Healthcare's future: Drive-through or sit-down service?

From the mHealthNews archive
By Eric Wicklund

Research indicating that some 70 percent of American aren't satisfied with their doctor's personality might seem disconcerting – or it might signal a shift in the concept of  "bedside manner."

The survey, from Vitals, asked approximately 800 Americans to describe their relationship with their primary care doctor, and offered four responses. The results: 54 percent said it was "good enough for the moment," 30.3 percent chose "This is the one and only," 11.4 percent said "I'm not really into him/her" and 4.3 percent chose "cold and emotionless."

Does this mean patients are dissatisfied with their doctors, or that they don't hold that much value in bedside manner, particularly in an era when the "bedside" might mean a video screen, smartphone, laptop or telephone?

It's pretty much a given that consumer attitudes toward healthcare providers are changing, and we can either credit or blame the fast-paced lives of the younger generations for that evolution. Whereby those of Baby Boomer age and older might prefer that their doctor be a trusted friend, and thus relish a visit to the doctor's office, Gen Xers, Gen Yers and millennials are all looking at the doctor more along the lines of a one-night stand or a trip to a fast-food joint, and most are happy if they can get healthcare quickly, cost-effectively and efficiently and then go on with their lives. This is why minute clinics and telehealth platforms that offer instant access to "a doctor" (not "your doctor") are going in popularity.

Hence the overwhelming popularity of that "good enough for the moment" survey response – if you can get the healthcare you need when you need it, then it's all good, right? 

Perhaps, or perhaps not. mHealth advocates have consistently pointed to the highly automated airline and banking industries as models of where healthcare should be headed, but even they are facing some backlash. TD Bank, for instance, is now running TV ads vowing to "put the humanity back in banking" by replacing the automated teller with a real person.

Even Hollywood has gotten in on the action. The film "Up In The Air" featured George Clooney as an executive who travels across the country to fire people at companies in the midst of corporate downsizing. When a young executive played by Anna Kendrick comes in with a plan to fire people by videoconference, Clooney's character objects, and takes her on the road to show her how much better it is to fire people in person rather than through a video screen (hey, this IS a comedy). Kendrick's plan eventually wins out with management – for a while, then is scrapped when it becomes clear the process is too impersonal.

The upshot of all this is that there's a fine line between automation and … over-automation, for wont of a better word. Sure, mHealth holds promise to revolutionize the concept of healthcare delivery, driving up clinical outcomes and access and driving down costs. But there's a limit. Healthcare providers still have to have a bedside manner, whether it's in person or through a video screen, capable of making that "good for the moment" healthcare encounter a success.

That's why some telehealth companies are marketing an online solution that enables consumers to connect with their doctors, rather than any physician in the company's stable; and why many of those companies carefully train their doctors before unleashing them online. That's also why concierge medicine is such a hot topic. There is a value to that personal connection between doctor and patient.

Then again, if this is what the consumer wants, healthcare might just simply go with the flow and develop an assembly line approach that favors speed over personality. It's very much at odds with the consumer engagement strategy, however.

Should healthcare providers be concerned with the results of the Vitals survey, or is "Good enough for the moment" going to be the industry norm? That's a tricky question.

Perhaps it will lead to a backlash against providers who rely too much on technology, and we'll see a rebirth of the solo physician making house calls – kind of like the service station bringing back attendants, or drive-ins with carhops, or movie theaters with ushers. Or perhaps that's just the way things are going to be in the future, in which healthcare will be delivered from vending machines.