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Next in Line: Lowered Care Expectations in the Age of Retail – and Value-Based Health | Timothy Hoff

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Timothy Hoff, Professor of Management, Healthcare Systems and Public Policy

The doctor-patient relationship is besieged by several forces transforming the health care system at the present time, particularly the introduction of retail thinking that seeks to turn patients into consumers. This book examines how the relationship has changed and continues to evolve within a care delivery context that is more corporatized, value-driven, metric-oriented, and transactional than ever before.

Through the voices of doctors and patients, combined with an in-depth analysis of bigger system trends, it finds that relational care characterized by proven interpersonal and humane features like trust, empathy, and mutual respect has withered over time, succumbing to a hostile delivery environment in which physicians are increasingly isolated from patients; the organization seeks to garner the allegiances of patients; and patients develop lowered expectations that leave them susceptible to cheapened forms of care delivery.

Both doctors and patients still emphasize the importance of relational care for effective diagnosis and treatment, and for maintaining strong emotional bonds that enhance both parties’ experiences. However, the findings suggest that the rise of transactional care delivery in the health system must be offset by greater physician advocacy for relational medicine; a sharp focus on measuring relational care delivery in all its forms; and monetizing relational care so that it becomes something of value to the large organizations in which doctors and patients now find themselves interacting.

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