I often tell the story of when my daughter corrected me…or at least, one of the many times my daughter corrected me. She needed a minor procedure, and I naturally recommended the major academic health center. Her answer: “Dude, your hospital costs me out of pocket $600 more than the community center. And I checked Leapfrog – they are equal. But in the comments, people say the community center is cleaner. $600 is a weekend in Miami, dude.”
She’s right. Millennials will knock our world apart.
We’ve all heard the mantra: Lead change, don’t let it happen to you. But few of us are jumping to the forefront of disruption, transformation, and meaningful change in the structure of the American delivery system. Few of us are writing the history of the future today.
Disruption is painful. As leaders, it means re-organizing our industry—even while the federal government is stuck in political gridlock figuring out how to stretch a federal $1.00 to pay for $1.50 of healthcare. As healthcare leaders, it means drawing on different skills—creativity and flexibility. And as clinicians, it means re-evaluating many of the practice biases we’ve learned and used up until now. No one volunteers for pain.
The consumer revolution is here to stay
It’s easier to blame everyone else for an expensive, fragmented and inequitable system where meaningful efforts to reverse health disparities continue to be too little too late, where people with chronic illness get shuffled around, and where end of life often happens with several lines and ports, not in bed at home.
But there’s no question that health systems that thrive in the future will shift from being hospital-centric to becoming consumer health entities.
Let’s define “consumer.” The consumer revolution is why Blockbuster failed and Netflix succeeded – because someone figured out that the product was entertainment, not the store. It’s why brick and mortar retail stores are collapsing in this country and Amazon is hosting an integrated shopping relationship with consumers.
So how do we define and differentiate our product? It’s not just better service. In healthcare, the consumer revolution has the opportunity to change our culture away from our hospital-centric design to allow healthcare “wherever you are.” More importantly, the consumer health revolution can begin the long road to allowing people to be the pilots of their health. When minorities trust care at home or in the neighborhood, they do better. When patients who battle chronic conditions feel invested in decisions, they do better.
When people facing the end of life believe they’re the pilots of their own path, they do better.
That’s why I hope millennials knock us over.
Why clinicians must adapt to the millennial patient’s needs
There’s nothing millennials take on face value—especially from some 63-year old. We’re going to have to prove value. There’s going to be a lot more transparency. There will be more guarantees. And the holy grail: There’s going to have to be what I call a BUB – a “believable and understandable bill.”
There’s no way that this conversation will still happen: “Congratulations, Mrs. Jones, you’re pregnant just as your home test showed. I’m going to send you to my friend the obstetrician who will deliver your baby.” I expect the millennial patient will say, “Wait, I have a list of things I recently read on a blog that I believe are important about my child’s birth. Will they take my doula or should I find a new one online? Can I change my next Tuesday appointment via your mobile app to Friday if I need to? What’s their C-section rate and why do they do them? You give me a few names, and I’ll look them up online today and make the decision.”
They won’t even buy a $1 avocado (now that avocado prices have spiked by 125 percent) without weighing their different options, let alone decide on a doctor to help deliver their child without weighing their options.
I think the other important thing is: They’re going to expect their doctors to talk to them. They’re not a big authority group. That’s good news for places like Jefferson, where we’re bringing integrative health together with traditional American medicine, and where our students and faculty are judged on empathy.
Which brings us to change as clinicians.
Being a better robot than robots is not the goal
The doctor of the future is going to have a sidekick. It may be a little round metal thing, or a glass, or an avatar, or whatever IBM or Google or Apple designs. But that sidekick will be much better at remembering diagnosis and treatment protocols, and even taking a genetic picture of the patient and telling them what to look out for and how medications will affect this person.
How did some of society’s brightest and most creative people become afraid of risk, become quick to accept authority, and struggle to work as interdependent teams with other people, including our own patients? In many cases, our selection and education was built around building human robots – omniscient, omnipotent, and able to act alone in the most complex scenarios of human rescue. Organic chemistry grades and MCATs didn’t prepare us to guide the older diabetic who forgets his medicine, is depressed, and now shows up at an emergency room with an undiagnosed late stage cancer.
As healthcare delivery systems shift to do a better job for people with chronic conditions, my ability as a doctor is not to be a better robot than the robot. We’re here to be the humans in the room. Not the robots. We’re here to give patients meaning and to help them be the pilots of their own health.
That’s the future we can embrace—and I believe, be excited to make happen.
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