The Consumer as Advocate

by Joanna Smith on Nov 29, 2010

I was talking recently with a colleague in the healthcare advocacy world, and she was wondering aloud in puzzlement how people who did not have medical training could be healthcare advocates.  I laughingly said, ”We asked for it and we got it!”  The world of “consumer driven healthcare” has done exactly what I had anticipated:  it has put the consumer in the foreground of healthcare.  No wonder consumers are flocking to the field of healthcare advocacy!

In the not-so-long-ago world of healthcare, the focus was on moving to “consumer driven healthcare” where consumers–those insured by (primarily) employer-provided health insurance– were asked to start assuming more responsibility for the cost of their healthcare.  Their economic responsibility for their coverage was increased, and the “first dollars” of coverage often came from the consumers themselves before their insurance would move in with coverage.  The insurance companies believed their mantra:  consumers with more responsibility for their own healthcare would be more cautious and not utilizes as many services.

That strategy was partially effective, but sometimes in a counterproductive way.  Consumers delayed care; the cost “containment” came at the expense of the long-term goal of reducing costs:  if care is delayed, then the care eventually provided will cost more because of the delay. Did we save money?  That part is unclear.

But consumers, while delaying care, became highly informed consumers.  They researched their diagnoses on-line; they formed support groups; they started to contact physicians and researchers directly to find out more information on their particular condition.  They read about treatments and outcomes of clinical trials, and they became savvy consumers of healthcare.  And then they realized they could share information and be a support to each other; they could help others with similar conditions navigate the complex waters of healthcare.  In short, they became their own advocates, and then helped others do the same.

Click this link to see a funny (and serious) comment on this new world of the empowered healthcare consumer:

http://www.publicradio.org/columns/marketplace/money-blog/2010/11/the_too_informed_patient_in_th.html

So why are people surprised that consumers have gone into healthcare advocacy?  Consumers are smart, creative—and have the biggest stake in their healthcare future.  Insurers and employers said “accept more (economic) responsibility”; consumers replied, “If we’re paying for it, then we will be involved in many ways, not just economically.  We will no longer passively sit and accept what you tell us:  we can organize, inform ourselves and push for the care we want.”  That is the new world of consumer healthcare advocacy. Some of these consumers have opened practices where they assist others through healthcare systems. The thoughtful providers see consumer advocates as partners in the complex world of healthcare.

I”m Not a Patient: I’m a Consumer!

by Joanna Smith on Jun 22, 2010

I almost entitled this “Please Don’t Call Me a Patient” until I realized this is not something we ask politely for anymore:  this is the new world of the empowered consumer as a self’-made advocate!

In the “old world” of medicine, people seeking care were patients.  The origin of “patients” is from the Latin for  “to suffer or endure”.  Is that a relevant description for today?  Only partially.  Yes, people who are ill do suffer and endure, but they are also taking steps to learn about their options, talk with others in a similar situation and research centers of excellence and specialists.  They approach their providers with this information, and are collegial in their approach to their care:  they don’t ask a healthcare provider to tell them what to do:  they discuss options, risks and benefits and outcome data and then decide with their provider what options to take.  This is a very different way to approach healthcare.

So language needs to follow the shift:  rather than a “patient”, which conveys a static, “waiting-for-someone-to-tell-me-what-to-do” position, I think the title now is “consumer”. People look at healthcare as a product they can research and purchase.  These consumers have shifted away from the old model to the empowered healthcare model.  Patients no more, they are driving some of the most significant changes in healthcare delivery today.