I can't help but look at the issue as a consumer--one who takes the time to research providers and medical conditions online, who is willing to pay more for better quality care, who isn't afraid to fire a provider if he or she doesn't meet my expectations and who will tell everyone within earshot about negative or positive experiences at the local hospital, including my primary care physician. But I'm just one person. And for some strange reason the pundits aren't basing their predictions solely on me.
One of the latest predictions about the consumer revolution comes from Don Seymour, president of Don Seymour and Associates in Winchester, MA. "The transition to consumer-driven healthcare will be evolutionary, not revolutionary, and cost, not quality, has been the driver to date," he writes in the introduction to Futurescan 2008, an annual report from the Society for Healthcare Strategy and Market Development (SHSMD) on a wide range of healthcare trends and their implications for strategic marketers, planners, and senior leaders.
If you look at more than a decade of these reports, Seymour writes, there is a clear, overarching message to the nation's hospitals: "Take care of more people who have growing expectations and more complex medical needs while providing increasingly sophisticated care with relatively fewer resources."
But, he adds, "lest consumerism become to the 2000s what capitation was to the 1990s--overhyped and precipitously reacted to--Futurescan readers are advised to proceed with a dose of caution." Among the data he points to: Out-of-pocket costs are relatively low, employer interest in consumer-driven products remains low, and decision-support for consumers is limited.
"Although the Internet is an important source of health information, barriers to its use include a lack of standardized performance measures, a lack of comprehensive information, and inconsistent information," he writes.
And that's where he loses me.
I get that consumerism isn't here yet, that it might not even be here any minute now. I get that health savings accounts aren't as ubiquitous as 401(K) plans. I get that not everybody's like me. But I don't think that the lack of standardized information online is going to stop people from making a decision about whether or not they want to go to your hospital, use your physicians and specialists, or tell everyone they know about their experience there.
In fact, all the lack of standardized information means is that people are going to make decisions based on whatever they can dig up online--be it nasty blog posts from a disgruntled employee, the story in the local paper about traffic hassles caused by the construction of your new building, or the fact that your competition is printing price and quality information on its own site, even if that information is oversimplified or misleading.
One of the six "magatrends" cited in the Futurescan report, in addition to consumerism, is competition. It seems to me that increased competition would be more of a minitrend if consumerism wasn't at play. Consumers who care about reputation and word-of-mouth might question a referral from their primary care physician. Patients who care about price might consider medical tourism, while patients who care about quality would think twice about getting surgery in a country where they can't drink the water.
OK, there's the issue of margaritas and sandy beaches. But that's a kind of consumer experience, too.
I respect the thought leaders who work hard to sift through data and reports, talk to industry insiders, and tap their own deep understanding of the healthcare market to create the annual Futurescan report. I wonder, though, what future reports will say about consumerism. Will the consumer revolution ever begin in earnest? Or will it turn out to be a bunch of hooey?
Gienna Shaw is an editor with HealthLeaders magazine. She can be reached at gshaw@healthleadersmedia.com.