Recently, having navigated my way through a difficult event, I got to thinking about how people interface and make choices within the healthcare ecosystem.
So, I jotted down a few questions:
- At what point does a person acknowledge that something is wrong and makes an appointment with a provider?
- How much time and effort do we invest in making choices based on what our provider tells us?
- How do we balance listening to and questioning our doctor's advice?
- How can we research providers and facilities?
- How can we determine where to access the care we need?
- How can we find out which providers and systems provide a 1st class experience of care and the best outcomes?
- How can we compare pricing without transparency?
- Why isn’t this process more consumer friendly?
I don’t want anyone to worry; my recent experience had nothing to do with my health or the healthcare system. It had to do with my beloved SAAB - my car was slowly falling apart and I was forced to do something about it.
It’s a bit of a long story, so buckle up.
Acknowledging something was wrong.
At first, the signs of trouble were subtle. A little shake in the front, a little shimmy in the back. Enough that I could tell that something was off, but not so much that I thought to get it checked out. But then the air conditioning started blowing hot. And then the locks started acting funny; sometimes my car would let me in, sometimes not. When it did let me in, the alarm would go off.
Making an appointment at a convenient location.
I took my beloved car to a nearby shop. Diagnostics revealed an ignition switch issue which was connected to the alarm and the locks. Oh, and both rear coil springs had collapsed. All manageable problems with somewhat affordable fixes.
However, further inspection revealed that the air conditioning condensation had been slowly leaking onto the frame of my car, causing it to rust; the result of a design flaw.
Diagnosis: The frame was shot. However, it was fixable. If we could find another care like mine in a junkyard, he could cut off the front end of the frame and wield it onto my car.
A solution! Maybe not the best solution, but somehow knowing that it was at least possible to fix my car made me feel better. I asked how long that would last? He said he couldn’t guarantee anything. But he also said that committing to such a course of action would cost more than the car was worth.
Evaluation of the treatment plan.
I went into research mode. I had to know if it was worth getting my car fixed. I searched junkyards for my make and model, I looked up the Kelly BlueBook value, I called other mechanics looking for a better estimate. I looked online for my same car. I called friends and family, I consulted with colleagues and co-workers. I spent hours and hours each day for the better part of three weeks trying to figure out the best thing to do.
Recognizing the end.
And then it hit me. This was totally ridiculous! I had to get a new car. Knowing what I want, but having no idea how to get it.
SAAB is no longer made, so what kind of car did I want? No idea. I knew what I wanted the car to do though - I wanted it to get me from point A to point B safely and reliably in any and all weather conditions under any and all circumstances. I wanted it to make it over the curb of my drive without scraping cement. I wanted comfy, heated seats, a manual transmission, a sunroof, and a CD player. I wanted a good service policy, a warranty, and excellent gas mileage.
So I dive in - Consumer Reports, TruCar, CarGuru, Edmunds, Car & Driver, J.D. Power. I made lists of brands and models. I settled on seven different makes with a couple variations in model that may or may not be what I’m looking for. I mapped out dealerships within a 50-mile radius. I started making phone calls and appointments.
Shopping around, second guessing, and committing.
Walking and talking to the salespeople, it becomes quickly apparent that they have absolutely no expertise about the specific cars on their lot. They can’t tell me what will meet my requirements or what is available nearby. But, it’s obvious that they know their monthly quota.
Another fun surprise was discovering that gas mileage has steadily gotten worse over time. Despite technological advancements, many cars only get 19 to 23 miles per gallon. On top of that, I started to get the feeling that I wasn't even buying a car, I was buying a computer that’s housed in a shell that looks like a car. I didn't want a computer! I wanted a car!
Ugh. I can’t find what I want and it’s starting to get overwhelming. Second thoughts start creeping in. Maybe I should just get my car fixed. I love my SAAB.
I refocus and commit to my original conclusion: it is not realistic or practical to fix my car. I take a step back and start narrowing my options to only those cars which meet my requirements. The list is not long.
I settle on one specific brand and one specific model. I get on the company’s website and start building my new car. I go back to the research - I find new pricing and median sold pricing both nationally and locally. I check out the incentives and rebates, I look at financing options. I research the trade-in value of my car.
Although I believe that I am now ready to buy a car, the automobile ecosystem was not quite ready to take care of me.
Lack of consumer-centric process.
I put in a call to someone outside the state who owns multiple dealerships. He refers me to one of his top sales managers who decides that I should not buy the car that I want. He tries to sell me my number two choice of car instead. I refuse and insist on my initial choice. Subsequent emails and calls are not returned.
I go to a local dealership where I’m told that what I’m looking for is not available. I show them the documentation from the manufacturer’s website. The website let me build my car, indicated it was available, and provided a price. The dealer doesn’t know what to tell me.
The hoops we must jump through.
Discouraged, I start looking at totally different cars and doing even more research. I still find myself drifting back to my original selection. I contact a different dealership that is willing to search for the car that I built online. They find one! Price negotiations begin.
Of course it’s in another state. And it’s the last Friday of the month. And if I want the incentives and the rebates, it has to be picked up, brought to Cleveland, and processed as sold before the end of day Monday.
I made the arrangements, traded in my old car, and left the dealership on Monday at 7pm in my brand-new ride.
I’m telling you this story because it amazes me at how much time and effort a person will invest in trying to figure out if they should fix, buy, or lease a car. But when it comes to health and healthcare, we don’t have the option of buying new, we must fix what we have. So why don’t we ask similar questions? Why don’t we commit to similar research? Why don’t we shop around? Why don’t we ask questions?
It's time we start.