Yet what about our patients – those people who are at the center of our care planning? The changing environment of decision making has led to an informal reform among the people for whom we provide care.  The economic recession fueled the growth in personalization and customization of health benefit plans offered by employers.  The responsibility for making informed choices and decisions on cost of care have shifted to the consumer.  At the same time, there is a drive by more people to be involved and participatory in care decision making.  How a patient arrives at the physician’s doorstep is more complex than ever.

Patient Generations Defined

Today’s family practitioner provides care to five generations: the GI Generation (age 88+), Silent Generation (ages 70-87), Boomers (ages 52-69), Generation X (ages 31-50), and Millennials (ages 8-30). Events of our upbringing influence our opinions and approach to life. Understanding a person’s key drivers and the influencers of their decision making is paramount to gaining acceptance of the new models of care.

The GI and Silent Generations were shaped by the Korean War, WWII, and The Great Depression.  They are family oriented and frugal. Their approach is to not question authority, follow their physician’s lead.  On the other hand, Boomers were defined by civil rights and integration of the workplace, and are accustomed to the world being shaped to their needs. Boomers are known for living to work and invented self-help.  They are the reason A Purpose Driven Life has sold 64 million copies. Boomers are the true sandwich generation.  They make healthcare decisions for four generations as they influence older parents, younger children, and, many times, grandchildren.

Generation X was shaped by the Challenger Explosion, Watergate, and the War on Drugs. They grew up with Michael Jackson, the Internet, and watching Boomer parents work ‘til they dropped.  As they raise their own families, their self-proclaimed work-life balance that defined their early career is now giving way to a desire to climb the career ladder.  They are characterized by “question everything.”  The Millennials saw Columbine, Nine Eleven, and the Oklahoma Bombing.  Their Boomer parents overscheduled them, hovered, and they are accustomed to being connected the world over.  The true social media generation, they make decisions with group influence and openly share their thoughts and lives on the Internet – Lifecasters.

The Rise of the e-Patient

A 2011 Pew Social Life of Health Information study illuminated how people seek health information and use online tools to share that knowledge with family members, fellow patients, and caregivers. The study revealed 75 percent of all American adults use the Internet, and researching health information is the third most popular online activity behind email and use of a search engine.  Eight in ten Internet users look online for health information, and nearly half reported their search was on behalf of another person.  More than one third said they read someone else’s commentary or experience about health or medical issues, and one in four said they watched a health video online.  People trust the information found online, with 30 percent of adults reporting either they or someone they know was helped by medical advice found online.

Those living with chronic health conditions are most active in seeking out those with a similar condition. The vast majority of people with chronic conditions never attend a support group; they depend upon their social network of family and friends for information, advice, and support.

A sense of trust in health information found online, coupled with a heightened awareness of healthcare issues, has led to a new dynamic in consumer power.  Today’s e-patient is equipped, engaged, empowered, and enabled; and they expect to be a partner in developing care plans. The evolution of a new Participatory Medicine movement means that patients are beginning to understand how to use their influence to change the healthcare landscape, to demand immediacy and transparency on cost and quality, to demand to see their data.

Twenty-five percent of all adults in the United States provide unpaid care for a loved one. Many juggle jobs, children, and their own chronic health conditions. With so many time constraints, people want to manage their care – and that of their loved ones – on their terms, on their time, online.  Healthcare providers who are successful in engaging patients in new models of care will provide decision support with the right tools at the right time to funnel large amounts of information. They will understand the value of trusted advisors and equip those individuals with information to simplify choice. The Institute of Medicine recommends providers adopt a framework to help patients understand the components of quality care: safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity.  In an era of informal reform, decision support, convenience, plus transparency must become a way of life. 

Lisa McCluskey is vice president of Marketing Communications at Memorial Health Care System in Chattanooga, Tenn. She specializes in developing physician liaison programs that leverage relationships for increased volume. McCluskey also provides consultation services to organizations looking to establish an effective program or take a traditional liaison program to the next level of volume generation. She may be contacted at Lisa_McCluskey@memorial.org.

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