Concierge Patient Care Coaching — A concept

Saeed Zeinali Published on Feb 6, 2020
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In an increasingly complex medical care system, the need for a service to help patients access the care they need has become crucial. While this impacts people globally, the Canadian healthcare system adds an additional layer of confusion. The semi-public system that exists means that Canadians are required to sort out what is covered by their provincial healthcare plan and what services require additional private insurance benefits. Within private insurance, there is the additional challenge of understanding what portion of services are covered and which require referrals from general practitioners in order to be covered. Many employers seek to offer a more seamless experience for their employees. This can range from providing services to optimize appointment scheduling to referral coordination. These features ensure that their employees can see the right practitioners as soon as possible.

Concierge services can offer one-on-one support to assist patients to navigate the multifaceted medical system and get to the right doctors quicker. This premium service is offered for an annual fee either direct to consumers or to businesses as an employee benefits add-on. For businesses looking to attract or keep high-quality talent and executives, medical concierge services can boost worker productivity and are an attractive perk for prospective employees.

These services provide significant benefits to both the employer and the benefit recipient. With the addition of this support, employees can save time on seeking out resources and information regarding their health concerns and needs. Studies have shown that internet searches by those seeking knowledge related to their health concerns can cause anxiety*. This is especially prevalent when the search provides conflicting information or results in an information overload**.

The benefits may be even more significant for top executives and business leaders. In general, these individuals have hectic schedules that cannot be halted or adjusted to accommodate their medical needs or those of their families. They tend to be at an age where they are caregivers to both children and elderly parents who have increased healthcare needs. Presently, the average age of C-suite executives is 54. This is also an age where they may be beginning to experience increased healthcare needs.

The Canadian Healthcare Industry Problem

The complexity of the medical system is a far-reaching industry problem that impacts people from all socio-economic groups. While there are many support services available that are covered by Canadian universal healthcare, they are hard to find and have to be actively sought out. The onus to navigate this system is placed on Canadians who lack the necessary expertise. Patients struggle to determine which type of doctor they must seek out and what specific practitioner would be the best fit for them. Additionally, once a patient has an understanding of who they need to see, they often require a referral. Getting this referral requires additional appointments with general practitioners and the referrals themselves often get lost in the system.

In addition to the complexity, the healthcare industry is becoming increasingly burdened. As the Canadian population is quickly aging, there is a new challenge of longer wait times. The older population requires increased care due to the higher incidence of chronic and acute illnesses. This high demand can overburden the system, especially for specialists and long term care centres. The resulting increase in wait times can lead to a further decline in health and an increased number of days of work missed for all patients. These impacts are felt by not only the person in need of care but also, in many cases, the caregiver. Just as for many patients, caretakers are left to navigate the system without assistance. They are not only responsible for researching the necessary steps but also for arranging the logistics. Often, they must seek out a person to assist them in taking the patient to the doctor, filling prescriptions, and providing care while they are at work.

While universal healthcare provides many benefits and allows all Canadians to access crucial care, government-funded healthcare does not cover all patient-needs. This poses an additional challenge for those trying to navigate the system. Without expert knowledge, many patients are unsure of which services are covered and which require additional private health insurance. Often, patients must transition from government covered services to private facilities. This is common during rehabilitation from accidents or medical incidents such as strokes. In these cases, patients are left to determine the next steps on their own. Without medical knowledge or assistance from professionals, these patients often fall through the cracks.

Affected Populations and Their Unique Challenges

These challenges impact almost all Canadians, which, in turn, impacts almost all employers. Navigating the system requires a significant amount of time and energy, which could be used in other productive endeavours. Additionally, the lack of expert knowledge means patients are often visiting more practitioners than needed. This leads to increased absences from work. Patients and caregivers alike struggle with these burdens which are likely to cause undue stress and lead to a further decline in health. Businesses who are looking to attract and keep their most valuable employees may consider offering concierge services as part of their insurance offerings. In an increasingly competitive market, many businesses have already turned to offering perks beyond standard compensation. The inclusion of concierge services for employees will provide tangible benefits for workers and companies alike.

Key beneficiaries of these services are also those who struggle to find the time in their own schedules. Many Canadians are willing and able to pay for these services through their private health insurance or out of pocket in order to spend the saved time focusing on their careers. Often, it is not feasible to take the necessary time off of work to navigate the healthcare system on their own for themselves or loved ones. Businesses as well can reap many benefits from covering the costs of these services for their employees.

Impact on Businesses

The complexity of the Canadian medical system results in two different time-intensive processes that are interrelated and result in negative business consequences. These activities include frequent use of the internet for seeking medical information and diagnosis and inefficient accessing of available resources.

The rate of patients googling their symptoms is increasing at a rapid pace. These habits can be found in over 80% of all internet users. This is a notable increase from 62% in 2001. This trend is particularly pervasive among high-income individuals, “Households earning more than $100,000 were nearly 60 percent more likely to do Internet health searches than households earning less than $50,000.” A significant amount of time is spent on this activity yet research shows, “A lot of people aren’t finding what they need.” This is time that could be better used on other activities, including work. As this process still does not result in conclusive answers, additional time is needed to access formal healthcare services.

In many cases, the information provided by the online services recommends seeking out immediate medical attention where none is needed. Research shows many patients attending hospital ERs and doctors offices for conditions that can be self-treated at home. This results in additional unnecessary time off work and increased healthcare spending. According to a study published in the Journal of Medical Internet Research, “Together, confusion, risk-averse triage advice, and cyberchondria could mean that symptom checkers encourage patients to receive care unnecessarily and thus increase healthcare spending.” Those who frequently attend the doctor are also more likely to receive unnecessary medical care that can have significant side effects and take employees out of work. The impact of unnecessary medical treatment can even result in death, “The third-most-common cause of death in the US… is “iatrogenic effect,” a blanket term that can refer to an unfortunate drug side effect or interaction, a surgical instrument malfunction, physician negligence, medical error, pathogens in the treatment room, or simple bad luck.”

With these factors in mind, there is a strong case for businesses to help curb these behaviours. The addition of a concierge service to employee benefits can not only streamline the process of seeing a doctor when necessary but also limit unnecessary doctor visits is a cost-effective way. By providing online services that allow patients to receive accurate information and be guided through the confusing system, concierge services can effectively eliminate this significant and costly issue.

According to a report by the government of Ontario, “patients and their families find it difficult to navigate the health care system.” For these individuals, it is difficult to access care due to inconvenient service hours of general practice physicians and specialists. The multi-faceted and confusing system also often results in patients not knowing where to access the appropriate care. “For example, Ontarians often go to the emergency department with mental health or addictions issues that could have been dealt with more quickly, and oftentimes more appropriately, in primary care or community mental health and addictions agencies.” This results in emergency departments becoming overwhelmed with patients and increasing wait times. These behaviours both impact the time taken off work to research and access care.

According to the government report, wait times are not only an issue for immediate care but also for long term care. “For example, the median wait time for long-term care home placement in Ontario in fiscal year 2017/18 was 146 days”. For the families of these patients, this may also mean additional time off to be a caregiver.

These issues facing all Canadians can be mitigated through the addition of concierge services. For employers, investment in providing these services would have a positive ROI. They can help ensure that patients and family members navigate the system in the most efficient way possible. The use of these services will help ensure they are accessing the correct care from the best providers. Overall, anxiety and stress can be alleviated through caring support from a dedicated concierge. Tech supported assistance will ensure that the process is as seamless as possible.

The Solution

Medical concierge services provide assistance in navigating the complex healthcare system in Canada. They ensure patients are accessing the right care with the least amount of wait time and confusion. Concierge services also assist patients and caregivers to access the many underutilized, government-funded, healthcare offerings. In addition to aiding patients within the government-funded universal healthcare system, they also support the transition to private care and ensure patients can access high-quality ongoing care. The result is that patients receive the highest level of care available with the least amount of stress. Health issues burden patients and caregivers with undue amounts of mental distress, but concierge services can make the process as seamless and caring as possible.

Some executive health clinics already are providing a level of this service to their members. However, in a lot of cases, it is done quite manually and with no proper resource-mapping. In the next article, I will explain more on a model that in my opinion, could work.

*Results suggested that anxiety might not always prompt a search (e.g. searches can be for general knowledge, curiosity), but may occur as a result of online health searching.

**query escalation (i.e. searches of benign symptoms leading to considering serious causes; White & Horvitz, 2009) in a subset of the sample and confusion deriving from conflicting information often led to the maintenance of illness thoughts and anxiety, leading to additional/revisited searches to resolve discrepancies, gain reassurance, and reduce anxiety.

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