Consumers want safe and effective health care, but they don’t talk about it that way; consumers tend to simply say they want “the best.”  Just what that means was clarified in a recent study published in the current issue of Health Affairs.

What the scientists found as they were gauging consumer understanding of evidence-based medicine was that many consumers follow a conventional wisdom, believing the best care is provided in large, expensive and shiny new doses.  As one focus group participant put it, “I don’t see how extra care can be harmful to your health. Care would only benefit you.” 

Fully one-third of the study participants agreed with this view.  Telling them that not all care meets accepted quality standards and that more or new (and therefore unproven) care could actually be harmful simply did not compute.  (The Associated Press took on this issue in a six-part series last week).

The good news (sort of) is that 40 percent of consumers weren’t sure either way, meaning that they are open to the concepts of comparative effectiveness and evidence-based medicine.  Most consumers trust their providers implicitly and generally believe that what their physician prescribes is best for them. 

However, this kind of passivity also means they may not be prepared to challenge or even engage a provider – most don’t bring any kind of research to appointments or even take notes.  Forty percent said they didn’t ask questions because the physician seemed rush or they were unsure how to talk to him or her.

Confused or intimidated consumers could also be swayed another direction, toward those who couch evidence-based health care as “rationing” or worse.  More than a few consumers in the Health Affairs study were already in that camp:  “Using medical guidelines sounds like…your doctor can’t give you other treatment without approval,” one said.  “It’s taking away your choice and putting the decision in somebody else’s hands.”

Such is the double-edged sword of empowered consumers and their role in high-value health care.  But with transparency, patience and well-planned outreach (the researchers have produced a communications toolkit for providers), health care consumers will embrace evidence-based medicine and join high-value hospitals, like those in Iowa, as allies in assuring that they receive the right care, in the right place and at the right time.