September 13, 2023

Generational change as young give flexible medicine a shot

This article first appeared in the Australian Financial Review.

Australians are becoming more engaged and proactive in managing their own health and many are shifting to a mix of digital and in-person care, a survey of health consumers reveals.

The NAB Health Insights Report, The Health Consumer reveals that while people are highly satisfied with the care they receive from their healthcare professional, they are also more likely to shift practitioner.

Consumers are taking more control of how they manage and spend their healthcare dollar and of how they select a medical professional, which has the potential to change the dynamic between patients and providers, says Dean Pearson, head of behavioural and industry economics at NAB.

The NAB survey revealed that financial pressures on households were affecting the healthcare consumer, with four in 10 saying they were switching to low-cost prescriptions and medications; three in 10 cutting back on regular dental appointments; and one in four scaling back on treatments from psychologists, psychiatrists, chiropractors, osteopaths and physios.

Consumers are also breaking long-term relationships with trusted health practitioners if they can’t get bulk billing or if they have to travel a long way, Pearson says.

“Particularly young people have a mindset that if it’s not perceived to be value, that they’ll move and they’ll take that relationship and shift it even if it’s a longstanding one,” he says.

At the same time, consumer satisfaction in those services is high. Doctors, nurses, dentists, pharmacists, hospitals and front-line medical professionals are seen, by the vast majority of Australians, as providing an excellent standard of care.

The pandemic lockdowns of 2020 and 2021, where so many services including healthcare shifted online, have had a lasting impact on the way Australians interact with doctors and other professionals.

“Consumers are researching brands, products, services a lot more now before they buy and I think a lot of that’s just evolved from much easier access to information and options that they’ve discovered as they moved online for the pandemic,” Pearson says.

The changes mean that healthcare providers need to be much more customer-centric, which involves getting closer to patients and understanding what they really want more deeply than the old model of “we just provide”.

The shift to ecommerce and online service delivery during pandemic lockdowns also drove a shift to online medicine, which has endured, with many consumers now expecting a hybrid of online and in-person healthcare.

Andrew Campbell, associate professor of cyberpsychology at the University of Sydney, says there is a marked difference between how younger Australians view online health compared with other Australians.

“Under-35s expect technology to work and they’re not concerned whether or not they may have got a problem or a privacy issue,” he says.

“The younger group expects entirely online support and no other choices. They’d rather just do it as remotely as possible.”

Those aged over 35 are a little more sceptical about online medicine. They expect that while they might start their healthcare journey online – such as by researching, booking and filling out forms online –they will end up speaking face-to-face with a provider.

But Campbell says government financial support for digital health has not been sustained at the same level it was during the COVID pandemic.

“Investment in digital health is still lagging behind other parts of the world in Australia. We need to see a real innovation in not just building technology but keeping it sustainable,” he says, adding that Australia is very much focused on health start-ups and innovations, but doesn’t take the five-to-10-year view of how new healthcare services can be maintained.

“If we don’t stay with the curve of what the demand of the consumer is then some of these systems are not going to be accessed properly or, quite frankly, the systems themselves won’t cope with demand.”

Chief executive of the Australian Dental Association, Damian Mitsch, suggests it’s not so much a technology issue for medical practitioners but there hasn’t been enough system-wide attention on the consumer experience whether that be medical professionals, administrators or health insurers.

Mitsch says consumers want to see the same level of convenience they’re seeing across other areas of their lives but it’s simply not available.

For example, the federal government’s My Health Record does provide consumers with much better access to information, but the interface doesn’t necessarily work well between the consumer, government and medical practitioner.

“It’s very difficult for a dentist to be able to put anything into an individual’s My Health Record because it doesn’t integrate with any of the dental systems,” Mitsch says.

“What this means is the grand idea that everybody would own their health record and it would become a key source of information across multiple health professionals, just hasn’t been borne out – yet consumers really want it.”

According to Mitsch, part of the problem is that care providers like, for example dentists, would rather invest in new medical technology for patient care rather than organisational technology. And with most practices running on tight margins, it’s a tough investment decision to make.

Bearing this in mind, Mitsch says “we’ve lagged a little bit in terms of investing in consumer technology”.

What this means is consumers get a little frustrated especially around giving out details about their chronic medical conditions for example as they must constantly reshare their information.

“Consumers such as diabetics or people with a heart condition have flow-on dental issues around gum retention for example and because of our fragmented system, theirs is not a simple journey and their dentist wouldn’t necessarily know of their condition.”

Furthermore, Mitsch says consumers are also frustrated by the opaque costs associated with medical care.

“Name me another sector where you can’t get online and end up with a reasonable understanding of what it’s going to cost or what your health fund rebate is going to be.”

Mitsch says the Australian Dental Association spends a great deal of time looking for solutions to improving the customer experience but the great challenge is trying to get all the stakeholders in the sector to “co-operate and play”.

Another change in health consumption brought on by the pandemic is increased skepticism about the “wellness industry”, NAB’s Pearson says.

“They’re less likely to accept the advice of someone who is in their view not qualified, but are looking more towards and are more engaged around listening to trusted and professional health advisors.”

Consumers are also becoming more active with preventative health.

“COVID has certainly made us more health conscious,” Pearson says.

“Making true behavioral change long term is a little bit tricky, but there does appear to be a wake‑up call for many people that being healthy and having a good sense of wellbeing is generally pretty important.”

The NAB survey revealed four areas where people were doing a better job of looking after their health: reduced smoking, although increased vaping rates remain an issue; staying connected to family and friends; eating better; and protecting their skin from the sun.

Many people say they would want a financial incentive to change their health behaviour. Pearson says that while paying people to look after their own health sounds counterintuitive, there is a broader payoff.

“When you look at preventative health, if you can do something about it and reduce hospitalisations, reduce charges on Medicare, you’ve got huge economic and societal benefits,” he says.