In this current era of health care, patients are increasingly being labeled as “customers” to provide a landscape suggestive of the need to provide customer satisfaction. Many health care providers grow increasingly frustrated with that terminology. It demeans the relationship that is fostered in the patient-physician encounter; belittling it to a transaction that occurs as the exchange of goods for an expected outcome. Perhaps a more appropriate corollary to the patient-physician relationship would be that of an “investor” rather than a “customer.”
As an investor, a person takes their valuable commodity (money) and puts it into an investment with the hope that it will grow. We hope for a decent return on our investment but not without the understanding that there is inherent risk of losing value. Similarly, a patient or loved one is indeed a valuable commodity, and when investing into the world of health care, we hope for a positive return.
However, there are expected risks in health care and in spite of all of its advancement, health care outcomes can result in loss of value or life. As with any valuable commodity, one can choose not to invest, but value will likely decrease over time. In the financial world we attribute this to inflation, and perhaps the health care corollary would be lack of preventive services.
Keeping in this investor theme, a health care provider would serve the role of the fiduciary financial advisor. We hope that our financial advisor or person who is performing the investment is well-educated about investment risks and takes these into account when putting together our investment portfolio.
Similarly, health care providers are tasked with the weighing of options, understanding benefits and risks, and helping patients make informed decisions. This also addresses the asymmetry of information that exists. In many customer transactions, the service that is being provided is exchanged for a financial cost, and it is often an experience that a customer has knowledge of and could have performed themselves. On the other hand, an investor uses their money to enter a world of investing that exacts a level of detail and monitoring that most are not willing to engage. There is nothing preventing an investor from learning more about their investments and direct choices, but there is a clear asymmetry that exists between the investor and the financial advisor in knowledge of the financial market. There are individuals that use websites and can self-invest for a nominal fee much like individuals in this era can use websites to diagnose and self-treat. But many others utilize providers as their “health care analyst,” to provide facts and steer away from poor choices and focus on appropriate choices to further their investment.
So what is owed to the investor? As with any enterprise, we hope to keep our investors happy with positive returns. Beyond returns, other points of emphasis emerge in the association with investors. Transparency is a focus in the financial world and becoming a common buzz word in the world of health care. During the process of investing, investors are given several prospectuses during the course of their investment. As changes occur with our investment strategies, we expect those changes to be reviewed with us and notifications to be made. Similarly, patients and families deserve to be made aware of medical decisions that change course or results that affect decision making. In this era of health care, many patients are becoming more involved in their health choices and wished to be involved in the decision-making process. Patient portals via electronic health records provide a mechanism for patients to see their own health “prospectus.”
Communication with investors is heavily emphasized in the financial world. Any transaction including an address change results in an alert to the investor- often in multiple forms such as email, letter, or phone call. Patients similarly desire clear, timely, and honest communication with their providers. Mechanisms to ensure communication through avenues such as provider emails, telemedicine, and social media are opportunities to gain patient or investor satisfaction.
Finally, a relationship is emphasized within the investment world between the investor and their investment firm. Investment choices are built around the investor’s goals, lifestyle, and dreams. In health care, the emphasis should be no different. A patient’s experience should always take into account their life goals, their lifestyle, and their dreams. How we address these in the care we deliver will directly impact the ongoing patient-physician relationship.
If we view our patients as investors, we acknowledge the valued life that they are investing. We move beyond a customer transaction and its inherent limitations. Our role as health care providers compels us to support and respect the investment with transparent practices, open communication, and a relationship worthy of such a valued investment. These efforts lead to satisfaction for not only the patient investor, but their provider as well.
Vincent C. Thomas is a pediatric cardiologist.
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