Every Patient wants every Medical Treatment that could help

But, does the prevalence of High-Deductible Health Plans and the growing importance of Patient Education means fewer Patient's wish for every Medical treatment available?!

Originally published by Being Well on Medium

Photo by Evan Wise on Unsplash

Healthcare realistically isn't free; it has never been free and never will. Because someone, somewhere, at some point in time, has to pay for medical treatment. In the modern sense, such payment is guaranteed by a 3rd party, be it private insurance through consumer premiums or government-funded by taxpayers. But such a fund is never limitless. It is somewhat dependent on the patient's sickness factors, a patient's needs, wants on the one hand, and the pool of allocated funds.

Furthermore, private insurance industries also stride to maximize profit amidst increasing millennial expectations. Hence, rising patient expectations is one of the biggest, if not the most important, drivers of patient shopping for doctors. The habit of patients wanting specific treatments and expecting more from medical care has given birth to the concept of deductibles. That is something that also drives healthcare costs high and patient satisfaction lower. Some advocate that patient education will fix high deductibles by not wanting every treatment out there. But, is it what the problem is with the increasing healthcare costs?

To elaborate more, we need to understand what it means to shop around for medical services and implement high deductibles.

The Misconception of Patient Doctor-Shopping

Doctor shopping is the practice when patients habitually visit multiple physicians. Although It is a common practice of drug addicts, suppliers of drug addicts, hypochondriacs, or patients of factitious disorder, today it happens among ordinary people merely searching for better care based on their personal opinion. Today's patients are more knowledgeable than their peers' couple of decades ago, thanks to the internet and social media. The current healthcare conveys the public seeking better care based on personal wants and opinions, a negative attitude, hence counterproductive to industry. Most administrations tend to suppress this as if it is a significant driver of the high cost. In reality, it is nothing but a reaction indicating a patient expecting every treatment that could help them. Such misconception has translated into solutions primarily directed towards the symptom of the problem rather than the disease.

Patient explanations relate to personal factors, including both illness aspects as well as psychological influences. Significantly, not all doctor shopping is driven by adverse motives. Being aware of these various patient reasons for doctor shopping is essential in understanding such a growing challenge.

The Notion of I Wants "what I Want" versus getting "What you Need" in Healthcare.

One of the ever-shifting concepts in the healthcare sphere is that the presumption of patients being in concordance with whatever is medically offered is no longer valid. The millennial's mindset and ideals are primarily focused on how they perceive the quality of care. And that is the driver of what they want from a particular medical service, not purely based on what they need.

Today most people go to a clinic for medical service because of a recognized need to receive a different treatment. The variances between needs and wants may be unpretentious to delineate, but they are ordinarily harder to separate in the real world.

Day in and day out, people are blasted with commercials relating to the newest and best medical treatments available and medications produced. Those of us residing in the United States are aware of the pharmaceutical marketing campaigns such as; Ask your doctor about the new Drug X if you suffer from condition Y.

Immediately after people begin viewing 'ask your doctor ads, they feel they weren't as healthy as they imagined. Of course, the latter does not fit the doctor-patient relationship, as it puts a significant burden on the doctor. But on the benign side, it also creates considerable awareness. In a scenario where patients freely interact with patients without 3rd party influence; therefore, it can create a transparent and accountable environment. In said situation, the decisions are made solely based on risk and benefits versus cost efficiency.

Patients now visit their doctor and demand certain services without understanding their actual usefulness, safety, or expense. But because they also know that the insurance company will refuse to authorize that service or medication, the trust component of the patient-healthcare interaction will be out of the door. Advertisements indeed tend to drive patients to the latest expensive treatments and patented drugs. Still, such medicines and services would not be costly if the industry did not suffer from corporate monopoly and price-fixing practices.

The challenge will always remain for the physicians to balance the burden of patients' needs, wants, and industry oppression. A patient's wishes vs. actual conditions may hurt them. It is also true that the patient has to concede that as a medical service user, they are asking a professional for their expertise. But the system has to respect the fact that the patients often know what they want and what is best for them but don't get it because of the corporate monopoly.

As patients become more knowledgeable about their care, physicians are developing a broader spectrum of treatment options. Parallel to that, the costs are escalating. Some believe it is time to better discriminate between medically necessary care and optional care, something that, for the sake of our nation's limited healthcare budget, such language requires further debate. Those people have created the wrong type of solution, i.e., developed the concept of out-of-pocket Deductibles, instead of creating transparency, accountability, and a competitive market.

Deductibles in Health Coverage as the Defensive Mechanism to overcome High Maintenance Patient

The deductible is the sum one pays for covered healthcare services before your insurance plan starts to pay. Insurance companies use deductibles to assure patients have "skin in the game" and share the cost of any claims. The role of deductibles is meant to cushion against financial stress caused by unwanted losses for an insurer. In simple words, deductibles serve as a buffer to absorb the costs of the patient's wants versus needs during their medical care. It means that patients at some point may get what they want but at an additional cost. However, what makes it stimulating is that the patient will still pay that deductible even if he does not demand particular care. In short, the deductible is designed for patients with moral Hazards, which help mitigate them. A moral hazard is a risk that a policyholder may not act in good faith (at least in their point of view); in the case of the patient is a doctor shopper or merely looking for personalized medical care.

Millennials Expectation of Medical Care and the Concept of Doctor Shopping

There are six expectations millennials have from their healthcare:

1. Millennials take medical care into their own hands. They see themselves as responsible for their wellbeing and are less likely to rely on a healthcare system.

2. They research; that is why they usually don't have a dedicated physician. Unsurprisingly they tend to trust their peers more than their physicians.

3. The millennial expects upfront cost estimates. That is why Price-transparency is a hot topic in healthcare, and millennials are the generation most often attributed as the purveyors of change.

4. "Healthy" to a millennial means more than merely being "Not Sick." On average, millennials have a very distinct definition of what health means as opposed to older generations.

5. They rely on Apps more than any other generation. While this may seem self-evident, digital options for patient engagement are a must for millennials. However, that doesn't mean electronic access to their health records or an app for their doctor's office.

6. Shopping for Healthcare Insurance is a behavior that also applies to "shopping" for health insurance for the millennial population.

Hospital and health system heads and their boards keep wrestling with whence to engage millennials in managing their wellness. Many payers, tech companies, and others allied to the field also are still trying to figure out what this generation wants from healthcare and how to retain millennials as clients.

Patients Expect Better, but not Everything they can Get

Despite the efforts to maintain patient satisfaction and well-being, the health industry is still struggling to compromise on poising patient expectations at a cost. Although the answer is simple nonetheless, putting it into action is too complicated. Because there is a substantial financial factor around healthcare delivery, it is, by virtue, the 3rd party payers and the pharmaceutical industry's incentive to keep costs high and limit the patient choice. And the more the government intrudes on mandates and price control, the worse the situation becomes. Despite short-term cost containment, price setting and kickback safe harbors have historically ensured the large health industries with special privileges to curb the market. Therefore, blaming the average patient for the rise in medical costs is rather unfair.

Millennials have high expectations for quality, convenience, and cost. In return, traditional and non-traditional physician practices adapt by responding to services such as same-day appointments. Physicians must better understand millennials' expectations and the factors that drive their decisions throughout the customer healthcare journey. So, the idea that they want everything is baseless.

In addition to physician expertise and knowledge, patients' esteem conveys erudition and efficient doctor-patient connection.

Personalized Care is What Millennials Want

The trendy passage in millennial rebelliousness on the way to medical service is the typical prediction of the market traction for personalized healthcare and consumerism, hence necessitating physicians to administer this transition by supporting patients bear the volatility of the healthcare landscape. Moreover, the protuberant millennial distrust of doctors and healthcare is a vibrant indication that the administration has failed to take on that layer of inception. Millennials need to find the proper personalized care by seeking professional help from the corresponding domain specialists from every industry; that includes medical specialties.

The younger generations prefer convenience when it comes to healthcare offerings. Although millennials value the types of services providers have traditionally provided, they strongly prefer a holistic approach to health.

Population Health does not meet the Millennials' expectations.

Although health administrations are aware of the modern patients' wants, nevertheless have flunked honoring them. And despite all the initiatives to maximize patient engagement in their care, they cannot still promote genuine, personalized healthcare systems because they still rely on population health models. The latter has worked well for two centuries, but it doesn't anymore!

Population health public health schemes would work correctly only if the general expectation is also limited, as before the advent of the internet and the expansion of digital information. But, Population health does not answer today's patient wants.

Patient Education is not the Problem; Lack of Educated Options is the major Obstacle.

The prevailing theory is that; to reduce doctor shopping by patients and ultimately reduce healthcare costs, we need to educate patients more. Such education entails, in their vision, convincing the patients that the system knows the best, and they will get what they need but not necessarily what they want. The system is trying to dictate to the public that the only way to reduce costs is through compromise, where it has to be the other way around. It is the system that must change; by becoming transparent, competitive, and open. It is the corruption that has rendered the healthcare system unaffordable.

The patients of today, all they want is the best of what science and technology of the 21st-century offer them. And they will pursue (even though at times may seem aimless) until they are satisfied. And suppose the system fails to personalize the medical care for them; in that case, the costs will increase, corporations will profiteer, physicians will burn out of high administrative burden, and patients will be dissatisfied.

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