Editor’s note: Ron Gutman is the founder and CEO of HealthTap, which connects people with trusted health information and doctors via mobile devices and PCs.
Scarcity is commonly defined as the problem of seemingly unlimited wants and needs in a world of limited resources. Money is scarce, power is scarce and fame is scarce, but most of all, time is scarce. And even more meaningful than all these prized assets — both concrete and ephemeral — is something much more basic and fundamental: health. And nowhere is scarcity felt more acutely than in healthcare.
Healthcare is, and always has been, a scarce resource. Accessing it has always required being close to where doctors live or travel, and on making yourself available to them in the places and during the hours in which they work. Not only is this a time-and-place limited resource, but it’s also in high demand: You have to compete with everyone else who wants or needs their time — most often by having sufficient means to pay the going rate for care. This means that doctors — and by extension, healthcare — have historically been scarce and costly resources.
So what has hundreds of years of progress in learning about health brought us? And how has information technology helped us to date?
Healthcare still remains largely local in character, and delays to meet with doctors to get health questions answered are commonplace. In the United States, for example, the average time to see a general practitioner is still 19.5 days.
When you finally do manage to book an appointment, the delays aren’t over. You go to a special place — the waiting room — so that you can wait some more, amid an anxious crowd of others who, like you, have suffered through not knowing for days or weeks. The annoyance is only half the story; the risk of catching a germ or two is quite real when everyone else is sick, too.
When your turn finally comes, you typically see nurses or assistants who prepare you for your time with the doctor, and the amount of time you actually spend with him or her can be just a few minutes.
The fundamental problem
What do you call “a customer” in healthcare? A “patient” of course. However, when most people experience physical or emotional pain, they feel anything but “patients”; they’re actually very impatient. And impatience, when it comes to health, really matters. As frustrating as it may be to wait to renew your driver’s license, waiting for health information is a much more personal and anxiety-provoking experience, especially when you’re in real pain. (The origin of the word patient is “patiens”, which literally means, “I suffer.”)
In many other industries, we long ago abandoned inefficiencies of the kind that still plague healthcare today. Breaking news is delivered via tweets and is only later summarized in daily newspapers. We use comparison shopping for goods and services online rather than physically traveling to multiple stores. Our entertainment is delivered on demand, to wherever we are, on whatever device we happen to own. We can even request a car by clicking a button in an app. And in a matter of minutes, a driver picks us up to take us to whatever destination we choose.
These efficiencies are wonderful, of course. But achieving instant gratification in these ways is not nearly as meaningful as it would be to get our health needs instantly gratified. Accessing quality health information, connecting with doctors and their knowledge, and receiving care immediately anytime we needed it would reduce the stress, anxiety and medical risk that typically accompany the delays we’ve become accustomed to.
Yet in health this kind of access is still a luxury. The very wealthy have it in the form of private physicians dedicated to serving only a handful of clients, each of whom receives very personal, very immediate attention. “Concierge medicine” is available only to the privileged few and comes at a significant price — often more than $10,000 a year. And even concierge doctors sleep at night, have other patients, and travel, so paying large amounts of money still doesn’t buy you a perfect solution.
Money aside, we don’t have enough doctors to serve the general population in this high touch way. In fact, we don’t even have the required number of doctors to serve the United States under our current standards of delayed care. Under the ACA, an estimated 48 million additional Americans are entering the U.S. healthcare system. As a result, we are facing an estimated shortfall of 44,000 primary care doctors in this country. This shortage pales in comparison to the number of doctors we need to serve the billions of people in the rest of the world.
Immediate gratification, please
So how can we take this scarce resource, which is becoming even more scarce with each passing year, and make it available to all? How can we realize the benefits of decreasing anxiety and improving care by giving people access to doctors and their knowledge when they need it most? In short: How can we achieve the same immediate gratification we’ve become used to in other industries in healthcare?
The answer is through a combination of technology and an open vibrant marketplace for exchanging health knowledge.
Today, we have an amazing opportunity. Advances in communications and digital technology, coupled with the highly developed health information marketplace, that many top doctors are already part of, enable us to efficiently distribute the knowledge of doctors. We can overcome traditional impediments to access and care and do away with geographic barriers and time differences.
How? With text, voice and video, real-time remote interactions between doctors and patients. With immediate access to health and medical answers, tips and referrals. With personalized information. With the ability to store and call up personal health records at any time. And with invaluable repositories of big data and advanced machine learning techniques that help orchestrate a high-quality, efficient, and cost-effective care when and where it’s needed most.
The future lies not in nurse call centers, which review symptoms and answer from set protocols. It’s also not about connecting to “any doctor” in a clinic that doesn’t have specialist expertise to help. And it’s also not about connecting with simple one-dimensional information — like merely accessing articles on a website or an app.
What the future holds for us is immediate connections. Connecting patients immediately with the right care at the time, at the right place, at the right cost.
Immediate gratification to the impatient
Today, we have the tools to turn the “Impatient” to an immediately satisfied customer in real time. With smart data-powered triaging, we can now get people in front of doctors or their relevant knowledge immediately. Today’s healthcare customer can now get the kind of immediate gratification that we’ve come to expect elsewhere, but have always been denied in health — where the potential impact of real-time information, support and care is truly meaningful and leads to better results and lower costs.
The English novelist Thomas Love Peacock said that “The waste of plenty is the resource of scarcity.” The truth is that once you can distribute health information at scale and connect people with doctors remotely and in real time, scarcity in health is more a scarcity of distribution than a scarcity of resources.
The future of healthcare is immediate and right here. It’s just not yet evenly distributed.