The Most Influential Person in Healthcare Might Soon Be the Care Manager, Not the Doctor

Everyone knows that the doctor has been the center of healthcare in at least our lifetimes and likely longer.  It makes sense that the doctor is the center of healthcare since they’re highly trained to provide the most effective care to a patient.  For our healthcare needs, we’d all love to be like the President of the United States who always has a doctor nearby to ensure the best care and health possible.  The problem is that it’s not possible to scale this model.  There just aren’t enough doctors and even if there were, we couldn’t afford it.

Thus healthcare is faced with a really challenging problem.  As we shift to value based care, how do we provide care “at the side” of every patient to ensure that each patient is receiving the personalized care they need and ensure the highest quality health and wellness for that patient?  As noted above, we can’t scale a doctor to every patient.  In fact, I’d argue that in our current healthcare world we can’t even scale a doctor to truly track and help a few hundred patients.  The economics just don’t work across the majority of patients.

As we’ve worked on various chronic care management and value based care models, we’re finding that the key to scaling these efforts is the care manager (care coordinator, case manager, care ally, etc).  Empowered by the right tools and technology, a group of care managers can track and follow thousands of patients at a time at a lower cost than one doctor.  Plus, as healthcare AI evolves, it’s going to make care managers even more effective in their work monitoring, tracking, and motivating patients that need help.

Of course, these care managers are providing something quite different from what the doctor provides.  No doubt the care manager will never replace the doctor, and the care a doctor provides will always be an essential part of healthcare.  In fact, doctors play a really synergistic role with care managers who need to escalate a patient in need to the doctor.

No doubt the doctor and the care manager will both be important in healthcare.  However, a doctor can see maybe 15 patients a day while a care manager has the opportunity to touch thousands of patients’ lives.  Ok, I get that the question of influence is fuzzy math when you’re trying to compare a doctor deeply influencing 15 people versus a care manager softly influencing thousands.  At the end of the day, which is more influential doesn’t matter, but what is important is understanding the rising importance of the care manager as part of the care team.

In healthcare, I’ve often heard people say that the front desk has more influence over a patient’s experience than the doctor.  This is largely true from a customer service perspective since patients have a hard time really judging the quality of care they receive from a doctor since their only basis of evaluation is “Did I get better?”  Patients therefore naturally rate their experience at the doctor based on customer service instead of care quality because it’s the only thing they can truly measure.

A care manager proactively reaching out to a patient and/or working on management of their chronic conditions is going to have a similar impact on a patient’s experience.  If for nothing else, they’re going to have more impact on the patient experience because they are going to have more contact with the patient.  Plus, it’s amazing how influential a proactive outreach to a patient can be for a relationship versus a reactive response to a chief complaint.

We learned this in the casino industry a long time ago when I helped build their loyalty program.  The right personalized outreach can make a person feel really special and changes your relationship with that person.  Although, I’d underline the word “right” since the wrong outreach can have the opposite impact.  In fact, we’ve learned that the outreach has to be personalized and always learning and evolving to provide the highest quality interaction.  The one size fits all messaging approach is better than no messaging, but the future of patient experience and value based care is going to require a more sophisticated and proactive engagement model that learns and improves over time.

Plus, to do this most effectively, the technology needs to empower the care managers to be able to interact with a patient population in a personalized way at scale.  Doing this puts the care manager at the center of a patient’s health.  They have the ability to influence a patient’s care choices in ways the doctor just can’t do with their interaction limited to a 15 minute office visit.  That said, the care manager can also drive a lot of needed visits with doctors for patients who might have otherwise avoided the doctor or who wouldn’t have been motivated to do something like an optional wellness visit.

Of course, healthcare is a team sport and the rise of the care manager’s influence in healthcare shouldn’t and won’t diminish the value of doctors.  In fact, it will enhance the value doctors provide by ensuring that more of the patients doctors see really need the doctor’s expertise.  However, we also should acknowledge that these care managers that proactively reach out to patients are going to have an increasingly important role in the business of healthcare.

About Sunny Tara

Sunny Tara is the CEO and Founder of CareCognitics, a digital health company applying casino loyalty principles and data science to transform patient behavior. CareCognitics’ platform brings patented technology innovation from the casino, hospitality and retail industries to deliver unprecedented patient experience and digital engagement that, in turn, drives transformational patient behavior.  Sunny works to create a win-win for physicians, payers and people with chronic conditions alike.  His mission with CareCognitics is to improve the quality of life (QOL) for one million patients by 2022.

About the author

Sunny Tara

Sunny is a serial entrepreneur on a mission to improve quality of care through data science. Sunny’s latest venture CareCognitcs, a digital health company that applies consumer loyalty and data science to transform patient behavior. Sunny has an impressive track record of Strategy, Business Development, Innovation and Execution in the Healthcare, Casino Entertainment, Retail and Gaming verticals. Sunny is the Co-Chair for the Las Vegas Chapter of Akshaya Patra foundation (www.foodforeducation.org) since 2010. Sunny brings great practical insights into the use of technology and data in healthcare.

   

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