April 2012

The Patient/Consumer Relationship
By Jim Knaub
Radiology Today
Vol. 13 No. 4 P. 3

Last month I read an online discussion thread debating one patient’s angry letter to a radiologist. The letter took the radiologist to task for an “unacceptable and insignificant” report and informed the doctor that the patient was lodging a complaint with the medical board. The patient also complained that it was “unacceptable that I was charge[d] for a service and not provide[d] quality care.”

Understandably, the radiologist was unhappy with the patient assaulting his reputation over a report written for the referring physician. The referring doctor understood the report, but the patient did not. Rather than asking the radiologist or the referring doctor exactly what the radiologist meant in the report—and rightfully expecting an explanation—the patient immediately went after the radiologist. The situation underscores patients’ changing role—and growing consumer role—in their healthcare and the challenge that can present physicians.

In my view, two events in the mid-1990s served as major catalysts to shifting patients’ attitudes (and their behaviors) about their role in healthcare. In 1995, online services Prodigy, CompuServe, and America Online introduced the general public to the Internet. Two years later, the FDA approved the use of comparative claims in direct-to-consumer pharmaceutical advertising. Those vague TV ads telling consumers that “it’s time for Claritin” and to “ask your doctor” became ads clearly selling the fact that Claritin is the allergy drug that “won’t make you drowsy” and to see your doctor about it.

Aggressive marketing to consumers and the mountain of information—and misinformation—the Internet provides make patients more aware. Those factors—also fueled by the steadily increasing share of healthcare costs paid directly by consumers—have prodded patients into demanding a larger role in directing their care. Patients who ask their doctors what they need to know and what they should do increasingly are being replaced by patients telling their doctors what to do because of what they saw on TV or the Internet. The trouble comes, as illustrated here, when patients’ advocacy becomes obstinacy, particularly in the absence of informational accuracy. (Of course, patients are not alone in wanting things the way they want things.)

As patients increasingly become consumers too, radiologists and physicians need to decide how they will manage this informed patient revolution.
Enjoy the issue.