How are urgent care centers changing the doctor-patient relationship?

As corporate anthropologists and culture change consultants, we're immersed in research on the growing appeal of urgent care centers (UCCs) and what they can teach us about the changing healthcare landscape.

While it's too early to make final conclusions based on our current sample of UCC patients at several Northeast facilities, our qualitative observations have uncovered potential trends worth sharing even at this stage.

Beyond that, these early insights are supported by other research in the field, which makes us want to dig even deeper.

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UCCs and the changing doctor-patient relationship

What was once deemed the cornerstone of medicine, the doctor-patient relationship, appears to be experiencing "growing pains," and that's putting it mildly. Many observers feel that relationship is suffering on many levels--and it could get worse.

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Based on our early findings, most of the UCC patients we interviewed didn't care at all about establishing a doctor-patient relationship. They weren't interested in preventive care and didn't have any loyalty to a family doctor. After they had received their care they could not tell us the name of the physician who had treated them.

They just wanted a prescription and advice on how to get better fast. They craved the quick fix to return to their daily lives. They didn't really care who solved their problem, assuming that they'd receive the same level of care no matter where they went.

Are doctors contributing to the issue?

While an increasing number of patients obviously feel detached from the doctor providing care, I found it a bit alarming that the UCC medical staffers--doctors, nurse practitioners and nurses--didn't seem overly concerned with promoting anything close to a doctor-patient relationship. (I mean, UCCs can benefit from repeat business, too, right?)

Granted, they were friendly and wanted to help care for you, but they didn't even hand out a business card as patients left. Often, they didn't even have a card to hand out.

The model was that the doctors rotated among the sites. Within that structure, neither party--medical professional or patient--seemed all that interested in starting an ongoing relationship.

"Sorry doc, I'm just not that into you"

While some of this can be attributed to the fast-moving nature of the UCC, many of my preliminary observations are supported by other studies that have been conducted this year among a much broader group of patients--not just those who use UCCs, but others who still go to primary care physicians (PCPs) and even emergency departments.

In general, there are serious changes in the doctor-patient relationship:

  • Vitals.com released a fascinating survey of 850 adults in January 2015. The key takeaway was: "A whopping 70 percent of people are not fully satisfied with their doctor-patient relationship." Given the intensely competitive, post-Affordable Care Act reform landscape, that finding doesn't bode well for many PCPs.
  • Vitals went on to note more statistics that wouldn't make doctors or hospitals feel much better: "Nearly 54 percent describe their relationship as 'good enough for the moment.' Another 15 percent said they weren't 'into him/her' or have a 'cold and emotionless' relationship with their doctor."

In stark contrast to the Vitals.com findings, just five years ago, Consumer Reports polled more than 49,007 of its subscribers and found that 75 percent of them were highly satisfied with their doctors.

That said, several consumers still complained about long wait times and ineffective treatments.

The physicians had their own complaints

Consumer Reports also surveyed 660 physicians back in 2010 and found that they thought patients could do more "to get the most of their relationship with doctors." Suggestions included:

  • Putting a high value on courtesy and professionalism
  • Taking notes about what the doctor advised
  • Trying to figure out ahead of time more about the doctor's personality and treatment style to help find the right match

Those suggestions from doctors in 2010 pointed to some issues that have become even more pronounced today.

Docs don't have enough time to spend with patients

Deane Barker states it quite simply: "Doctors have no time to spend with patients anymore. To stay in business and make money, they have to churn 'em and burn 'em."

Meanwhile, in a Forbes article, Todd Hixon also notes that the doctor-patient relationship is "at a crossroads," adding that it often depends on the type of healthcare system pursued by the patient.

"This decade is bringing large new demands on the healthcare system from expansion of health coverage to aging of the large baby boom cohort," he adds. "These changes are forcing change of the structure of the healthcare system and particularly the doctor-patient relationship."

At UCCs, is there a "customer relationship," anyway?

So this discussion brings us right back the UCCs. Some 9,300 UCCs exist now. They've increased 14 percent from 2008, and the share of patients using them is up 40 percent year over year, according to the Urgent Care Association of America.

Hopefully studies like these will help doctors, hospitals, and healthcare systems see the urgency of updating and upgrading their patient relations' efforts, so they can reverse negative trends around the doctor-patient relationship.

Andrea J. Simon, Ph.D., is a former marketing, branding and culture change senior vice president at Hurley Medical Center in Flint, Michigan. She also is president and CEO of Simon Associates Management Consultants.

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