing strategies, product lines, services and educational forums around customer needs. And they should reward and recognize those employees who lead the way.
Health prevention and consumer education are tools of managed care that can help patients while controlling costs. However, success will require more sharing of quality and cost data and improved communication between caregivers and patients. Some of this sharing of information might be painful to physicians and may leave healthcare administrators feeling uneasy. That's why an attitude adjustment is required, and it should start with management, physicians and nurses.
Bridging the knowledge gap will build the strongest ties between providers and their patients. Savvy consumers are looking for report cards, quality measures and other relevant data so they can better manage their own health. That trend will only escalate as Internet technology improves and the demanding baby boom generation increases its search for ways to prevent or delay the effects of aging.
At the same time, providers must tap into the incidents and experiences that shape the patient's image of the healthcare experience. Asking health plan enrollees if they are "satisfied" or questioning hospital patients about meal service is just scratching the communications surface. Proper evaluation requires patients to identify particular areas of concern. If the physician fails to make eye contact, if the nursing staff is cold, if waiting time for an exam or test exceeds 45 minutes, then serious problems exist. It is this kind of probing that will identify patterns.
Convenience also is a retailing imperative. Expanded physician office hours, reduced waiting times and faster turnarounds on medical tests are obvious service improvements. Simple things like timely response to telephone inquiries and accurate billing also will build better patient relations. During this year, MODERN HEALTHCARE will feature stories on organizations that are doing the right things.
There is, however, a dangerous downside of catering to the demands of patients. It's called inflated expectations. As we see it, consumers basically want three things from the healthcare system: the ability to pick their providers, open and convenient access to those providers and availability of the latest medical technology. The tricky part is that they want all this to cost less.
As many HMOs have found of late, offering open access and ample benefits is a prescription for loss of revenues and control. The same fate could await those who try to accomplish too much.
But in reality, patients are your customers and they do have choices. They can vote with their feet or sing your praises. They are the end user and will spend nearly $200 billion this year out-of-pocket on medical needs.
Value-the relationship between cost and quality-will ultimately determine winners from losers in the managed-care healthcare marketplace. Competition and local market conditions will dictate pricing, but optimizing value by improving quality requires internal systemic change. The new year is an opportunity for your organization to fully commit to the measurement of medical outcomes, adoption of nationally recognized practice guidelines and improvement of patient education efforts. Such efforts will guide behavioral change on the part of providers and patients.
And that's what the Year of the Patient is all about.
Clark W. Bell