Who's Afraid of the Health Care Consumer?

CHICAGO - According to legend, the Mayan calendar predicts the world will end on December 21, 2012 - a prediction that has conspiracy theorists and dwellers of the fringe speculating on what's going to cause your ultimate demise. A meteor? A heretofore invisible planet?

Radiologists have been facing down another apocalypse: Consumerism. But according to a panel at RSNA 2012 this week, that's about as likely to end radiological life as we know as an ancient stone timekeeping device.

"The word ‘consumer’ bothers a lot of physicians," said Richard Duszak, MD, FACR, CEO and senior research fellow of the Harvey L. Neiman Health Policy Institute of the American College of Radiology. "They're really just smart patients."

Yes, smart patients are concerned about costs. But that doesn't mean they're bent on cutting out imaging. In fact, the latest study of health consumers by Harris Interactive found that "unrestricted access to medical technologies like CT and MRI" was high on consumer's list of priorities in choosing a health plan.

"What we find is that price continues to be the No. 1 criteria," said Debra Richman, senior vice president of healthcare business development and strategy at Harris Interactive. "What we also find is there is an interest in not having a restriction on primary care services and preventive services. Our thought is interest in unrestricted access to advanced imaging was so high because consumers’ perception was that it was such an important service as a diagnostic tool, it was seen within the context of preventive care."

But cost containment is definitely part of the picture for health consumers. They're facing larger deductibles, higher co-pays, and other costs that they have to swallow themselves. So services that help compare costs of imaging services may gain traction. "You can pay $200 for a CT scan, or $2000,” said David J. Soffa, MD, FACR, senior vice president of medical affairs for AIM Specialty Health. “Often that is on the same scanner, sometimes with the same radiologist reading it."

Competing on cost alone is unlikely to be a sound business plan. So how can you attract savvy health consumers and live to image another day? It's all about how you position yourself, said Christine M. Hughes, advocacy research leader for the healthcare economics team at GE Healthcare.

"Market yourself to the consumer as a credence good, similar to accountants and lawyers," she said. Those professionals attract clients with their reputation for expertise, service and results, not low costs. After all, would you really trust the cheapest accountant to keep you from getting in trouble with the IRS?

And Duszak said there's another tactic you can adopt from accountants and lawyers: "We're sort of culturally indoctrinated into believing we as physicians, we know what's best for our patients," he said. "That's a very different paradigm from how a lot of other professionals are brought up to deal with their clients. They're clients. They make decisions together about processes. That's something that historically we haven't done a very good job of doing."