The Industrialization of Personalization

Steven R. Feldman, MD, PhD

Steven R. Feldman, MD, PhDThe modern world is technologically advanced. In the last 100 years, humans have created a world that their ancestors would not recognize. The last 20 years have seen extraordinary advances in the development and delivery of many goods and services, not to mention biomedical advances and new treatments. But, alongside all these technical advances, we’re still people.

Throughout the economy, companies realize that they must attend to interpersonal relationships. Pay attention the next time you are at a hotel or a bank or a restaurant — you can expect the people working there to be personable and friendly. And this isn’t just true at mom-and-pop establishments. On the contrary, large, faceless, corporate, industrialized businesses are on the forefront of trying to give customers a personalized, or at least what feels like a personalized, experience.

How do they do this? Do they pay high salaries to attract the best, brightest, most personable people available? Not likely. Companies hire people — not necessarily great or even above-average people — and attempt to instill in them company rules and regulations to be — or at least to appear to be — personable.

What this Means for Dermatology

Chief Medical Editor's MessageMedical care is clearly heading the same way. Marcus Welby is out and institutionalized, bureaucratic medicine is in. While the dermatologist of the past was in solo or small-group practice, the country is headed toward large, integrated health systems to deliver care. In those systems, doing things your own way and other idiosyncrasies — which may well have been tolerated in solo practice — will not be highly valued characteristics; being a team player who follows the checklist, attends to documentation in the EMR-du jour, and achieves high levels of patient satisfaction on a standardized patient satisfaction survey will be.

Health systems will be looking for efficiencies, wringing out unnecessary spending. They will talk about achieving — and will honestly try to achieve — cost reductions through higher-quality care, including reduction of hospital readmission rates and hospital infection rates (stock up on hand sanitizer, or better yet, invest in hand sanitizer supplier stocks). They will also hire people — not necessarily great or even above-average people but almost certainly lower-cost employees — and will set standards for their behavior, particularly related to interacting with the customer and to giving the customer a “personalized” medical experience.

Will integrated health systems pay a premium for the acumen of highly skilled, senior, established, experienced physicians? Perhaps, but I think it is as likely as the supermarket or bank paying a premium for particularly experienced check-out staff or tellers. More likely, physicians and other healthcare team members will be graded on their patients’ satisfaction and will be both taught and encouraged to provide individualized, personalized, warm, friendly care the industrial way.

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