Jeff Bezos is very smart and very right when he says that people don’t really want to renegotiate the price of the ordinary goods and services they buy repeatedly. We’re lazy and we know it and most of us decided long ago that it’s simply not worth the time or effort to shop around to save a few bucks — especially when the world is largely convinced that Amazon’s real-time, automated repricing technology Ensures that you’re getting the lowest available price anyway. The key word here, of course, being available. The lowest price is actually only true if you willingly confuse available with possible.
The lowest possible Price – typically dictated by aggressive competition in the marketplace – isn’t often available to Amazon shoppers because anti-competitive behavior on Amazon’s part prevents third-party sellers using Amazon’s warehousing and shipping services from offering better and cheaper pricing on their own products elsewhere even on their own websites. So, Amazon shoppers settle for the best prices that Amazon chooses to offer. But, in the real world, I’m not sure that these nickel and dime distinctions matter much when we’re talking about toilet paper. Your concerns change and become more substantive as the value proposition changes: you care a lot more when it comes to buying the dishwasher than you do the dishwashing pods. But that, too, is changing: these days you can pretty much buy a television set sight unseen.
I’ve said for years now that, for the vast majority of digital shoppers, except for those poor souls who have abandoned coupon clipping for the pathetic joy of spending hours bargain hunting online, our time is more important than modest amounts of our money. Speed, ready access, and convenience are what it’s all about in large parts of our hectic day-to-day lives. One-click purchasing was a brilliant innovation and the most overt manifestation of the Bezos master plan to remove any deliberation, calculation, or hesitation from consumers’ buying decisions. The idea was to do everything you could to eliminate thought from consumption. Fast and frictionless. Click it and forget it and it’ll be delivered in a flash.
That attitude is probably safe and somewhat sane when you’re talking about groceries and gifts, but what if you’re talking about cancer and chronic diseases? The problem with our perpetually progressive service expectations is that we believe that the best practices and experiences are readily and easily transferable among all of the various parts of our lives. If Amazon is a one-click experience, why shouldn’t our banking, borrowing, one-click brokerage and betting interactions be just as smooth and rapid? Why not try buying or selling a house with a couple of clicks through Zillow, which can’t even remotely keep its own house in financial order?
There’s obviously a reasonable and rational line that needs to be drawn, but it’s not clear that anyone’s really paying attention. Is it a matter of how many dollars are involved? Is it an age thing at both ends? Too young to be involved in gambling on your phone when you’re barely old enough to drive or too old to be doing instant reverse home mortgages because some huckster on TV says it makes sense?
How about when your life’s on the line? Would you really rather get a swift answer or a smart one when your health and well-being are the matters at hand? Unfortunately, it’s pretty clear that we didn’t learn any serious lessons from the Theranos debacle about imaginary but rapid test results that were too good to be true. We’re still all in a hurry, wevwant to get quick, cheap and simple answers on the spot, and we’re too often willing to trade easy for exact.
I’m sure this attitude is a problem in many industries but in healthcare, it’s more like a sin. Two out of three consumers surveyed recently said that they would prefer to use a digital medical app rather than wasting time and money traveling to their doctor’s office and then burning more time waiting to be seen. Even before the COVID-19 pandemic, office visits to primary care doctors fell almost 20% over a two-year period and, of course, many older doctors are retiring and not being replaced. Remote digital care is certainly better than no access to care, but we’ve got to help patients (especially those with potentially serious medical issues) make the right choices.
COVID-19 and the explosion of telemedicine really put one of the final nails in the coffin of the traditional patient-doctor relationship, where you actually knew your doctor, visited in person, and he or she knew you and your medical history. Today, your car mechanic knows more about your car than the dialed up “doctor” you’ve never met on some telemedicine service knows about your body and your medical background. Similarly, while it’s convenient to get a flu shot at CVS or Walgreen’s or have a bruise examined at an urgent care storefront clinic, but what about reactions and complications? Do they call 911 or an ambulance for you?
The know your customer (KYC) rules in the financial industry– as trivial, made-up, and superficial as they are– at least make a gesture toward the time-honored idea of understanding the people you’re dealing with to do a fair, reasonable and intelligent job of providing advice, guidance and services to them. To date, I haven’t seen much of a similar effort in health care and, as a result, we’ve got millions of people settling for remote and/or digital medical care because it’s cheap and easy. Their employers love it, too, even if it’s not a smart bargain for them and their families.
Now I realize that there are plenty of good reasons to avoid a trip to the doctor’s office: taking time off of work; taking your kids out of school; waiting to see the doctor once you get there; too often filling out the same paperwork for the umpteenth time; sitting surrounded by a bunch of sick people; discovering that your alleged insurance doesn’t cover whatever; and – after all that – getting the “take two aspirins and call me in the morning” diagnosis. But technology alone isn’t going to be a sufficient solution. Even if about 75% of the in-office consultations would be treatable online. You don’t want you or your family members to be the exception to the rule.
Before we go overboard and turn all the family docs into screen images whose skills, experience, and credentials we’re all asked to take for granted, I think we need to take a breath and ask for one simple thing for and from all those people with serious concerns and medical issues. We need to slow down, calm down, and tell ourselves and everyone around us that not everything important and valuable can be done in an instant. Some things will always take a certain irreducible amount of time and we need to make enough time to address and deal with them properly.
Right now, we’ve got too many patients with too little patience.