A Cynical Muse On Consumerism

Taxi rides in Chicago last month were 42% lower than they were in May 2016.

Uber and Lyft.  A one-hundred-year-old industry, an industry embedded in every city in America is disappearing in less than a decade.  It is disappearing because people found an alternative solution that took them from A to B and provided a better user experience for less money.

Until healthcare decides to reinvent its business model to one that is more closely aligned with Uber, it is destined to suffer the same fate as Sears.  Patients will seek an easier solution.  They will fly to it like moths to a patio light.

A recent trend on provider websites has gone from ‘find a doctor’ to ‘request an appointment.’  To boldly go where no man has gone before.  Patients are still left chasing unicorns, the elusive online scheduling.  Had the group which designed your health system’s website taken the time to ‘open the doors, and see all the people,’ people who wanted to schedule an appointment instead of requesting one, your health system would have more new patients.

Some health systems view consumerism as though they were walking through their house in pitch darkness, confident they knew where all the furniture was, only to have someone flip the lights on and show them that nothing was where they thought.  By the way, I’m the guy at the light switch.

Novice consumerismalists want to put ‘two and two put together,’ and argue that the answer is four, as in if consumerism were any simpler we would be diagraming the issue with crayons. From my perspective, I try to appreciate their keen sense of advanced mathematics and to suggest that simply focusing on two and two does not get them where their patients and customers need them.

I ask, “have you ever heard of cognitive dissonance?  It’s when you hold on to a belief that all of the facts attest to your belief when they attest to the opposite.”  Novices study consumerism like an anthropologist on Easter Island.

If your health system’s call center is the control room in Oz, healthcare consumerism is the issue behind the curtain.  Those who feel comfortable positing a solution are the same people who misunderstood the problem.  When we meet to discuss consumerism, some hospitalists try to sit at the big people’s table.  While your system is focused on finding the needle in the consumerism haystack, your consumers are trying to tell you that they own those haystacks.

Many health systems treat consumerism as a ‘theory,’ like climate change or evolution.  They assess my intentions like they had a fifth of a second to identify me as friend or foe before they start shooting.  They look at me as though I am an unhinged refugee from a boy band. (Was I supposed to be hinged?)  We sit there mute, as if we were in a no-talking competition and serious about winning.  They like to pretend I am not there, like I am a hole in the air.  The last time they listened to a consultant, Abraham Lincoln was in short pants.

Health systems form consumerism committees. They meet.  They buy bagels and muffins and a fruit tray and yogurts served in cute parfait glasses and cardboard boxes of coffee.  Because your health system has gone-green, biodegradable cups woven out of recycled hemp fibers are positioned next to the coffee.

I bite the head off a muffin.

Yellow legal pads are placed on the table, made from recycled paper from a defunct organic bookstore, directly in front of each chair.  Pens inscribed with the hospital’s name lay parallel to the pad of paper.  Post-meeting, the committee members will email their notes around like birds spread seeds from berries.  They should have hired a bunch of interns to write a term paper.

The purpose of the meeting is to suss out consumerism. Long slow periods of nothing much, with occasional bursts of something.  Like cutting the arms off an octopus; dealing with seven arms is better than dealing with eight.  Like chaos theory.  A butterfly flaps its wings in Ontario, and two hundred prospective patients wonder why they can’t schedule an appointment online.

Fortunately, slothfulness is not a capital crime.  It’s like getting a task force trying to figure out how to turn the Titanic.  While the task force may eventually succeed in turning it, they won’t accomplish it until they hit an iceberg.

The committee members are as focused as a kid with a magnifying glass focused on an anthill.  Consumerism kindergarten.  They want to go down the rabbit hole when the best approach would have been to cozy up to the Queen of Hearts.  They are looking for easy solutions, and they have the budget to make them happen.  They’ll vote on whether to use the committee’s funds to buy a philodendron for the call center.

Recasting consumerism involves taking a risk. But so does getting out of bed every morning, and a lot of people are not morning people.  Even though there is a degree of risk, it’s not like having Comey testify before Congress.  Most consumerism efforts fail.  Patients view those efforts as a Zen thing.  If health systems try to be more consumer-friendly, and their patients don’t know that their system tried to be more consumer-friendly, patient wonder whether the health system really tried at all?

One executive told me her system was going to address consumerism later.  “Later than what?” I asked.  “Is this one of those perpetually imminent initiatives?”  It felt like her strategy had no place to go, and all the time in the world to get there.

As a consultant, I’ve had to learn to roll with the punches.  Fortunately, waterboarding has gone out of favor.  Who knows, maybe they’ll name a bridge after me.


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