Healthcare and the Neighborhood Hardware Store

Dear Readers –

The effort required to write blog posts on a regular (or even infrequent) basis has become too much for me to bear alone.  Therefore, I have asked valued partners of Amazing Charts to contribute posts about Health IT, Electronic Health Records, e-Prescribing, and other topics of interest.

Our first contributor is Mark Shary, CEO of Updox, a leader in provider and patient communications software.  I hope you find his blog post as poignantly true as I did.

- Jon Bertman

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In my childhood neighborhood in Indianapolis, we made frequent trips to Hedlund’s Hardware, welcomed by its creaky, warped wooden floor planks and musty aisles.  My dad swore there wasn’t a problem the family-run store couldn’t solve.  He sought advice from the shopkeepers on cars, appliances, mechanics, and other vendors, which they willingly offered, and he’d always make sure to buy something in return.

I didn’t want to lose Hedland’s, and I don’t want all of my healthcare to go the way of Lowes and Home Depot.  I want my primary healthcare to be as familiar and comfortable and trusting as those trips to the neighborhood hardware.  Fortunately, in my current neighborhood in Worthington, Ohio, we still have our local hardware, as we also do around the corner from our office in Dublin.  What allowed these shops to prosper in the face of the march to institutionalize hardware stores?

Capable, trustworthy service, reasonable supply and not unreasonable (but not the lowest) prices seem to be the core elements, but plenty of non-survivors shared these attributes, too.  Two major, related advances that each embraced gave them the foundation to compete well enough with the big chains that they were given a chance by their customers to let their unique brand of service to keep them in business.

First, they negotiated as a group (Ace, TruValue, etc.), much as independent physicians do today with payors and vendors.  Second, they adopted technology and tools that allowed them to be efficient and more importantly, allowed their customers to get the service they were expecting.  Tracking inventory accurately allowed them to stay stocked, rather than Hedlund’s telling dad, in an entirely reliable way, that they’d get the tool for him by next week.  Advertising and adjusting prices for certain commodities kept their volume high enough to sell their premium products.

Independent physicians will face similar challenges as institutional healthcare becomes more automated, where patients can more easily serve themselves and get information electronically that they historically relied on from a visit.  Customer conveniences, such as scheduling online and knowing costs in advance, will be baseline capabilities to retain patients, but just as importantly, will become needed efficiency gains, just to remain competitive.

Technology, and specifically software, might seem like cost that’s not core to the provision of medicine, but when it’s done well, it actually allows the providers’ unique capability and differentiated service to shine through.  As a patient, I want the physician’s total focus.  The energy I put into scheduling, waiting, paying my bill, getting reports and remembering advice is not why I like my primary doctor – it’s those few minutes I get to talk, exchange notes, and see the look of confidence.

Leveraging practical software, sharing best practices with it, and supporting one another and your key vendors is a key part of the ecosystem you have to have, if we will retain “our neighborhood physician”.  Technology is the great equalizer – use it well, so that the great differentiator in private practitioners can march on.