The Competition – by Steven Tomlinson

(Community Matters)  Unfortunately, our customers also want empathy.  For whatever reason, people need to feel like their doctor knows them.  It takes only two minutes of conversation for an expert clinician to diagnose an illness, but it takes ten times that long for the typical patient to feel understood.

Third of four parts Steven wrote for the People’s Community Clinic luncheon earlier this year. #1 The Doctor, #2 The Nurse.

THE COMPETITION    ©2011 Steven Tomlinson

As the Board of a huge healthcare corporation, it’s your job to protect shareholders.  It’s my job as CEO to make sure our strategy is competitive.

Our customers want efficiency. They demand the full range of treatments at the lowest possible cost – so we’ve scaled up with specialists and technology and systems that get people in and out and on with their lives.

Unfortunately, our customers also want empathy.  For whatever reason, people need to feel like their doctor knows them.  It takes only two minutes of conversation for an expert clinician to diagnose an illness, but it takes ten times that long for the typical patient to feel understood.

And that’s why we’ve got a healthcare crisis:  Send someone to medical school and give them a white coat, and you’ve created an authority — someone who can validate and affirm and absolve.  And since the demand for all that is infinite, you’ve created a bottleneck.  Patients try to tell their doctors their stories, so appointments run over, wait times increase and there goes efficiency.

We told doctors to cut it short.  Keep it moving.  But people complained we were taking the care out of healthcare.

So we tried reasoning with them:  If you can just be more matter of fact about your body, more stoic and existential, if you can see your doctor less like a priest and more like a plumber, you’ll get all the medicine you need at a price you can afford.

But some people would rather wait in line and wreck our cost structure if that’s the only route to someone who seems to care.

Now add the unfortunate accumulation of evidence that when we feel like the doctor cares, we get better faster — and we’ve got a competitive threat from small-scale healthcare providers who specialize in empathy, those funky little clinics where people work late, things run behind and the waiting room looks like day three of a family reunion.

Right now they serve patients we don’t much want, but that could change.  They’ve got passion and grit and a bedside manner that gets measurable results.  If they can find a way to scale this mess, they’ll give us a run for our money.

And with all our sunk capital investments, that’s a risk we can’t take.

So let’s stop trying to convince patients that empathy doesn’t matter and give them what they really want — efficiency and empathy.

Of course, it’s an illusion.  Our doctors can’t afford to listen.  But our computers can — and our superior information technology can mimic life-like compassion and concern.  I call it scalable empathy, and it’s even better than listening.  It’s more like mind-reading, and it’s all the edge we need.

First, we create an exhaustive database on every patient.  Every provider you see enters particulars into a file that’s available throughout the system.  No more complaints that your specialists treat you like body parts — your endocrinologist will ask about your sprained ankle and that cough you had last year.

Plus, we’ll have bots crawling through social media and credit card transactions and police records and your web-browser history, so we’ll have relevant information you may be shy about sharing.  We can ask better questions.  We’ll tell you why you’re under so much stress.

Next, we get doctors off the frontlines.  We just did an experiment where we gave actors white coats and three minutes to scan a computer-generated script from a patient file with open-ended prompts, like: “How do you feel?”  “Tell me more about that.”  “I’m so sorry.”  — and patients liked the actors better.  They were more likely to follow their orders and much less likely to sue them.

Plus actors are lots cheaper than doctors.  If actors see patients, then doctors can eavesdrop on consultations remotely and just long enough to relay their diagnoses to the actors.  It’s not that radical.  Just more specialization to leverage scarce expertise.

And even cheaper options are coming.  The robotics lab at A&M has programmed androids to emulate the body language of empathy.  [Demonstrate.]  And patients feel heard.

In another test, patients got better health results after switching from an analytical doctor on a tight schedule to an online consultation with an empathetic avatar, sort of a cross between Marcus Welby and Shrek.

See, once you realize how eager people are for empathy, how much of it happens in their minds, how willing they are to suspend disbelief; you see how easy it is to simulate and you wonder why we ever resisted it.  It’s going to save our business.

Of course, some people will still prefer to wait in line at their funky local clinic.  They’ll say efficiency doesn’t feel urgent and human.  Real care should cost the soul something.  And doesn’t a line mean something’s worth waiting for?

Well, we can simulate all that too, if you need it.
For the rest of us, scalable empathy will feel like the system we always wanted.  So streamlined, so cost effective, so profitable, so effortless that it’s literally too good to be true.