Empowered consumers and the Internet will dominate in the new decade
Patient relations coming in for major changes
One day in the not-too-distant future, you may spend almost as much time communicating with patients over the Internet as you do in the office. Patients may routinely set up appointments, ask questions, and discuss treatment options — all through e-mail.
You’ll have instant access to all your patients’ records, whether you’re at home, in the office, or on vacation. Your patients will come to the office armed with information they’ve gotten from the Internet, and they’ll expect you to work with them to come up with the best plan of care.
That’s just a taste of what’s in store for physicians in the 21st century, a panel of experts told Physician’s Managed Care Report.
"Physicians are looking at a much different world in 2010 in terms of how they interact with their patients, how they use technology, and how they work with patients to prevent disease rather than just treat it," says Sandy Lutz, health industry analyst for the U.S. health care practice of London-based PricewaterhouseCoopers (PwC). Lutz is author of the organization’s report "Healthcast2010: Smaller World, Bigger Expectations." (For more predictions from the PwC report, see p. 6.)
The next 10 years will bring exciting breakthroughs in medical care, greater efficiency, and improved quality of care, but providers can expect major changes in the way health care is delivered and must shift their thinking to survive, the experts say.
How physicians handle the more informed, more demanding consumer is a barometer for how they will fare in the new health care world of the next century, Lutz adds.
"Physicians are starting to see more empowered consumers. There are very few doctors who haven’t had patients come in with some bit of information off the Internet, or even hundreds of pages," Lutz says.
Consumers are more educated now, and they’re used to doing research. Also, the Internet has made a wealth of medical information available.
"It used to be that the physician was the source of all medical information. That has changed dramatically. In some cases, patients may know more about their disease than their doctor because they’ve been on the Internet researching it," Lutz says.
As copayments, insurance premiums, and deductibles rise, consumers will have to pay a greater percentage of their health care costs, and they are going to want to be even more involved in decisions about their care. (For more predictions of what managed care will be like in the future, see story on p. 5.)
System may implement defined contributions’
"We’re going to move from a defined benefit plan for health care coverage to a defined contribution plan. Many employers are saying they’re not going to absorb any more health insurance costs," says Thomas R. Reardon, MD, president of the American Medical Association. This means patients will be asking more questions about their care, he adds.
"Any time patients pay out of pocket, you get their attention," says Reardon. He says that in his 30 years of practicing medicine, the only times patients have questioned the necessity of a test or treatment was when they had to pay for it.
As a result, physicians will be expected to become more of a partner to their patients. As patients take a more active role in their health care, they will become healthier. Rather than expecting the doctor to do something to them, they’ll want to work with their physicians to improve their health.
"In the health care world, it’s been that patients take what they want rather than demanding what they think they need. That is changing fast," Lutz says.
Physicians should be prepared for patients to ask more questions and demand to be part of the decision-making process, Reardon says.
"In the past 30 years, there’s been a tremendous change in my practice. Physicians are going to have to accept that patients will have more information and will want to make their own decisions. They may not make the decision their physician wants, but we have to recognize that the ultimate choice is with the patient," Reardon says.
While patients are boning up on health care, preventive measures, and diseases on the Internet, it’s likely that you’ll be using the Internet in a number of ways to enhance patient care.
"We’re heading into the information age in medicine," Reardon says.
Nearly 90% of the respondents to the PricewaterhouseCoopers survey predict that office visits will decrease as physicians offer Internet-based consulting services. The majority of respondents believe that by 2010, physicians will spend 20% to 30% of their time on Internet-related patient care.
While the Internet won’t replace the face-to-face patient-physician relationship, the World Wide Web offers doctors the opportunity for more interactions with their patients, Reardon adds.
"We are concerned about diagnosis and treatment without seeing the patient. But on the other hand, we all tell patients to call if they’re not feeling better. We could do that by e-mail, or instead of calling the office for a prescription to be refilled, patients could do it by e-mail," Reardon says.
In the 21st century, physicians can expect to treat two categories of patients: e-health patients and traditional patients.
While physicians can expect to treat more patients via the Internet, they also must be prepared to accommodate patients who resist technology, such as those who refuse to use automated teller machines. Establishing a mix of health care products to please both types of consumers will be a challenge of the 2000s.
And bear in mind that even patients who use the Internet are still going to want personalized solutions and care, Lutz cautions.
The Internet has already created virtual communities of people with health problems, such as people with diabetes, people with asthma, and people facing specific surgeries.
"The Internet has a unique ability to find information and find people and sort things that we’ve never had before," Lutz says. "People share information much more quickly. It will change the whole medical education system, where physicians have learned from each other. It’s going to change the doctor-patient-insurer relationship."
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