Top 10 Changes in our Patient Expectations


Rapidly advancing technology, the Internet with its instantaneous, and increasingly mobile, access to information, increasing insurance deductibles and co-pays, regulatory changes, healthcare reform, high unemployment, evaporating assets, savings and general uncertainty are causing profound changes in the way patients view and interact with providers.

Business has deftly reacted to and adapted to these changes. Healthcare? Not so much. Most often, not at all.

Understanding how patient expectations and behaviors have changed is the first step toward successfully navigating the next five years of change. Adapting to these changes will increase everything from patient flow to reimbursement to malpractice insurance costs — all while making you increasingly competitive and less vulnerable.

This is not supposition or prediction, it is today’s reality. So, in reverse order, here are the top 10 changes in patient expectations:

Expectation #10 — New and better drugs: A cure for cancer is an amorphous thing. A drug that cures cancer? Now that is tangible. Today, patients are exposed to a constant stream of new drugs claiming to treat everything from chronic pain to restless leg syndrome. And, they expect something to be available to treat them, whatever their health issue may be. The reality of medicine is different, and how you relate and communicate with your patients will make the difference.

Expectation #9 — Portable Medical Records: The media, government spokespeople, and politicians speak of PMRs’ as a thing of today. They are, but only if you have invested in interactive EHR technology and staff training. Being an early adopter of medical technology is subjective. This one is not. The NIH estimates that 25 percent of the cost of medicine is administrative. Automation reduces those costs and, properly applied, provides a fast and favorable return on investment.

Expectation #8 — Accessibility: Requiring patients to call off-hours voicemail is frustrating for them and time consuming for you. Providing a cell phone number is a nice gimmick, but slogging through voicemails takes time and leaves anxious patients hanging. Think about texting. Reading and responding to texts takes seconds and everyone associates texts with immediacy. An automated response telling the patient that their text has been received and that their concerns will be addressed is a huge leap in perceived service. A response at a later time is a smart use of technology. Abusers can always be blocked. The bulk of your patients will appreciate the convenience and accessibility.

Expectation #7 — Communication: Being reactive is a leap forward. Being proactive using e-mail, Internet, and texting to educate, inform, respond, and book and confirm appointments is a key to patient retention, patient referral, and a more efficient operation. A relatively small investment in experienced professionals to perform the tasks yields big gains in revenue and reduced costs.

Expectation #6 — Personalized Medicine: With highly publicized advances in genetic research, medical care is becoming even more customized to a person’s health, family history, and genes. People are beginning to expect customized treatment, better results and fewer side effects. Keeping up with the latest technology, and being able to explain why it is not available or why you do not recommend it for that patient will become increasingly important.

Expectation #5 — Better Coordinated Care: Higher deductibles and co-pays, and millions of uninsured and under-insured people, have made patients acutely aware of the cost of care. Patients expect their providers to coordinate their care with other providers, facilities, and allied health care not only for convenience, but to keep the costs down without compromising safety or outcomes.Expectation #4 — More Outpatient Procedures: These also equate to less expensive procedures with less down time and recovery time. With high unemployment and increased demands to perform, people can rarely afford long recovery times or hospitalizations unless there is no other choice. With the most frequent surgeries such as hip, knee, and spine becoming minimally invasive and moving to outpatient settings, the feasibility of having a dedicated-purpose ambulatory surgery center attached to a practice has superseded economics to a near necessity. A single continuity of care structure from diagnosis to recovery holds strong attraction to today’s patients.

Expectation #3 — New Alternatives to Pay for Care: While high deductibles and co-pays play a role, paying for necessary care for the uninsured and under-insured has become a fiscal reality that is allowing easily treatable conditions to progress into more complex and acute stages. People understand that if they put off treatment, whether it is a sore back or a sore tooth, things are likely to get worse. They hope against hope that they will get better, and insurers exacerbate the problem by being more generous with emergent situations than minor ones. The problem is so prevalent that medical finance companies such as Care Credit, which were built upon cosmetic dentistry and plastic surgery, have hit the mainstream, and have been joined by the likes of Bank of America, Chase and other large banks. Don’t just require payment at the time of service; help your patients to pay by providing a range of personal financing options.

Expectation #2 — Customer Service, Technology, and Outcomes: Three fundamental systemic changes: access to information, expectation of quality service and quality care, and the patient perception that technology has evened the playing field making skill less of a factor, have taken permanent root:

• Access to Information: People don’t look for credentials, they look for a solution, and their search is easier than ever. Eight of 10 people do their healthcare research using the Internet, the vast majority using Google. They also post their experiences with providers, good and bad, and they are all just a search phrase away. Search engine rankings not only make your practice more visible, higher rankings have a profound effect on how prospective patients view your capabilities, status, and popularity as a provider. Furthermore, your practice website must be changed from an electronic brochure to an interactive, integrated element of your operation. Websites are no longer marketing vehicles; they are a primary service delivery point and integral to the quality of service and care. • Quality of Service and Care: It is necessary not only to say what you do, but to do what you say professionally, effectively, and consistently. In short, your operational processes from the first telephone encounter to discharge should be equal parts quality of care and quality of service. With more and more personal responsibility for payment comes the expectation that patients will be treated as paying customers.

• Differentiation: There is an old adage — Pick a young doctor and an old lawyer. The moral?

Experience counts in the court room, and experience with new technology counts in the operating room. It may not be fair, it may not be right, but it is. Providing quality of service equates directly to the perception of competence. You may be getting away with doing things the way they have always been done, but not for long. The industry is changing, and perceptions and expectations have changed, and are changing, with it. Those who fail to adapt will likely be employees of those that do.

Expectation # 1 — Access to Care: The primary decision metric for most patients is accessibility. Waiting in line may enhance the guest experience for Disney, but waiting to be seen when you are sick and scared, whether it is for an appointment or in the waiting room, does not enhance the patient experience. In fact, it complicates it on numerous levels including clinically. It impacts physician and patient referrals, patient retention, patient acquisition, patient attitude, patient perception, and a host of other issues Prompt, professional, and accessible win the day every time. For specialists in particular, long waits for appointments have much more to do with patient screening and the quality of their referral system than logistics. Attracting appropriate patients, and using RNPs or PAs to assess patients can broadly expand accessibility — and solve a myriad of problems.

Meeting patient expectations is more than accommodation, it is risk management (happy patients do not sue), effective competition and improved clinical care (good patient experiences lead to better outlooks, outcomes, an enhanced sense of security and wellbeing). Meeting patient expectations is also a practical reality, and the sooner steps are taken, the better your outlook.