How changing patient expectations will impact your practice

In 1996, Regina Herzlinger, a leading analyst of the health care business and a professor at the Harvard Business School, wrote an engaging book, “Market Driven Health Care.”

Herzlinger’s book was a multi-layered work that addressed the impact of technology on health care costs, the impact of technology on the structure of health care financing and the impact of technology on the emerging role of consumer choice. These three areas-cost, financing and the increasing power of the consumer-are beginning to powerfully influence dentistry.

Herzlinger points out that most hospitals are organizations designed to meet the needs and interests of the providers, not the patients. But, this dynamic also exists in nearly all dental practices. The prevalent model of dental practice now in place is practices are completely built around the dentists. Dentist-centric. Scheduling, treatment planning, systems, structures, staffing, procurement, location and IT are all built to enhance the preferences and performance of dentists. 

But changes are beginning to occur in dentistry. Extended hours, better and easier payment plans, online appointment scheduling, text confirmations-and these are only the very beginning. The question that dentists should be asking themselves is what would a practice look and feel like if it were wholly built and operated around patients?

First, you’d need to have a better understanding of who patients are today and who they will be in the future.

Patients are moving from the passive to the active side of the equation. They are moving from submissive to authoritative. They are taking much more control of their health care. Why? Because they are connected to massive technology that gives them access, advice and understanding.

Patients are thinking and acting much differently than in the past. Patients are adding a new persona: the mindset and skill set of a consumer. They are using technology to make smart consumer choices, and, at the same time, they are patients. A melding of the two-patient and consumer-is occurring. They are what I term “patsumers,” a potent mixture of a patient and a consumer.

The birth of the “patsumer”

Because of technology, people will have a deep understanding of which dentists provide an exceptional patient experience and excellent outcomes. Technologies such as cloud computing, wireless sensors, Big Data, mobile devices and especially social media will provide information that puts greater power in decision making in the patients’ hands.

Technologies will shift the transaction locus from dental practices, whose work has been essentially controlling patients, to well-informed patients having far more power in the transaction, shifting control from the dentist to the patient.

Those in the business of dentistry who fail to grasp what is occurring will totally miss the future. Those who understand how to satisfy some very smart and demanding patients, because patients are thinking like consumers, are on the right track. Those practice owners and executives who see their patients not just as patients but as patsumers will realize success in the future.

Dentists and their organizations need to wake up. Patients themselves don’t have to get much smarter. We’re now in an era of digital technology that increasingly is about machine learning systems along with machine-to-machine communication. No conscious human intervention is needed. The scale of patient-relevant data form and about dentists (clinical, historical, quality, value, outcomes, comparison data) will become massive, ultimately giving the patient immediate information and individual power on an unparalleled level.

Also, dentists and their organizations must realize ultimately they have two sets of customers: the dental benefits companies and the patients. And their technology will be informationally linked. These two customers want to select their dental care providers based on outcomes and value. Before long, all a patient will have to do is tap his or her “dentist app” on a smartphone to get the information he or she needs to make a decision.

As the patient becomes more consumer-savvy, aided and abetted by their insurance company, a “patsumer,” patients who think and act like well-informed consumers, will directly influence the future of dental practice.  

Consumer-centric industry

Putting power in the hands of the consumer is occurring in every industry on the planet, including health care segments. Physicians and hospitals are now being rated by various agreed-upon standards of quality and value. Reinfection rates, readmission rates, length of stay, success of procedures, patient satisfaction and cost of care are all being computed and made available on various websites.

Then there is the gossip occurring on Facebook, via e-mails and the like. Your market is talking to each other. People will compare notes.

People will want information about physicians, hospitals and procedures. People will have access to others with similar medical situations. Patient-to- patient communication will grow exponentially-it’s inevitable.  

The same will soon hold true for optical, physical therapy, veterinary, pharma, audiology, etc. Dentistry cannot avoid this trend and in fact, because of the nature of dentistry, it is an ideal candidate for consumer-centric dentistry.

This trend can now be seen as emerging in dentistry. At the same time, it is generating new opportunities for entrepreneurs as confirmed by this video.

With technology putting the power in the consumer’s hands, channeling the consumer’s intention and standing for the consumer’s outcomes, the power will shift from the provider (dentist) to the consumer (patient).

How will organized dentistry react to this shift in power? What impact will it have on dental practices small and large? How will insurance companies react to a consumer-driven dentistry? 

Just like Uber impacted transportation or Amazon disrupted retail shopping, in consumer-centric dentistry, patients will better be able to self-assess their dental condition. What will that do to dental practice? It will empower new kinds of companies to position themselves to disintermediate the dominant power brokers, dentists and insurance companies. We’ll have companies that champion patients, which will change everything. And, like Trivago does hotels, there will be companies that do dentists. Loads of data about dentistry and dentists will be available.

Dentistry is no longer undergoing evolutionary change, which is simply an extension of the past. Evolutionary change is gradual and incremental. Instead, dentistry is undergoing revolutionary change, change that is rapid, occurring all at once and fundamentally altering the very nature of the system.

Consumer-centric dentistry will cause a revolutionary change in dentistry.

Reimbursement in a consumer-centric world

Previously, the dentist was the primary driver in the equation and the patient/insurance companies were the decision makers. They were the ones who wrote the checks. But as the patient becomes more consumer-like, and they have to write more of their own checks and are armed with greater and greater information, this equation will shift, putting more of the driving force into the hands of the patient/consumer.

In addition, employers and therefore their dental insurers will be pushing for this shift to the patsumer. If we look at medical insurance as the forerunner, what we are seeing is that the satisfaction gap is narrowing between employees with traditional health insurance plans and those with consumer-driven health plans (CDHPs). CDHPs consist of high-deductible coverage plus a health savings account (HSA) or health reimbursement arrangement (HRA) from their companies.

CDHPs are intended to encourage employees to make more cost-conscious decisions when selecting health care providers for nonemergency care, since unspent funds in an HSA or HRA can be used in lieu of out-of-pocket spending for future health care needs.

A recent study reported that 61 percent of traditional plan enrollees said they were extremely or very satisfied with their overall health plans in 2014 (down from 67 percent in 2006), while 46 percent of CDHP enrollees were extremely or very satisfied with their plans (up from 39 percent in 2006).

The trend is shifting to consumer-driven plans. As the ability of the patients to become more and more knowledgeable and empowered about their dental needs and their oral health status increases and as dental benefits move more and more toward consumer-driven plans, the impact on dental practice will be significant.

Here is the address to a company that understand the patient becoming a patsumer and has developed a dental business around this concept.

Conclusion

We order products over the internet and they arrive at our door step in just a few days. There isn’t a vendor you deal with that doesn’t have a strong Web presence and delivers exceptional customer service. That’s why you take Uber and not cabs. That’s why you buy your concert tickets on StubHub. That’s why you get a reminder text so you don’t forget. And when you have a medical issue, you open Google and go to WebMD.

There is a different context when one puts on the “hat” of the consumer.  Different mindset, different world view, different relationship with people.

And, there will be a different relationship with dentists.

When one is a consumer you do not interact with a vendor or service provider like a patient-docile, passive, compliant. That’s how you win as a patient. But as a consumer, you’re a different person. You think differently.  You interact differently. You listen differently. And, you speak differently.

Combine a patient with a consumer and what do you get? A patsumer. The industry better realize patsumers are a different breed.

Given the emergence of the patsumer in dentistry is at hand, it will be interesting to see how it will impact dentistry as patsumers grow stronger, older and wiser-and more connected. The question the reader should be asking is, what do dental practices need to do today to succeed in this future tomorrow?