One of the speakers at the Direct Primary Care Nuts and Bolts to 2.0 conference was David Goldhill—President and CEO of the Game Show Network and author of Catastrophic Care: Why Everything We Think We Know About Healthcare Is Wrong. As a businessman, he naturally views healthcare differently than physicians. His outsider-perspective revealed something that I had not considered before: The future of medicine requires “irrational” thought.
Mr. Goldhill was tapping into his deep understanding of progress in competitive markets when he acknowledged the necessity of “irrational” consumers. By “irrational,” however, Mr. Goldhill was not suggesting we need truly illogical consumers. Rather, we need consumers who ask questions that only appear illogical. Questions which challenge the basic operations of an industry appear illogical to those who have committed to status quo thinking. For example, a patient asking for transparent price information to determine if The Price is Right is a logical demand. However, many providers deem this request as impossible due to complications of predicting cost or because prices are usually negotiated behind closed doors. This is a result of growing up in—and becoming assimilated into—a third-party payer system (i.e. an insurance-based system in which patients don’t usually ask for prices or pay directly).
We need all 320 million Americans asking “irrational” questions about healthcare. Questions that challenge the assumptions of the system like, “Why do I get more time with my hairdresser than my doctor?”
The ability to ask the “irrational” questions that drive innovation requires nothing short of a miracle—the miracle that is the creative human brain. The human brain is uniquely suited to switch between the realms of material and ideas; from what is to what could be. In fact, children seem especially capable of this task, constantly asking “Why?” and creating their own imaginary worlds. Perhaps we should take the question more seriously—“Are You Smarter than a Fifth Grader?” As children get older, however, it seems the realities of everyday life crowd out this imaginative spirit and many stop asking questions. I believe a similar phenomenon occurs with many physicians. As a first year medical student, one’s dreams of what medicine could be slowly fade as requirements, regulations, and other realities flood our mental bandwidth. While we should do what we can to prevent this deterioration of creativity among physicians, we can also look to our patients for help.
We need all 320 million Americans asking “irrational” questions about healthcare. Questions that challenge the assumptions of the system like, “Why do I get more time with my hairdresser than my doctor?” and “Why do I have to come into an office to see my doctor at all?” are absolutely essential for true innovation to take place. An unanticipated benefit of the skyrocketing deductibles induced by the Affordable Care Act is that more healthcare will be purchased with cash. This transformation in healthcare transactions may be the impetus for the birth of a patient population that asks questions and challenges the status quo.
With these changes and the advent of direct pay healthcare professionals, like direct primary care, I believe healthcare in the United States is on the verge of a paradigm shift. Patients and physicians may finally be able to minimize the intrusion of third party payers in their relationship, because let’s face it, Three’s A Crowd. As patients save money via this more efficient system, some extraneous players may lose income, but Who Wants to be a Millionaire anyway? This transformation may lead to a healthcare Family Feu.. oh never mind. But one thing is certain, this revolution will be truly entertaining to watch.