New power dynamics for successful health solutions.

Louisa Holland

Health Practice, VMLY&R

with Claudia Holland, MD

and Stephen Rinehart

A doctor, a patient and a marketer walked into a bar. Literally. Okay, it was a coffee bar but same premise. And for several hours over several cups of coffee, the three of us talked about the changes in science and healthcare delivery that have resulted in the breaking down of many taboos in the health profession.

We each brought our own perspective but there was considerable consensus. Most notable (or top of mind) was the change in the relationship between doctors and their patients.

For generations, it was unthinkable to question the expertise of our healthcare professionals. After all, didn’t they spend years of toil to become specialists in their field? All of this is rapidly changing. Whether described as a “commoditization” or “Starbucks-ification” of medicine, the doctor-patient relationship has become less hierarchical (it’s not “Dr. Smith” to patients, it’s “Ed” or “Amanda”), less deferential (patients want to own their own health data, even if they don’t fully understand what they’re seeing) and more transactional (patients rate doctors and hospitals on consumer websites just as they rate restaurants or artisanal beer).

IT WAS UNTHINKABLE TO QUESTION THE EXPERTISE

OF OUR HEALTHCARE PROFESSIONALS.

Breaking down barriers and improving transparency is all to the good, but what’s the impact on care? When patients are willing to switch doctors because the office isn’t within two blocks of their home or work (à la Starbucks), then the entire relationship becomes more fragile, often resulting in less continuity of care. It also takes on the tenor of a more convenient yet somewhat more distanced relationship—with 24/7 messages left via a health portal and lab results “posted” for patient review. Broader, but less deep.

At the same time as patients (now consumers) want more control over the way healthcare is delivered, traditional medicine itself is under pressure to change. This has led to an increasing dialogue around integrating Eastern and “fringe” medicine into today’s Western clinical practices, with herbal remedies and acupuncture more frequently discussed openly and taking their place alongside traditional medical approaches. Doctors are increasingly accepting of this approach and appreciate its value, helping patients to understand how to include traditional medicine “in the mix” alongside the alternative therapies.

Yet this newly empowered patient movement, and questioning of the status quo, has also led to bad results when popular beliefs clash with sound, scientifically based practice. One alarming example is the persistence of the anti-vaccination movement despite the lack of empirical support for its dogmas. This would have been impossible years ago. The demystification of the medical profession and the pervasive suspicion of authority throughout contemporary society have made it immensely difficult for doctors and scientists to push back against the nonscience nonsense of the anti-vax movement.

These trends—both positive and less so—in the doctor-patient relationship and the nature of medicine are, of course, amplified and abetted by the “volumizing” effect of the internet. In many cases, this constant sharing of information has helped to advance and elevate the discussion of topics that had previously been considered taboo for open dialogue. Mental health, for example, is now much more openly discussed and explored by physicians and patients, and doctors now have “a million different ways” to ask a new mother about postpartum depression. With recent data from the World Health Organization indicating that the US is now “one of the most depressed countries in the world,” ranking third just behind China and India, this newfound openness and candor offers an enormous opportunity to improve these dismal statistics. So the internet provides a way to make positive change and tap into the “wisdom of crowds.”

At the same time, we need to remind ourselves that medicine is science, and science is not a popularity contest.

Well-caffeinated, we packed up and left the coffee bar. Taboos are for breaking, and scientific progress is often made by the outliers. The web intensifies the pace of change, but can we anticipate and manage change in a way that improves outcomes? That’s the challenge for doctors, patients and marketers. At a minimum, it behooves all of us—especially marketers—to be cognizant of the forces that question and challenge the status quo. Marketers have the important role of supporting both physicians and patients in their search for new ways of understanding and communicating rapidly changing priorities about healthcare.