Let’s start with a little bubble bursting, and no, I am not talking about the price of Bitcoin.  Apologies to the Trekkies, but nowhere in the original Star Trek series were the words, ‘Beam me up, Scotty’ ever uttered.  Captain Kirk came close a few times, but that iconic phrase is some weird amalgamation of our collective imaginations.

The very idea of the teleporter in Star Trek arose from an economic need.  The original show had a very small budget (Let’s save money on costumes by making them all wear these pajama outfits all the time!) and could not afford to show the entire Enterprise spaceship landing on different planets for each episode as originally planned.  So, someone came up with the idea of the teleporter, and wa-la, Kirk, Spock and the gang could magically appear wherever the script needed them to be.

We’ve been thinking about the Star Trek teleporter as a metaphorical representation of the role technology (along with consumer brand preferences) is playing in the erosion of the old adage, ‘All healthcare is local.’

Sheldon or some other theoretical physicist would tell us that actual Star Trek-type teleportation is impossible.  But while we can’t disassemble, transport, and then reassemble actual atoms, we can do a lot of things that now render the restrictions of time and place far less restrictive.

Telemedicine, which sounds a lot like teleportation but then turns out to be more like a FaceTime call with your mother than a quick trip to Vulcan, is just the most front-of-mind example because of ol’ annoying COVID but is illustrative.

Once patients adjust to using technology to access aspects of their healthcare, then the range of alternatives gets a lot bigger.  It used to be the options for getting your meds filled were the pharmacy on this corner or that one.  To compete, you just had to be a little better than the other guy.  Now you must beat Amazon, too.

Telemedicine is the same.  If your patient experience is limited and clunky, your patients are just a click away from someone better.  Local doesn’t mean jack squat.

I acknowledge the immediate objection.  Most things in healthcare still require one human (let’s call them the least interesting and sexy thing we can imagine – how about ‘provider?’) to lay hands on the patient.  Technology can help, but not replace, that process.

Fair enough.

But ask yourself this – how much more healthcare can be delivered remotely now compared to just five years ago?  What about five years from now?

What will remote patient monitoring change?

How about patient-directed at-home diagnostic testing tied to a ‘provider’ via technology?

Even hospitals, never even a finalist in the ‘most innovative thinkers’ competition, are trying to imagine the ‘at home hospital.’

The point is technology will continue to abolish historical demands that care must be local, including things in your practice that you take for granted.

Next time we start talking about what you can do about this sea change.

In a time long, long ago (that is, before COVID) a lot of us used to enjoy taking the laptop and headphones to a nearby coffee shop to plop down and do a little work.  Our oldest, who slipped in just in time to qualify as a Millennial, and I, just barely a Boomer, were debating our respective coffee shop preferences one day.

My choice was the ubiquitous one.  I traveled a lot (yeah, this was long ago) and frequently had coffee shop meetings.  I could count on finding my coffee shop on every corner, their Internet was reliable, and I didn’t have to stand staring at the menu for ten minutes trying to figure out how to get just coffee.

She stated that she preferred ‘authenticity,’ a central Millennial value that was a coded diss to all things Boomer.  As typical, I was confused and agreed to meet her at one of her favorite places down in the old industrial part of town that was suddenly the hippest neighborhood around.

There I learned that ‘authentic’ for a coffee shop meant there had to be creaky wood floors, a dog laying by the door, extension cords pulled everywhere to power the laptops, and a dude behind the counter with a lot of ink and those big holes in his earlobes.  There were no freshly pressed green aprons being worn by overly eager smiling staff who had completed 8 hours of corporate training on customer service.

Marketing experts frame this difference in customer values as my preferring ‘consistency’ while my oldest wanted ‘distinctiveness.’

As we explore whether the old axiom ‘All healthcare is local’ still holds true (or better, how true is it still?), part of the question pivots around this particular dimension – do patients want consistency or distinctiveness?

That may seem a bit odd given the set up of my prologue as most patients probably don’t seek out a doctor with the grunge factor of 1980s’ Seattle band, but let’s frame it this way: Do patients prefer getting to see the whites of the eyes of their personal physician or are they now increasingly trusting, and preferring, the ‘brand?’

I get that even asking that question will get me in trouble with some of my clients (not a good marketing strategy, regardless of your generation) who have patients who have been loyal to them for years, but we must ask it if we are to help you plan for the future.

There are plenty of stories about small players succeeding in the face of big brands by delivering ‘distinctive’ in a special way to a targeted and relevant audience.  We love those stories. That truth will hold in healthcare as well.

But we would not be talking about these local success stories as success stories unless the larger backdrop were not about people increasingly opting for the known consistency of bigger brands.  That truth is just as true for healthcare, and maybe more so since consistency, not unique and cool, matters more to my care than my coffee.