Is efficiency killing healthcare?


 

D’Amore-McKim School of Business Professor Timothy Hoff’s latest research, compiled in his new book, “Next in Line” is featured in a recent issue of Northeastern Magazine. Hoff examines the setbacks of healthcare commodification and underscores his belief that the quality of doctor-patient relationships is at stake because of rushed, impersonal, and data heavy healthcare practices. Read a portion of the Q&A below.

Q: Why is a strong relationship with your doctor so important?

Although the doctor-patient relationship is often seen as old fashioned and inefficient, there is good evidence that its core features—including trust and empathy—improve patient outcomes and compliance with treatment regimens. Also, improved communication and knowledge sharing enhance satisfaction among both patients and doctors. There’s a lot of burnout among doctors, in part because the relational aspects of their work—the part of the job that many doctors value most—are being stripped out of their workday.

Q:If strong doctor-patient relationships increase both satisfaction and the quality of care, why is our system moving in the opposite direction?

The system is increasingly controlled by hospitals, insurance plans, and large healthcare organizations that are too interested in cutting costs by reducing the role of physicians. There’s been a long-standing tension between corporate entities and doctors in the U.S. healthcare system, and corporations have gotten the upper hand for the moment.

We’re moving toward a retail-focused model in which patients are seen as consumers, and a key goal is selling them new products and services—everything from Fitbits to wellness programs.

With the growth of retail clinics and urgent-care centers, healthcare is increasingly transactional, and there’s less continuity of care. Efficiency has become a chief buzzword and a goal, as if all patient care could be work-flowed as easily as what occurs inside an Amazon fulfillment center.

Q:But if this trend keeps costs down and makes healthcare more convenient, isn’t that what everyone wants?

It doesn’t necessarily keep costs down—it just shifts the costs to other services and products, which often have little proof that they improve people’s health. And when costs are reduced, that money may be used to boost the company’s bottom line rather than be passed onto patients through reduced insurance premiums.

Patients are deeply ambivalent about what’s happening in the healthcare system. They know something’s not right with their care, and they realize they’re paying more. Although they value a strong relationship with their doctor, those relationships have become so fractured that they’ve

Read more in Northeastern Magazine.