The doctor-patient relationship is changing, and both parties face a variety of challenges and opportunities as they navigate the transition.
One example of the clash between newer and existing approaches to healthcare comes from Lygeia Ricciardi, EdM, chief transformation officer at Carium and a recipient of a HIMSS Most Influential Women in Health IT Award. During the birth of her second child, Ricciardi was just moments away from giving birth in a car on the way to the hospital after laboring at home with the support of a doula.
“I hired the doula on my own, with the agreement of the obstetrician,” Ricciardi explained. “The obstetrician was to deliver the baby, and the doula was to help prepare and guide me through the end of pregnancy and labor in a way that met my personal goals and that supported me physically and emotionally in the context of birth. After the birth, my obstetrician was furious. He refused to collaborate with the doula ever again, blaming her for encouraging me and my husband to wait until the last minute to go to the hospital.”
Scenarios like this illustrate the major shift that is occurring in the doctor-patient relationship.
Given the cost of healthcare in the U.S., it’s reasonable that consumers want to better understand the cost of their care up front. It’s also easy to see why the lack of transparency around healthcare costs is affecting the doctor-patient relationship.
“We’re trying to get better around transparency of cost, but cost is so individualized to a patient,” shared Rebekah Angove, PhD, vice president of evaluation and patient experience at Patient Advocate Foundation. “It’s not like a doctor can come in with a menu of services and say, ‘Here’s X treatment, it’s going to cost you this,’ because we don’t know what that personalized cost to the patient is.”
On top of that, the doctor-patient relationship can be affected if patients feel uncomfortable bringing up the cost of care, said Angove. “They’re worried their care is going to be biased, that they’re not going to get the best care possible, and they also don’t want to be judged for their financial situation.”
In the following interview with HIMSS TV, Dr. Angrove shares how we can change the conversation around cost between doctors and patients, including patient-focused screening tools to help make talking about healthcare costs easier.
Attitudes are also shifting about the role of the patient and the provider as patients get more access to information about healthcare treatments and diagnoses, Ricciardi explained.
Consumers have access to more information—and misinformation—than ever. In a survey by Merck Manuals of primary care providers, 97% of respondents shared that their patients have come in with misinformation they found online. And 80% felt that patients who read health information online were more likely to question the guidance given by their provider.
“I think a challenge that I wrestle with is that I feel it’s very important to be responsive and respectful of a patient or consumer’s own views, and yet I also realize that there are cases where people may embrace a view that’s against what scientific evidence would show to be appropriate,” said Ricciardi.
As we aim for a more collaborative doctor-patient relationship, the provider should become the patient’s navigator through the mass amount of conflicting and questionable information available. To help develop this partnership, one thing providers can do is educate patients on where to find credible health information. Another critical component of the relationship is for patients to have open communication with their providers about their priorities when it comes to health and wellness.
As the industry moves to value-based care, more cost transparency and greater access to data, using technology as part of the doctor-patient relationship is of critical focus. “You really can’t have better health outcomes unless you have people participate in that process themselves on a daily basis,” said Ricciardi.
Sam Hanna, MBA, CISA, professor and associate dean at American University, agrees that patient engagement is about making patients part of the healthcare ecosystem through continuous touchpoints. When patients contribute data and information, their providers can begin tailoring offerings to their needs and wants.
“As a physician, for example, you want to be able to provide [care] when the patient needs it. At the same time, that patient has to be able to provide data and information back to that clinician in terms of their sleep habits, in terms of their diet, in terms of their whole life experience,” explained Hanna. “Together, that creates that feedback loop between the two. The technology enables that. Technology is not the solution—it’s one piece of the solution.”
Aligning with Dr. Angrove and Ricciardi, Hanna said another piece of the solution is communication between doctors and patients. “You cannot just rely on an app to do something for you. There still needs to be that dialogue between the patient and the doctor or the patient and the nurse.”
Hanna speaks with HIMSS TV about how implementing patient engagement required much more than technology enabled communication between doctor and patient.
It’s easy to see why all this is so essential to the patient, but building relationships is also important to the provider. In a survey of physicians by the Physicians Foundation, 78% of responding doctors shared that one of the best parts of their jobs are the relationships they form with their patients.
While the long-standing view of how a doctor-patient relationship works won’t change overnight, data like this is a positive sign that both doctors and patients are willing to work toward a more collaborative partnership.
The views and opinions expressed in this blog or by commenters are those of the author and do not necessarily reflect the official policy or position of HIMSS or its affiliates.
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Originally published July 25, 2019; updated January 5, 2021