Healthcare Executive: What Consumers Should Know About Finding Care

Healthcare is a precious — and finite — commodity.

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In my previous post, I discussed the commoditization of healthcare — how increased competition in the marketplace has caused medical facilities to re-evaluate their brand and reconsider their prominence in their communities. Increased competition can be a win for consumers — one that results in greater cost transparency and improved service. But it might also result in a more impersonal healthcare experience, which means that patients need to bear more of the responsibility for their own health outcomes. In this post, I am going to shift the focus away from facilities and toward what "healthcare as a commodity" means for consumers.

Pizza and the Free Market

When a community has a pizza parlor, pizza-philes tend to be generally satisfied. Maybe they serve New York-style and you like Chicago-style, maybe the price is a little higher than you'd like to pay, maybe the service isn't as attentive as you'd like — but it's pizza, and you didn't have to make it at home. But when a community gets two or three or four pizza parlors, the local pizza game becomes forever changed. Pizza connoisseurs no longer have to sacrifice taste. Competition brings prices down. Plus, pizza providers are incentivized to find ways to bring in new customers while retaining existing customers, perhaps by providing a cleaner restaurant or by sponsoring the local youth soccer team.

But while all of these are wins for pizza fanatics, there can be downsides too: In the interest of cutting costs, your pizza parlor is likely no longer able to accommodate your particular tastes. Like crushed pineapple on your pizza? Too bad — it's not economically feasible to keep crushed pineapple stocked if not enough people order it.

In many ways, the same is true in healthcare, which was a $4.1 trillion-dollar industry in the United States in 2020. Healthcare providers now have to think about how their brand is viewed by consumers. They're competing at all patient interaction levels: primary physicians, in-patient, outpatient and specialists. A newly competitive marketplace can be a significant win for consumers, resulting in improvements in the healthcare experience and cost. But there can be sacrifices too: services are scaled back, amenities are cut, and the doctor-patient relationship, which used to be long-lasting and intimate, now becomes rote and hurried and often a patient-to-physician-group relationship.

Where Pizza and Healthcare Diverge

The assembly-line approach to healthcare, when left unchecked, can be a problem. As sublime as a good slice can be, for most people, there is no substitute for good health: It helps us maintain longevity and mobility and lets us experience more of life's joys (including pizza) for a longer period of time. So when something as large and complex as the healthcare industry becomes commoditized and impersonalized, it's up to the healthcare consumer to ensure they're getting the "product" they asked for — even if that means modifying their own behavior in new and potentially uncomfortable ways.

Be your own advocate. Be aggressive in managing your healthcare journey. This can be a challenging position to be in, as you're relying on the expertise, counsel and cooperation of medical professionals while also asserting your own priorities — and sometimes that might mean pushing back. On top of that, managing your or another's healthcare — keeping records up-to-date, tracking and making appointments, arranging schedules, finding the right specialists — is practically a full-time job. The truth is, not even the most well-intentioned doctor has the time to serve in this function, and no one knows your specific concerns and circumstances like you do. For something as consequential as healthcare, self-advocacy is essential.

Learn about the healthcare process. Part of being your own advocate is educating yourself, both about your own health concerns and conditions but also about the broader health environment — the professionals and facilities you're working with, the systems they (and you) are operating under, your insurance coverage and the financial choices your health insurance provider is making. Are your doctor and hospital in-network? Can they access your records? What procedures are covered in your healthcare plan? What services are provided by a local team, and what will require external expertise? What specialists will be involved, and for what reasons?

As part of this process, don't be afraid to interview providers. Your healthcare team is an important relationship: Meet them, engage with them, ask questions. Telling yourself to "trust the professionals" is fine, but in a commoditized industry, getting the best health outcomes requires you to take an active, educated role.

Research, research, research. When the stakes are low, like at a pizza parlor, you might be willing to take a chance without doing a lot of research. When the stakes are higher, you're better off being informed. Talk with friends and family about their experiences with different doctors and facilities. If you have a healthcare provider you like, ask them for recommendations and advice. Even third-party reviews can be enlightening.

Don't be afraid to lean on friends, colleagues and even experts outside of healthcare as you figure out a care plan. This is especially important as you get older. Taking an active role in your healthcare is a particular concern now. During the first two years of COVID-19, many people put off preventative or nonessential care for fear of being exposed to the virus. Those are two years of medical warning signs getting missed and nonessential health issues turning into significant health concerns. As the healthcare system makes its way back to pre-COVID staffing and patient levels, many are seeing what happens after years of missed colonoscopies and mammograms. It's an acute reminder of just how important an active, proactive consumer is to achieving superior health outcomes.

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