Tag Archives: healthcare

As I Lay Dying…

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Being knocked down with a nasty cold has me thinking, particularly as I consider a visit to the doctor today.  High touch care is becoming a centerpiece in the developing healthcare system.  While expectations are low for most people, they do see the trend shifting to a more engaged type of care and expect it become more the norm over time. Just as people have a wide array of choices when shopping retail setting, so to do they have a wide range of choices in healthcare providers and they are increasingly making choices based on the degree of involvement of a wider body of knowledge and people in the clinical setting.

Several factors are contributing to the desire for high touch care.  First, there is a purely psychological component that makes people see themselves as the center of the universe when ill.  Generally speaking, people either resign themselves to their condition and begin looking to take care of their loved ones (the paternal response) or they focus exclusively on their own condition, functioning as though the needs and conditions of others are secondary (childlike association).  In either case, there emerges a need to have a team working their behalf. This leads to both a sense of increased security and a sense that no matter what happens, they are not alone.  Remember, the response of many people when confronted with an illness is to run worst case scenarios through their minds.  Seeing a team of highly involved, smart, caring people helps detract from the worst case scenario thinking pattern. The result is that the patient feels more in control, positive and secure in the belief that he/she will come out of it well and healthy.

One the one hand there is a rational response that assumes the quality of care they are receiving is simply superior – the more people there are engaged, the more likely they are to solve the problem.  On the other hand, there is a deep emotional response.  Whether true or not, the high touch response has an emotional component wherein the patient comes to see the team of healthcare professionals, and even the institution, as caring and loving.  They impose strong emotional markers to the experience and come to view the system in a highly humanistic way.

It is also important to remember that at a fundamental level, human beings are social creatures.  The individual exists at the level of the organism, but that’s where it stops.  We carry our cultural baggage with us and have a deep need to be socially engaged.  Why does it matter?  First, the more people feel that they are part of a social system at the clinical level, the more likely they are to create positive memories about the experience.  In addition to turning the patient into a long-term devotee of the system, the patient typically becomes an advocate, telling other people about the nature of the care.  In other words, they become a representatives across a range of their social networks, meaning they essentially work as word of mouth advertising.

Second, when people enter into a clinical setting they are essentially foreigners entering another population’s culture.  There is a hospital culture made up of the people who are inside the system and there are patients.  This is decidedly nerve wracking.  The more the clinic takes on a high touch approach to care, the more likely the patient is to feel like they are part of the cultural system and the more likely they are to have a positive experience.  They are as invested as the medical personnel.

Space and Healthcare

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Healthcare and wellness are complex and involve more than a mechanical application of technical skill. Wellness is about engagement. Engagement can be as simple as reading to your child or as complex as being in an adult basketball league – the key is that engagement involves others and mobility through a range of environments. It is bound to human interaction.

In contrast, illness is understood on a personal and singular level – illness is a break with everything good and positive in life. Healthcare today is, rightly or wrongly, conceptually aligned with the negative because, whether literally or representationally, it connotes something is wrong and out of the ordinary. From TV to radio to print, healthcare is presented in a light that fosters a cognitive model of apprehension if not outright dread. Wellness is the steady state, healthcare is the episode. It is inherently frightening. But the spaces in which healthcare takes place can have a remarkable impact on shifting these perceptions.

Environmental sensibilities shape cultural expectations about how every environment we interact with should be properly organized. Hospitals and clinics that are visually and contextually different from the hospital archetype are generally perceived as providing better care. But it isn’t as simple as a new coat of paint and better magazines.

This means that how we interpret space and our physical environment (both public and personal, literal and symbolic) can have an enormous impact on how an interaction and its outcomes are perceived. When patients are encouraged to interact with the space in a non-transactional way, creating new configurations collectively and dynamically, they are more inclined to interpret themselves as part of the storyline. The contextualization of these actions by location provides a deep and varied “interaction space” and sets the stage from creating a recognizable, positive shared identity.

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Healthcare Options and Identity

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We all know the perils in marketing healthcare. While there is a mythology created about the world’s best clinics, the fears people harbor about healthcare tend to drive the conversation – the wait at the office, the horror stories of infection, etc. Healthcare has responded over the years by giving a list of positive attributes about their offerings. Though a necessary element to be sure, this “promise of good” also serves to create a barrier between the people in the institution and the people using it. People are reminded that they are “foreigners” in another land, because we spend such little time thinking about the nature of identity and how it can be used to enhance an experience.

The ways that health is invoked in the formation of identity and subjectivity is central to understanding how people internalize your brand. This is because identity as it is constructed in relation to the choice of a doctor (or hospital, a pharmacy, etc.) touches on fundamental issues in social science; namely the workings of power in relation to social differentiation and senses of self and other. Heavy stuff, but the point is simple – healthcare isn’t about a commodity, it is about the people who use it and how they construct their notions of “self.”

It is the verb to identify and not the noun “identity” that opens the richest analytical perspectives. The verb makes identity a process that happens between people, not individuals and the institution. Social identity is a game of playing roles. Offering a list of services means little in this sense because the decisions about where to go and how to select a provider are bound up in interactions, metaphor and story telling. The lists healthcare providers supply differ little from one another and serve only to enhance the already enormous sense of distance between the healthcare worker and the person seeking attention. Identities work and are worked.

There is often an overlap between the people seeking treatment from the people in the medical facility, for people sharing a common problem. Between the two poles of identity politics, the collective social roles of doctor/patient and the personal, different balances are made between common diagnosis and treatment efforts and individual endeavors to rework a devalued identity.  In other words, the lines between healthcare worker (be it doctor, nurse or physical therapist) are increasingly challenged in an age where identity can be so readily reconstructed according to setting.

Whereas an older generation of social scientists was concerned with the relation between health and bioidentities like race, gender and age, we must now examine the ways that diagnostic technology actually creates social difference and social groupings. Maybe this is beginning to happen even in developing countries: In Uganda, people who have been screened for HIV are encouraged to join post-test clubs. Therapeutic technology can also form the basis for bio-sociality as in the case of support groups for people who have had mastectomies, colostomies, and transplants, or who are on lifelong antiretroviral therapy.

By describing patterns of social interaction morality, and meaning, they suggest the processes through which assumptions and consciousness about health assume significance. They are richly textured because the researchers have talked to many kinds of people and considered the multiplicity of domains in social life. The differentiated picture shows not only the uneven seepage of science and medicine into social life, but also the uneven effects of different social conditions on the possibilities for the formation of health identities.

What all of this means is that the age of commoditized healthcare, like the age of commoditized shopping, is at a crossroads. Smart brand teams will rethink the way healthcare is marketed, focusing less on a list of attributes and sterile claims, and more on the shared experience of the different parties in the healthcare exchange. The doctors in these systems already treat and administer to the “self.” It’s time for the system itself to do the same.

By Matt Cloud and Gavin