The very first thing you say when communicating an idea has everything to do with whether your audience will pay attention to the rest of your message.  For example, if you are writing a suspense novel a good first sentence might be, “The man sitting across from me in the diner did not know he had less than ten minutes to live.”  If the man was truly enjoying his breakfast during those last ten minutes, another good opening sentence might be, “It was the best of times, it was the worst of times”—but somebody already wrote that line.

When presenting an idea to a hostile audience it doesn’t do to leave a live dragon out of your calculations.  Sometimes you can lead your audience to where you want them to go by leaving a trail of breadcrumbs.  There are times, however, when the audience looks like they are still trying to figure out why Gilligan never got off the island.  That is when you know leaving a trail of breadcrumbs won’t suffice, and you the only way you can get them to follow your train of thought is by leaving entire loaves of bread.

During my last presentation, I should have hijacked an entire bakery.  A woman in the front row kept shaking her head each time I spoke.  She was slim and trim, poised and preppy, and had the look of someone of keen intellect—the final step in the evolution of the species; or perhaps she was supposed to have been in the Wellesley Tri-Delta sorority reunion across the hall. I was trying my best to explain that healthcare consumers’ use of technology in other industries is what created healthcare’s driving force towards consumerism.  She looked at me as though I had suggested subliminally that she should assassinate the president of Colombia. I did not know if she was going to faint, cry, or ask for asylum in Iowa.  Though I thought she and I were on the same journey, I had overlooked the fact that she may not have been issued a roadmap.

Her behavior had usurped what little poise I had. “You’re not really into complex sentence structures, are you?”  I thought of asking her. Then I said, “If you display my slides in reverse order it says ‘Paul is dead.’ ” (For those of you who didn’t grow up listening to the Beatles you may have to Google the allegory.)

Trying to explain healthcare’s immediate need to move towards consumerism to some people is like trying to explain the idea of cholesterol to a Big Mac; they don’t get it.  Judging from the looks of some members of my audience I realized I could have communicated the idea of consumerism better had I displayed a single slide depicting the game Wheel of Fortune, and prefilled the slide with C, O, N, S, U, M, E, R, I, S, _, leaving audience members wondering whether they needed to buy a vowel.  I mentally texted myself to start my next presentation with something more upbeat like the music, Ride of the Valkyries.

There is a worn military expression, which states the diversion you are ignoring is really the main attack. I suggest respectfully to the provider community that healthcare consumerism is not a diversion or a feint; it is the main attack.

I displayed a slide showing how healthcare consumers expect to be able to interact with their providers.  Click-to-buy.  Twenty-four-seven access.  Up-to-date records of all interactions and real-time health data. (The concept sort of follows a generalized retail business model, but that is the concept because the retail model works.)  If you count yourself among the healthcare consumerism misanthropes you may be better served by opting out of the rest of this blog.

“Have you ever seen the model you are describing being used by a provider?”  A gentleman in the back row asked.

“No,” I replied. “But I’ve never seen my pancreases either, but that doesn’t mean it doesn’t exist.”

The most material difference between retail firms approaching healthcare from the perspective of consumers, and healthcare providers approaching patient acquisition and retention from the antediluvian perspective of the new-kids-on-the-block, the new-kids are actually adding customers hand over fist. If you do the math, they are actually adding customers hand over fist, and hand over fist…and so forth.

And here’s my point—yes, it took me a while, but hopefully it was worth the wait.

So, if you are a provider executive or a board member of a provider, you should be screaming at someone.

Most of the people in your health system’s radius of service, the population you serve—think population health management—are regularly spending their healthcare dollars everywhere else but with you, spending it on retail providers.

Perhaps you are thinking, “We can’t make money testing people for strep throat.” CVS has a line of dump trucks carting away the money they are making from performing those tests.  Provider executives vehemently decried they are not in the business of healthcare consumerism. And they are correct in their declarations.  They aren’t.

Maybe they should be.