Enough has been said about the significance of healthcare sector and its role in promoting and sustaining economic progress in emerging economies such as India. Equally much has been said about the business opportunity that the healthcare sector presents. However, somewhere in this brouhaha of an upcoming business bonanza, the core and essential relationship between a doctor and a patient has been forgotten. Indeed, healthcare today has come to be defined by the insurance companies, bureaucrats, policy wizards and business executives. Patients and doctors have merely become unwilling and grudging actors.
On one side are the doctors facing a mind boggling amount of administrative paperwork and regulations causing distractions from their most important task of treating the patient. In India, today, after years of medical schooling and training, doctors are expected to ‘run a clinical or hospital business’ often confronting a complex array of issues such as pricing, operational management, sales and marketing, technology etc. The consequences are lack of standardized and transparent pricing policies in hospitals, inconsistent quality of delivered care and administrative inefficiencies frustrating both the doctor and the patient. On the other hand, a patient who needs the best possible treatment feels that not all information is shared with them in a transparent manner. In fact, a patient has no real decision making power or ability to choose something as personal as his or her medical care. They usually depend upon the information shared or whatever comes their way. Complicating the issue further, is that healthcare purchase is essentially an unplanned purchase – reflected by the poor rate of insurance penetration which is based on financial planning for healthcare needs. Hence there is a perception mismatch between the provider and buyer – a tobacco company making profits doesn’t bother us much but eyebrows are raised when a doctor charges a consultation fee. There are numerous stories about patients being advised an expensive treatment or even an unnecessary one that is a common perception and has charged both public airwaves and imagination alike, which may not be always true.
In short, the root of India’s healthcare malaise lies in the ‘information asymmetry’ created by a myriad of administrative and communication barriers that separates the doctor and the patient. The only way to eliminate this asymmetry is to once again bring the doctor – patient relationship to the forefront by empowering them and allowing them to access one another in an open and trust filled atmosphere. The manner in which healthcare is being consumed and marketed in India today can be improved dramatically if a patient can actively participate in his medical care decision. Like any other major decisions in his life where he weighs the pros and cons, he should be able to carefully make choices and decisions pertaining to his health. He should be enabled to make an informed medical care decision by seeking information on prices, doctors, procedures and hospitals, by asking his doctor well thought through questions, by evaluating carefully his choices, by expressing freely his opinion/feedback, by understanding the value of hospital services, and, most importantly, by respecting the doctor as a human being and not as ‘God. And a doctor needs to be empowered to access patients and share critical information on pricing, inclusions/exclusions without fear or any stress. This will clear the murk of mistrust in the healthcare space and provide an open and honest exchange of medical care information and feedback between the doctor and the patient.
In a hospital treatment, the ‘purchase’ is subjective in terms of experience. The current model of hospital pricing may sound arbitrary to a payer as he does not understand the value received. Basically hospital pricing system is value based and cost plus. The customer has to understand this value which is very difficult because the value is often compared to the final achieved result – cure, complication, chronic illness, disability and death. Also there is a ‘halo effect’ masquerading the total perceived value in case of a hospital care – if one thing is good the consumer believes the whole set is good and vice versa – if desired result of cure is achieved then all services are perceived good and if an undesirable result is achieved then the whole service in that hospital including the doctor is bad. Moreover, the healthcare payer is many situations different from the recipient of care and hence a mismatch on money spent v/s value perceived. The earning member usually has a corporate insurance but pays for the treatment of the non-earning members of the family who are not covered by the corporate plan.
Can a customer get to know the price of a procedure beforehand? Can he understand the pricing and relate to its value? Can he choose his provider at a price that suits him? The Government wants all hospitals to list their prices - is that realistically possible? Can each patient know beforehand what his price of medical care is going to be? The answer is yes! Mechanism to exchange information on the type and price of healthcare in advance along with information which can help patient put a value to the offered services can change the face of this sector. By achieving this we will have an informed patient who will be a good healthcare consumer.
(The author is CEO & Founder, DocTree)