Many providers are trying to advance the consumerization of healthcare, experimenting with ways to create more frictionless, retail-like experiences for patients. One of the most important things that healthcare leaders can do on the journey toward consumer-driven care is to check their paternalism at the door, said Nworah Ayogu, head of healthcare impact at Thrive Capital.
Ayogu is a healthcare veteran — he earned his MD at Harvard Medical School, was part of the founding team at Cityblock Health, and recently served as chief medical officer of Amazon Clinic. His comments on paternalism in healthcare were part of a panel discussion held last month at the 3rd Annual Summit on the Future of Rural Health Care in Sioux Falls, South Dakota.
He recommended that providers ask themselves who their services are oriented around.
“Are your services orienting around and optimizing your doctor? We are a rare resource, we are important, and we can be divas. So I think that makes sense — but are you also optimizing around the patient’s experience?” Ayogu said.
He suggested that providers think differently about patient autonomy as well.
Medical ethics courses often discuss patient autonomy and the “dignity of risk”, Ayogu noted. Dignity of risk refers to the idea that patients are allowed to do things that their clinicians disagree with and think are harmful to them — as long as patients are fully informed, he explained.
“I think that is where I think a lot of our paternalism comes from. We often do know what is right clinically, but it’s because we think it’s right — it doesn’t mean it’s right for you. And I think it’s often hard for us to respect the patient’s choice to make whatever decision works best in their lives,” he declared.
Ayogu also mentioned that providers should rethink the metrics they use to track their progression toward consumer-driven care.
He brought up call centers as an example. Providers usually focus on reducing wait times — but they also need to be paying attention to more subjective data derived from consumer feedback, he stated.
“To me, your metrics should always be in two categories, and one should be more important than the other. There are your objective metrics — your dwell time, your wait time, your P-90 pickup times. You want to have those objective measures, but for everything you do, you should also always be measuring your NPS — or some measure of patient satisfaction,” Ayogu remarked.
An NPS (Net Promoter Score) measures consumer loyalty by asking how likely they are to recommend a product or service.
In Ayogu’s view, the NPS score always outweighs the objective data.
“We’d always say at Amazon: when your patient experience and your data disagree, always value the patient experience. The subjective NPS should always actually be primal over all of your objective measures,” he declared.
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