Hospital Impact—Providers must help patients navigate delivery system changes

Doctor patient
Patients trust their doctor to send them to the best place for care—but if they are anxious about the unfamiliar, they may not go.
Andrea Simon
Andrea Simon

I have a healthcare client who is being encouraged, even pressed, to shift her patients out of hospital-based services to community-based delivery options—affecting everything from the best place for same-day surgery to where to get an X-ray. At the same time, hospitals are being pressured to reduce costs while keeping patients healthy.

In these times of great change, is it possible to satisfy everyone?

For the patient: the challenge of changing care delivery systems

None of this surprises those of us in the healthcare industry. The challenge for this particular doctor revolves around how to get recalcitrant long-standing, and often older, patients to now go to different locations for care, even if the “new” places can deliver the care they need at lower cost to the system and themselves.

Add to this situation the highly influential generation of millennials, the sons and daughters of baby boomers and Gen Xers. These younger patients are less loyal, less obedient and less concerned with traditional service delivery points in the system. Instead, they focus on fees, quality and ease of access.

For example, when my firm recently conducted research on urgent care centers, we listened to millennials talk about how they view the healthcare system. They want their care easy-to-get and affordable. They don’t want to lose time from work, nor do they want to spend their day waiting in a physician’s office until it’s their turn to be seen. And the ability to book an appointment on their cell phone is paramount. They have different values and different ideas about quality.

Most noticeably, for these patients, time is money. In many cases, they are self-insured, which makes them very price sensitive. In today’s gig economy, they only earn a living when they are working. Thus, they want to be able to get the care they need when they want it or they will skip the referral until they end up in the emergency department at 10 p.m. As one millennial said to us: “Is one X-ray center really any better than another? I’m going where it’s cheaper and open when I can go.”

For the physician: how to satisfy the higher-ups and please your patient

Our physician-client is not alone. Indeed, physicians everywhere are facing the complex pain of change, particularly cultural change. When a patient doesn’t follow their instructions, they are frustrated. Even doctors themselves don’t always follow their doctor’s recommendations, as a physician with multiple sclerosis explained in a recent guest post for a Boston news station. Why? Because patients, like people in general, find comfort in the familiar. Not focused on the cost-benefits, they trust their doctor to send them to the best place for care—but if they are anxious about the unfamiliar, they may not go.

This is actually a culture change, not just a change of where to get an X-ray

As a corporate anthropologist and culture change expert, I can report from experience that people have a story in their head that defines the reality they are experiencing. They select from that experience the elements that fit the story they believe to be true. For physicians, this means that they must rethink their patient experiences so that the new actions they are asking patients to take actually fit each patient’s own story. In other words, patients will do best when they get the care they need “their way,” regardless of what payers think is the right way.

For the best outcomes, physicians should approach the situation from the perspective of a culture going through dramatic change, one patient at a time. Here are four “shoulds” it might be helpful for them to consider:

  1. Physicians should think about the care-change experience as a collaborative conversation. Rather than simply telling patients where to go, they should discuss the options with them at length. This way, patients “feel” the physician’s concern that they will get the right care in the right place.
  2. The conversation should have a lot of “whys” in it. When my firm works with organizations that are trying to change, we overcommunicate the “whys.” Answering these “whys” goes a long way in building trust during (often painful) changes.
  3. They should personally visit the facilities they are recommending for their patients. What is the experience like? Is it consistent with what they are promising? Will their patients feel important, special and ultimately, pleased—the feelings that are at stake here?
  4. They should help the “new” facilities become good communicators to their patients. It should be one voice that is speaking to a person in different places. It’s almost as if they are creating a common brand for the care system, even if it is owned by different entities. Joint workshops to improve the customer experience are always a good idea at this stage. Each will benefit from happier patients who will then share their experiences with others. This opportunity should be highly leveraged.

Bob Dylan was right. The times, they are a-changin’.

Are you changing with them? You really must. Your patients need you to help them in new, innovative ways that focus less on technology or drug solutions and more on the experiences you are delivering. This is what will be the bridge between the old way of getting care and the new, with the result being patients who are more satisfied, less anxious and hopefully, healthier. Ready to change?

Andrea Simon, Ph.D., is the principal and founder of Simon Associates Management Consultants. She has more than 20 years of experience as a senior executive with financial services and healthcare institutions.