Practical Challenges to the Idea of Healthcare Consumerism

Despite numerous industry advancements designed to simplify access to healthcare, it can be incredibly difficult for your employees to know what may or may not be necessary in the moment of diagnosis.

In today’s article, I leverage my health scare to explore how to help your employees become better healthcare consumers.

It’s been a few years now, but in 2017 I was diagnosed with Basal Cell Carcinoma.

This is what they call “good cancer.” I guess it’s called that because it’s unlikely to spread. Personally, however, there was nothing good about it. It was a brutal process, and it resulted in a nasty hole, ghastly stitches and both internal and external scars.

I don’t mean to be dramatic. Several years later, it’s now a nearly forgotten memory. The scars are mostly unnoticeable. And what at the time felt draconian and completely unfair, has largely faded into nothing more than a bad moment in time.

In retrospect, I was lucky.

Furthermore, I look back on the experience with gratitude as it was my first meaningful taste of the difficulty so many of our clients’ employees and family members experience when they too have to seek medical attention.

Concept versus Reality

In 2004, Qualified High-Deductible Health Plans/Health Savings Accounts (HDHP/HSA) plans were introduced, bringing healthcare consumerism to the masses.

The fundamental concept underlying these plans was that because members would now have to pay the upfront costs of their care, they would be more diligent in seeking effective and efficient solutions.

Unfortunately, in 2004, no resources were available to enable that behavior.

Over the last 10-15 years, we've seen a proliferation of resources emerge, each designed to help people navigate through healthcare decisions and compare the value of each option.

Companies like Castlight, Alight, HealthJoy, Amaze, First Stop Health, Nice Healthcare, PeakMedical, Teledoc, Livongo, SimplePay, Cancer Care Plus, Valenz, Progency, Healthcare BlueBook, and dozens of others have stepped into the conversation, each promising to make healthcare decisions more cost-effective and efficient.

All well and good. However, in the moment of a diagnosis, it can be difficult to impossible to know the right thing to do.

As am employer, we have to recognize these challenges and work endlessly to close the gaps.

With that, it feels useful to share some of the lessons I learned in the hope that your employees become better consumers of healthcare.

Lesson 1 – Trust Your Inner Voice (or your spouse’s)

In my case, the eventual diagnosis of cancer began with an unresolved blemish. The blemish, which seemed to be nothing more than an ordinary pimple, made its unwelcome appearance on my right cheek roughly a year and a half before I had it removed.

As so many of us do, I ignored it.

It took me about six months to schedule my first dermatology appointment — partly out of ignorance, partly out of stubbornness. I was in my early 40s, so “I was too young for skin cancer.” My wife was more persistent, and eventually, I conceded to her concerns that this wasn’t normal.

I scheduled my first-ever dermatology appointment. That dermatologist, however, gave me a clean bill of health, so I went on my way.

The blemish persisted. Eventually, I went to a second dermatologist. This one had the good sense to perform a biopsy. Unfortunately, it returned negative, so I was again told I had no concerns.

I later learned that multiple biopsy methods can be done, and this doctor chose the wrong one.

After more time passed, the third dermatologist performed the correct biopsy, resulting in an accurate diagnosis.

It took over 18 months from onset to surgery.

You have to learn to listen to yourself (or at least to the people who love you). Had my wife been less vocal, I likely would have brushed it off as an anomaly after two doctors gave me a clean bill of health – at least until it became so overwhelming and evident that I had no other option but to deal with it.

You know your body better than anyone. When something’s wrong, you must be your loudest and most passionate advocate. Doctors make mistakes, just like the rest of us. If you know, you know. Trust yourself.

We have to permit ourselves to have the final say on our well-being.

Lesson 2 – Understand Your Options

Unfortunately, Basal Cell Carcinoma grows roots. Over time, those roots grow deeper and broader into your skin. What may look superficial from the exterior can be a mess underneath. My doctor used the term “aggressive,” which is an excellent way of saying, “That bastard has been growing for a while.”

Of course, I didn’t understand any of this at the time.

Mohs Surgery is the standard treatment prescribed for Basal Cell Carcinoma (BCC). From a layman’s perspective, this is the equivalent of using a spoon to scoop out the cancer spot. Then, they look at it under a microscope to see if they got all of it, and if not, they come back and get a bigger scoop. They repeat this process until all the edges are clean.

Approximately 85% of BCCs occur on the head and neck, which are the areas most frequently exposed to the sun. Practically, this means that you are likely to end up with a scar visible to the outside world.

Board-certified Mohs surgeons are common. Many excellent dermatologists have this certification, but much fewer have the skills to stitch you up in a way that will minimize your scarring.

Again, I didn’t understand any of this at the time.

In my case, I could have quickly researched to learn that you can locate a board-certified Mohs surgeon who partners with a plastic surgeon.

Had a navigational resource been available, this would have been the perfect time to make a call.

Instead, I trusted my dermatologist. He was, after all, the doctor.

That trust left me with about a four-inch scar that was utterly avoidable.

Whatever your situation, know your options and then act. You’ll feel pressure to act immediately, especially when something foreign is growing in your body.

We must help employees understand they must take the extra step to understand best practices.

Don’t be afraid to demand a full explanation of your options. If they are not forthcoming, consider changing doctors if it assures a more positive outcome.

Some doctors will stonewall you, trying to force you to have surgery in their practice. Surgeries make money.

Hopefully, you will find a doctor who truly prioritizes your needs, but you should approach every conversation with a healthy dose of skepticism.

Lesson 3 — The Emotions Are Real

I was fortunate. People deal with more insidious diagnoses every single day.

Even with such a favorable diagnosis, four inches and 20+ stitches across my cheek left me feeling shattered. At no point did the doctor, his nurses, nor his staff ever indicate this was anything more than a simple procedure.

When I made it to my car, looked in the mirror, and saw the long line of stitches across my jaw, I broke down in tears. I felt like Frankenstein and immediately mourned my unwelcome and unwanted facial modification.

I don’t consider myself a vain person, but I was disfigured. It hurt my soul. I was angry, embarrassed, sad, and deeply disappointed that I had joined a club I never wanted to be a part of. I was convinced no one would ever meet with me again professionally, let alone choose to be my friend. It threw me into a downward spiral unlike anything else I had experienced.

Maybe that sounds dramatic, but my face was jacked up.

The experience helped me understand the gravity of and challenges that arise when the unexpected happens.

If you have an employee or a loved one who experiences a health scare, don’t dismiss what they are going through. It’s real. It’s rough. It’s raw. Please don’t minimize them by telling them it’s a good kind of (insert illness here).

Also, continue to promote behavioral health resources, employee advocacy and concierge programs, nurse lines, or whatever tools you have in your arsenal. Often, we dismiss the value of those programs because of low utilization, but when they are needed, they can be a lifesaver.

Lesson 4 – Promote Self Care

Don’t be as stupid as I was.

You get one body for the entire trip duration, however long it may be. Take good care of it.

I do this well in many ways. I exercise daily, eat well, and try to get good sleep. I consciously try to be a good example and practice what I preach.

But until receiving a cancer diagnosis, I never thought about something as simple as a daily face lotion with SPF. I was a child of the 80s. Not only did we not use sunscreen, we thought it was cool to coat ourselves with the tan accelerator stuff when we were kids.

Maybe for you, it’s also SPF lotion or wearing hats and sun-protection shirts.

But I’m guessing it’s a hundred other micro-failures. You skip that workout. You finished the whole bottle of wine on a Tuesday. You stare at your television or phone long past when you should have just gone to bed. You begin your morning by checking your email. You constantly amplify the cortisol running throughout your body because you haven’t figured out how to quiet your mind.

At some point, we each come to the realization that our everyday choices directly correlate to our everyday outcomes. If you don’t like those outcomes, it’s up to you to change the habits that create those outcomes.

And yes, we now have a magic pill available to help you lose that dad-bod, but that comes with its complications.

We don’t talk about it, and if we do, we likely don’t do it at work.

Why is that? Why is self-care so infrequently a regular topic in professional environments?

We spend the majority of our waking hours each week at work. How you approach and promote self-care becomes a part of who you are as an organization.

Promoting self-care equates to promoting culture.

It’s fundamental to creating a quality employee experience.

It’s a critical part of any effort to help you and your employees become better consumers of healthcare.

Lesson 5 – People Are Both Amazing and Resilient

When the proverbial hits the fan, we put our lives in the hands of others to fix what ails us. It’s crazy when you step back from it, but it’s also awesome.

It’s fantastic that certain men and women have been uniquely created to remove the bad that happens to their fellow humans.

When I pause and think about it, I love that humans care for humans. We are fortunate to live in a time when our medical professionals have the knowledge to solve real problems.

It’s easy to bash the healthcare industry, and it happens everywhere. Whether it’s big pharma, the insurance companies, the lack of access to quality primary care, or a hundred other challenges, we always hear about healthcare’s failings.

But let’s not forget that most people are inherently good, and many of those good people chose healthcare as their calling.

We must continue to work collectively to remove barriers, encourage positive healthcare consumerism, and help our people feel safe and comfortable going to see their healthcare providers. They’re good people, and they exist to help.

Let us also remind our people that they are resilient.

Unfortunately, we don’t recover from every healthcare scare. However, most of the time, the scars and memories fade, and we end up stronger for having overcome that obstacle.

We can use it as a catalyst to become a better version of ourselves.

Sometimes, it’s hard to remember that this, too, shall pass. Help remind your people that they are resilient, too.

Part of creating a quality employee experience exists in those profoundly personal situations. Be there for your people when things get complicated. Remind them of their resiliency.

Final Thoughts

Nothing ever gets fixed by ignoring the issue. Hope is never a strategy.

Whether it’s a health issue, a relationship issue, or a confidence issue – take action. Talk to that person. Start. See the doctor.

Do.

Taking action on life makes life more livable.

And, you and your people deserve to live fully.