Understanding What Motivates the Empowered Patient

by HealthCentral

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From a presentation by Chris Schroeder, CEO HealthCentral and James Burroughs, Associate Professor of Commerce, University of Virginia, April 8, 2010, DTC Conference, Washington D.C.

Making treatment choices and selecting health care providers are high stakes decisions for people living with chronic conditions such as diabetes and rheumatoid arthritis. Finding the right doctor who can in turn find the right therapeutic regimen often makes the difference between a high quality of life and a low one for these patients.
Some of these people who are faced with ongoing treatment decisions take a more active role in their health care plan, while others are more comfortable following a doctor’s lead. To determine what makes more highly engaged and active patients tick, HealthCentral partnered with Professor James Burroughs of the University of Virginia. Professor Burroughs specializes in marketing and consumer psychology and behavior. He helped us design a survey to identify traits and habits of a person who feels empowered to take a lead role in managing his or her health care.

We asked people living with chronic conditions about:

  • Relationships with doctors
  • Treatment history
  • Social habits
  • Need for cognition
  • Self-confidence
  • Media preferences

Each question about health care behaviors had four possible levels of engagement from very low to very high. Respondents who selected answers in the two lowest categories fit more the traditional patient mold. People who selected answers in the two highest categories represented a highly engaged patient.
A respondent could score from 4 to 16 in terms of level of engagement. People who scored 12 or above were categorized as empowered patients.

We found that people who take a direct role in managing their treatment plan have several traits that other more traditional patients lack. We also discovered what factors don’t influence the chances of a person being an empowered patient.

Finally, we have a few recommendations marketers can use to see if their brand.com sites and other marketing materials resonate with these patients.

Need for cognition drives the empowered patient
In our survey of registered users of our sites, we found that about 30% of respondents can be considered empowered patients. Fifty percent of respondents are more traditional mainstream patients with some characteristics of empowered patients, and 20% are mainstream resistant patients with a low probability of engagement.
We found that these people have a high need for cognition, which means that they’re not happy with simply knowing a particular prescription successfully treats their condition, they want to know why it works.

These people want to understand not only their condition but their treatment options.

Empowered patients were much more likely to answer, “Very true of me,” to the following two questions:

DTC_Image1_ThinkingDTC_Image2_Problem

These patients are more likely to have a strong sense of self-efficacy, meaning that they are confident in their ability to accomplish almost anything if they decide to do it.

Education, income, source of health insurance had no effect

Our study showed that none of these factors had an impact on a patient’s ownership of his or her health:

  • Makes $25,000 or $200,000 a year
  • Has a high school diploma or a graduate degree
  • Uses private insurance or Medicare

Personality traits seem to play a much stronger role in patient empowerment than education, income or source of health insurance.

Empowered patients are leading the way online

When we looked at more passive Internet activities, we found little difference between empowered and more traditional patients.

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When we asked about sharing personal experiences or seeking out other patients’ stories, empowered patients are much more likely to be doing both of these things. They take a more active role online than traditional patients do.

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This tendency to be on the early edge of the curve is even stronger when you compare the social media habits of empowered and traditional patients.

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These consumers are even more likely to use text messaging.

When it comes to marketing materials from pharma companies, all patients seemed to prefer a combination of printed patient education materials and brand.com websites over television and magazine ads.

DTC_Image6_Marketing

This group is the most demanding but the most loyal

The tendency to want to be in the driver’s seat extends to an empowered patient’s relationship with her doctor. In our survey, we asked if changing doctors was a viable option. Empowered patients were much more likely to find a new physician if they felt their current doctor was not managing their condition well enough.

DTC_Image7_Fire

We dug a little deeper into the numbers and found these patients are the most demanding but also the most rewarding. They are more likely to change doctors, but once they’ve found a person they can work with, they are more likely to stick with that provider. It is possible that this same attitude could extend to other aspects of healthcare such as brand loyalty to prescription medications.

DTC_Image8_Loyal

These people still rely on traditional medical authorities to help improve their health, but they’re not willing to cede all control.

What about the other 70%?

After we had a good profile of an empowered patient, we were curious about the rest of our audience. Could they be motivated or influenced to become an empowered patient?

DTC_Image9_Arrow

NFC: Need for cognition

The middle group in the illustration above has many of the same tendencies and personality traits as empowered patients. Part of this 50% can be influenced by appealing to their need for understanding and desire to be addressed in a direct, straightforward manner, as opposed to a patronizing approach.

The rest of the traditional mainstream patients are more likely to be swayed by social appeals from empowered patients. Empowered patients have the potential to be influencers and affect the opinions of traditional patients.

The last group – traditional resistant – doesn’t share any qualities with the other two groups and it is unlikely that marketing appeals of any kind would motivate them to become empowered patients.

Do your campaigns resonate with empowered patients?

Now that you know what this kind of consumer values, it’s time to put your brand.com sites and other marketing materials to the test.
First, find a group of high need for cognition consumers in your target market (learn how to identify people with a high need for cognition).

Then use them to evaluate your marketing materials by following these steps.

  1. Look at the ratio of quantity of information and return on information. Empowered patients want just enough information to make a good decision but not so much that it becomes overwhelming to sort through it all.
  2. Watch out for complexity and redundancy
  3. Consider the style of these communications. If empowered patients feel they are being talked down to or not taken seriously, they will reject the message.
  4. Watch out for patronizing tone and fit with personal experience

If your communications don’t work with empowered patients, it’s probably worth making a few changes to win over these people. Not only do they have the potential be loyal customers, they can also help you win over other people as well.

For more information about this study, or to speak to a member of the research team, click here.

Read the methodology of this study.

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{ 4 comments… read them below or add one }

David stillwagon April 22, 2010 at 9:40 pm

Chris,
This is terrific information. On my meniere’s blog I write a good deal about taking an active part in trying to deal with meniere’s disease. I get alot of comments from Empowered Patients who find it necessary to do the research and ask the questions that need to be asked. It is difficult for some because they, like me, grew up thinking that you couldn’t question a doctor about anything. Their word was final.
But now a days you need to go into a doctor’s office informed and ready to discuss treatments and if necessary seek out another doctor.
Good stuff, Chris

David Stillwagon

Anne Llewellyn May 28, 2010 at 2:38 pm

Patient advocates and case managers are also working with patients with chronic medical conditions to empower them to self-manage. They can help the patient and the family navigate the health care system an find the resources they need to manage their condition. This is a growing trend and with the consumer having to pay more out of pocket..people are learning to become educated consumers.

Fran June 1, 2010 at 11:11 pm

You said, “These patients are more likely to have a strong sense of self-efficacy, meaning that they are confident in their ability to accomplish almost anything if they decide to do it.” I prefer to think of self-efficacy in terms defined by Kate Lorig. It is not a global sense of confidence, but specific to the task at hand. For example, I can be generally confident, but have a poor sense of self-efficacy related to my potential to play professional football.

john conner August 18, 2010 at 4:14 pm

Personalized care is also becoming a popular option for people willing to spend a little more. Pay a physician or medical group an annual fee, and have your doctors cell phone number, after hours access and the immediate attention we all wish for. This is not only coming from the patient side, the physicians enjoy this type of practice as well. I like where this is going.

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