HLTHAGE lecture 7 (week 9)

patient

patient

Primary responsibility is to submit to the physician’s authority and follow directions, least able to advocate for themselves, autonomy is control on one’s self, greater reliance of professionals

client

Acknowledges own lack of experience and “hires” a physician to provide knowledge and expertise, a bit more autonomy than the patient, greater reliance of professionals

consumer

Works in partnership with health care providers, but ultimately take control of own health care decisions, partnership between provider and themselves, the individual seeking care is taking control of their own decisions, most autonomous and least reliance on health care professional

roots of consumerism 1960s

topic rose, language of consumers rose and patients being experts in their care

roots of consumerism 1970s

grassroots activists start the notion of “patient as active consumer” of health care

roots of consumerism 1990s

governments and health care businesses start pushing this idea

free-market capitalism

Humans have unlimited aches and pains for which they desire products and services, best place to provide these products and services, ensures that patients/consumers get the best products and services at the lowest costs

free-market capitalism applied to health

Individuals should be able to access a range of services by choosing between different treatment modalities and health care providers, health and health care services can and should be purchased

informed consumer

must be informed about the benefits, drawbacks, risks, and costs of the various options open to them, empowers the client and reduces the power inequities between the patient and the health care provider

problems with informed consumer

Information on the internet may be incorrect, leading people to make bad decisions, can be very time-consuming and not always helpful to their own case, may request expensive tests or treatments, which can drive up the costs of health care

marketization

Hospitals, clinics, and individual providers sometimes use the tactics of profit-driven businesses to attract and retain patients

The hospitality industry provides many strategies now employed by the health care sector

marketization controversies

Health is now viewed as a commodity that can be bought and sold, contrasts with the idea that health is a basic human right that should be enjoyed by all

attracting new patients

Branding, slogans, and public relations techniques are becoming commonplace, the creation of “regional franchises” of providers with recognizable names

pharmaceutical medications

The increase in consumerism has been paralleled with an increase in medications use—primarily to treat chronic conditions (medicalization)

chronic illness

Primary focus of health care services has shifted to the management of chronic illness, rapid improvement in medicine, sanitation, now viewed as chronic conditions needing management, medicalized

lifestyle drugs

used to treat non-life-threatening conditions, expensive and a waste of physicians’ time, allow patients to define and manage pain and distress on their own terms, not waiting for the physician to determine what conditions are worthy of treatment

DTC (direct-to-consumer) advertising

Only educated health care practitioners could understand the complex process of deciding on medications, healthcare information is very sensitive and it brings people to a very vulnerable place

pharmaceutical companies promote their medications and specific brands of medications, provide information about the conditions the medications are intended to treat, illegal in Canada

“Disease awareness” websites

sponsored by pharmaceutical companies provide information about health conditions and promote their products

DTC (direct-to-consumer) advertising PROS

Provides consumers with information to better converse with practitioners and reduces the power imbalance between patients and practitioners

DTC (direct-to-consumer) advertising CONS

Reduces physicians to drug dispensers, encourages people without medical expertise to believe they know as much a their physician, drives up the cost of medications and increases the likelihood of iatrogenic harm

medical tourism

people crossing national and international boarders to access health care treatments, serve as intersection points for economic globalization and health consumerism

North America and Western Europe were traditional destinations for wealthy consumers from around the world, some Western governments are paying to send patients abroad in an effort to cut costs and wait times

medical tourism treatments

range from minor dental work and breast augmentation to complex heart surgery and cancer care

medical tourism key tenets of consumerism

Individuals gain greater choice in treatment options, consumers’ wishes are the priority, information available on the internet is offered by brokers rather than health professionals, consumers may be pressured into treatments and procedures

cons of medical tourism

Health cultures in destination countries may be very different from their home country, economies of destination countries may in fact be worse off with health tourism, resources are used to attractive facilities rather than to address local needs

medical tourism supply

Hospitals and clinics in destination countries now equipped with advanced technologies, often foreign- trained, inexpensive practitioners, low-cost of airfare and internet deals

medical tourism demand

Health care costs in Western countries continue to rise, under-funding and/or rationing of services lead to long wait times

attracting consumer

Destination countries often have to overcome stereotypes about their personnel and facilities, some governments offer tax incentives to organizations who attract foreign consumers

attracting consumer tactics

branding and public relations, paying for licensing of famous North American institutions to add familiarity, teaming up with local tourism to offer exotic vacations in combination with health services