Trust: The Hottest Trend in Healthcare
With the proliferation of telehealth technology, people are going to the doctor less than ever. That makes the role of doctors even more important.
As physicians, we’ve noticed a dramatic dropoff in the number of people making physical trips to the doctors’ office. While it’s true that some of it is attributable to the pandemic, it doesn’t tell the entire story.
The pandemic has certainly scared off a fair share of the public from visiting their local clinician, but there’s a third leg that makes the table stand: the robust availability and proliferation of telehealth solutions. In the last week of March 2020 alone, there was a 154% increase in telehealth visits. By April, nearly half of all doctor visits were done via telehealth, compared with just 1 in 1000 in February.
That’s an astronomical rise, yet it’s a trend we’ve been anticipating for years. Over the past decade, telehealth solutions have made inroads into the mainstream medical community. The pandemic was the accelerant that led to widespread adoption. That trend will continue, meaning fewer physical doctor visits. Ironically, that means it’s more crucial than ever for patients to build trusting relationships with their doctors.
How Did We Get Here?
In the 20th century, the family doctor was the single source of truth when it came to caring for one’s health. They were relied upon for inpatient and outpatient care, and they referred you to specialists. Trust wasn’t vital, it was blind: there was simply nowhere else to go for information. If a patient was skeptical, they sought “second opinions.”
But doctor-patient relationships were built over a lifetime. Trust was built in a practical sense and an emotional sense. That practical trust was a given: the doctor’s coat, diploma and stethoscope lent an aura of credibility. But there was also an emotional layer of trust, as well: patients assumed they were understood and cared for.
Over the past 100 years, but particularly in the last 10, the American healthcare system proliferated into a multi-tentacled apparatus including HMOs, technicians, nurses, payers, regulators, researchers, hospital administration, triage, scribes, devices and so on. All sharing information at an ever-increasing rate.
With the advent and saturation of the internet, patients gradually began going outside the doctor’s office for medical advice. That’s not always ideal, but it’s almost always more convenient. What’s easier than Google?
We went from a single point of contact to a multi-pronged labyrinth, as technology and complexity increased. That leads us to today’s current state.
The Lay of the Medical Land
Between regulations, astronomical price increases, documentation burden, and a shortage of providers we’ve netted out in a near-dystopian maze of interchangeable providers, endless specialization, lack of coordination and unavailability in an emergency situation. This has caused myriad bottlenecks and lulled people aiming to take charge of their health into toggling between states of overwhelm and learned helplessness.
Digital is making it worse. There’s increasing fragmentation between providers, between patient and provider, and even between research and provider. Increasingly, “patient-centered” has been warped to mean “give patients all the information and tell them to make sense of it all,” even if that’s not the intent.
In short: it’s become harder than ever to trust the healthcare system. Despite all the increased technology and demand for professionals in the industry, things don’t run smoothly. In addition to medical information getting hung up between providers, patients receive a battery of conflicting advice and opinions.
But despite the exponential pace of technical and logistical change in the health field, robust literature suggests we’re still very human creatures. People just want to throw up their hands and yell, “is there a doctor in the house?”
The doctor-patient relationship is paramount, still, when it comes to deciding the best course of action for our health. The therapeutic alliance is still the gold standard when controlling for all other variables. We want to listen to our doctors, still. A collaborative and affective bond makes the best tag-team for optimal health outcomes.
The Way Forward
This places the role of control tower back squarely on the doctor. A transparent, trustworthy PCP is invaluable in this age of information overload and information silos. Yes, digital transformation is here to stay, and it can be used to engage patients and motivate behavioral change, but it is no substitute for genuine human connection.
While machines and one-off specialist visits can approximate credibility, they cannot replace empathy and trust. PCPs can facilitate trusting relationships by being consistent, handling specialist consults, coordinating among providers and being available via telehealth as on-demand as possible.
Rather than work against technology to cut through, it’s incumbent upon physicians to harness technology to amplify the doctor-patient relationship. For example: Technology can help doctors meet increasing demands that in a more analogue era would seem impossible. Although they may get less physical time with their patients, they can act as “CEO” with ultimate say in a person’s health. That takes a healthy dose of trust.
Unified Health Platforms are the wave of the future. They allow the doctor to be the head of the care team, including specialists. They can empower physicians to be the single “trusted health resource,” consistently. They allow seamless communication and put the doctor and patient in the hub of the many-spoked health ecosystem, with an endless array of options they can navigate together.
We’re at an exciting inflection point in healthcare, but there are things we can’t get wrong. We can’t let exciting tech result in more fragmented, decentralized care where Dr. Google is everyone’s first opinion. We doctors need to thoughtfully leverage those technologies that actually solve a problem for the patients and themselves. They have the ability to be there for their patients, regardless of whether or not they can actually be there with their patients.
