A shortage in primary care physicians, advances in technology, a national push toward quantifiable outcomes, and the “corporatization of healthcare” has created what Professor Timothy Hoff considers an environment for retail thinking to transform healthcare.

Hoff's research is examining current trends in the healthcare sector that are impacting patient care, leading to “retail” inspired healthcare coverage and a decline in good doctor-patient experiences. “What we're seeing now is this tug-of-war between a physician-centric healthcare model and a corporate healthcare model,” Hoff said.

His new book, Next in Line: Lowered Care Expectations in the Age of Retail- and Value-Based Health, examines this issue.

For his book, Hoff interviewed 40 patients and 40 doctors to gain insight into the current state of doctor-patient relationships. He found that doctors feel overwhelmed by their increasing workload while patients feel frustrated by wait times and rushed when they are finally seen.

The best doctor-patient experiences, Hoff found, had a measure of “relational excellence.” “These were person-to-person experiences. They weren't transactional. It was doctors who knew their patients and patients who knew their doctors,” Hoff said.

These experiences are causing many patients to look elsewhere for their appointments, such as at a walk-in-clinic.

“Companies such as CVS and Walgreens are true retailers who happen to do healthcare,” he said. “They're starting to buy up health insurance companies and funnel those patients into their system.”

Hoff does believe there are some benefits to this change but these too come with their own setbacks.

“Who has your best interest in mind here? A physician still has to take the Hippocratic Oath,” Hoff said, referring to the promise physicians make to uphold ethical standards, “and CVS doesn't.”

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