Understanding the Physician's “Product” in Today's Marketplace: Improving Patient-Centered Care

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The conceptual role of the physician in delivery of health care services/patient care is likely to undergo significant change in the coming years as the nature of our society and economy changes. The continued aging of the baby boomers, projected shifts in ethnic and racial makeup of the working-age population, exponential health care costs increases, along with changes in financing of health care, intervening health care regulatory bodies, and improved access to health information, will collectively continue to drive health care consumerism. Evolving markets in health care create new opportunities and challenges in providing higher quality, lower-cost care that better meets patient needs and expectations. Although much attention has been given to the process of “disruptive innovation” as a key ingredient in the transitioning of the health care to furnish an affordable higher quality product, little discussion has centered on the assumptions and expectations underlying the role of the physician in delivering these services. To appreciate better what these roles might be in a comparatively open-market model of healthcare, we must more thoroughly understand the “product” or “service” that physicians are offering for “purchase” by prospective patients who assume the role of ultimate “consumers.” The drivers of this need are at least twofold. First, the expansion of competitive markets into more health care specialties (especially those with more lucrative payment for providers) means that providers must now consider the way in which their patients evaluate the service received. Second, a greater appreciation of the need for patients to use medications and follow-up care for chronic diseases (“adherence”) will increase the pressure to motivate all involved to do better, especially if providers might one day be held accountable for such behavior patterns. Currently, in health care, patients equate customer service with overall perceived quality of their health care experience. Although quality of health care services has gained tremendous interest in recent years, it has generally been evaluated by 2 separate and independent groups of stakeholders. First, governmental and nonprofit agencies (e.g., Centers for Medicare and Medicaid Services, Institute of Medicine, Agency for Healthcare Research and Quality, and Joint Commission on Accreditation of Healthcare) have focused on safety and compliance with standardized practice guidelines as quality indicators of healthcare services. Second, payors have concentrated on patient satisfaction and expectations as a measure or means of promoting quality of health care services. Thus, patient perceptions and satisfaction with valued components of health care are quality indicators from the payor and ultimately the