Is Online Health Advice a Net Benefit to Patients?
Is Healthcare Becoming Decentralized?
Experts are noticing a trend: The delivery of healthcare services is becoming decentralized in some ways, but more importantly it is becoming more consumer-focused, more connected, and more patient-centered. Rapid advances in technology, combined with market forces, business interests, and policy objectives, are all converging to create a new hierarchy of healthcare in which each individual patient is the ultimate gatekeeper of his or her own health.
HIMSS19, the largest health information and technology conference, took place in Orlando this past February. At the conference in 2019, an entire symposium was dedicated to the topic of the Consumerization of Health. Jennifer Sargent, an executive officer for Vera Whole Health medical clinics, had this to say at the symposium: “We are in a world where consumers have a lot of information and we need to give them a system to figure out how [to] use that information appropriately” to manage their own health. Sami-Aid is attempting to do just that.
While retail clinics, online lab testing companies, and software-as-a-service are decentralizing some aspects of care, hospitals and managed care organizations are increasingly merging and consolidating in an effort to save money themselves. There are some signs of a trend towards “value-based” care, says Dr. Howard Forman, professor of radiology at Yale, who is skeptical of the viability of this top-down model: “[We] now need a new fixed infrastructure and group that you have to put in place just to be able to measure those things and keep them on the right side of the ledger.” The reality is that even if health experts think they have perfected a new model for healthcare, consumers (patients) are the ultimate arbiters who will decide what they feel is most valuable to them.
Convenient and timely care is even more important to patients than coordinated care.
A 2005 Health Confidence Survey found that 89% of employer-insured respondents rated timeliness of care as a top priority, compared to only 81% who said that coordination of care was important. In a 2017 report of 700 patients surveyed by online provider review site Vitals, 84% said that the wait time was somewhat or very important to a quality patient experience. 30% of respondents said that they had walked out of an appointment due to an unreasonably long wait time, and 20% said that they would switch providers over the issue of wait times. Providers with 5-star ratings had average wait times of just over 13 minutes, while those with 1-star ratings had average wait times over 34 minutes.
Young people especially are abandoning the primary care model that their parents and grandparents were used to, for the sake of receiving immediate and affordable care. Having a personal relationship with a doctor is still a top priority for patients, but sometimes the pressures of limited time and money drive patients elsewhere.
Price-shopping and convenience are driving more patients to retail clinics.
Healthcare consumers are increasingly price-savvy and are recognizing that in many cases they can save money by seeking non-traditional options. More and more patients are visiting retail clinics for urgent and even routine care. When possible, price-conscious healthcare consumers are veering away from hospitals, urgent care clinics, and sometimes even primary care physicians. A working paper from the National Bureau of Economic Research found that those living within 2 miles of a retail clinic were between 4% to 12% less likely to visit an emergency room for minor acute or preventable conditions. This trend has been in motion since the early 2000s, but has accelerated to the point where many hospitals and traditional practices are now working with or even establishing their own retail clinics.
Self-diagnosis and DIY healthcare are on the rise.
Despite the well-known dangers of self-diagnosis, patients are increasingly using symptom checkers on the Internet to diagnose themselves. While being able to identify potential health problems using the Internet is certainly empowering, it’s also important not to rely too heavily on this information without consulting an actual medical professional. A Harvard study from 2015 found that among 23 online symptom checkers tested, they listed the correct diagnosis first only 34% of the time and provided correct triage advice only 57% of the time. Online symptom checkers often tend to encourage some patients to seek unnecessary treatments, which drives up the costs of healthcare.
Given the reality of the situation, however — people are going to use “Dr. Google” anyway — there are some steps which medical professionals can take to reduce the barriers to patients communicating with their doctors about health information that they have found online. These barriers include concerns about embarrassment and concerns that the doctor does not want to hear about it. Doctors need to have patience in working with patients who try to diagnose themselves and may come to erroneous conclusions.
Impromptu diagnoses are not the only medical resource for which healthcare consumers turn to the Internet. People are also increasingly buying over-the counter medicines, ordering lab tests online, and using at-home test kits to discover their ancestry as well as to test themselves for diseases such as STIs, gluten intolerance, prostate cancer, and Alzheimers. A healthy dose of humility may be necessary in order to find the proper balance between using the information at one’s fingertips, and possibly being very misguided by misinformation or misuse of information gathered online.
Where Do We Go from Here?
At SAMI-Aid, we believe in empowering patients with information, but also in promoting better communication and personal relationships between patients and doctors. We think that you shouldn’t be forced to choose between either reasonable wait times or quality relationships with trusted physicians. We want you to be able to talk to a doctor — on the phone, from your laptop, or in person — about anything you want, any time you want, at a price you’re willing to pay!