Safe from harm?

According to a new global study into healthcare perceptions, only 1 in 4 Britons (26%) are very confident in their national health service, with Chile being the only country where more than half of respondents are very confident with their healthcare system.

The public's relationships with their healthcare providers may seem simple enough, but they're littered with complications. It might be taken as read, certainly in Europe, that the first port of call for patients is the surgery for a one-to-one with the doctor or other healthcare practitioner, but in reality, the path to medical care can be confusing and worrying for the patient.

Our concerns can cover everything from whether we'll be able to describe our symptoms correctly through to whether in fact we trust our doctors to make the right decisions for us.

Compound that on a global basis, and the way we feel about our healthcare practitioners, how we choose to interact with them and on what basis we make our decisions is complex. Add in the fact that the digital landscape is disrupting healthcare at some speed, and you have a murky picture of the relationship between patients and healthcare practitioners.

To understand the landscape, Future Thinking as part of the world's largest network of independent research institutes, IRIS, canvassed more than 21,000 people in 23 countries across five continents. Our objective was to get to the nub of how we feel about healthcare in each of the countries canvassed, as well as to find out about the behavioural differences across each territory.

The findings have given us a great deal of insight into how different people think and feel when faced with healthcare decisions. Three of the key behavioural trends are explored below.

49% of respondents see themselves as fully responsible for their healthcare - in practice this is not something we do alone

The physician-loyalist vs the physician-sceptic
While 49% of our respondents see themselves as fully responsible for their healthcare, in practice this is not something we do alone. Diagnosing and treating illnesses requires a huge amount of training and resources, which we invest in hospitals, physicians, research and pharmaceuticals. Simply put, the average Joe cannot heal himself. We rely on doctors to help us.

But how do we trust the people providing this healthcare? If you're putting a substance you don't know much about into your body, you have to trust the people advising you. When you think about the crises that our healthcare systems are facing across the globe and the rising cost of medication, this level of trust becomes even more important.

We wanted to understand how this trust between patients and their healthcare provider develops, so we asked our respondents a series of questions to build an overall picture of their thoughts and feelings towards the healthcare system.

Using advanced statistical techniques, we developed a segmentation of the respondents. The two key driving factors of the segmentation were: who makes the decision and how much they are willing to pay for innovation. We identified that five key segments existed across the globe with significant variations between different segments and countries.

At a global level the physician-loyalists vs. the physician-sceptics were the first key split. Loyalists leaned more towards trusting their healthcare provider and were happy to let them make the decisions for them, while sceptics sought greater involvement in healthcare decisions, and were more likely to question and challenge their doctor's advice.

We then took these two groups and split them again depending on how much they were willing to spend on healthcare. We called these the thrifty vs. the acceptors. The thrifty paid closer attention to their healthcare expenses and were more reluctant to pay for more expensive treatments, while acceptors were willing to pay more if it meant that they had access to better treatment.

This gave us five segments, which each had a different percentage of the population:

1. Thrifty physician-sceptics (16%) - less willing to pay, more involved in decisions
   
2. Thrifty physician-loyal (30%) - less willing to pay, less involved in decisions
   
3. Web-based dynamic acceptors (13%) - more willing to pay, more involved in decisions
   
4. Physician-loyal dynamic acceptors (25%) - more willing to pay, less involved in decisions
   
5. The average Joe (16%) - those who fit in the middle of both axes.
   

What did all this teach us? Beyond the obvious lesson that healthcare practitioners need to cater to all these different groups, we learnt more about who they are and how they think.

We know, for example, that there are stark differences in how much each group will pay. Physician-loyal dynamic acceptors will pay €77 a month for an innovative new medicine, while thrifty physician-sceptics and thrifty physician-loyalists will only spare €19 a month. This is a global average across the 23 countries in the survey.

Across the world, attitudes towards healthcare decision-making vary substantially. Peru (75%), Bolivia (75%), Egypt (71%) and Chile (66%) are the countries where physicians are most likely to make treatment decisions. In Germany (75%), Austria (71%), Canada (66%), Finland (65%) and the US (64%), patients were most likely to work with the physician so that both of them have input into decision.

Perceptions around the cost of healthcare also varied considerably around the world. In Ireland, they estimate that they pay around 50% out of pocket and 19% say that's far too high. But in Germany, they believe they pay 16% out of pocket, but 14% say that's far too high.

The group who most felt that their healthcare system was in a state of crisis were the average Joes (45%), closely followed by thrifty physician-loyalists (42%). Those who felt most confident in their healthcare system were the web-based dynamic acceptors (45% compared with an average of 39%). Chileans (59%) were most likely to believe their healthcare system was the best in the world, followed by the UK and France at 26% and 24% respectively.

The results have also made it clear that we shouldn't blindly believe stereotypes about who comprises these groups. The thrifty physician-sceptics come from all ages, genders, levels of education and employment statuses. How we imagine and treat this group has to reflect this variety.

Dr Google will see you now
Where patients are getting their information from is a key area of interest for healthcare brands.

Today for many people, the first person that they turn to if they want information about their health is not their doctor or a friend/family member - it's Google.

Websites have proven to be very important across all of the segments that we identified. Our research showed 'Dr Google' is such a prominent trend that nearly one in five people in the UK and Japan say that websites are their number one source of health information, above trained healthcare practitioners.

Yet consumers have to be careful. The internet isn't always reliable or truthful. You could end up panicking about conditions you don't have, or underestimate the seriousness of your symptoms.

We have to acknowledge the trend, however. People want to know more about what's going on in their minds and bodies. This should be welcomed by pharma brands. And when healthcare can be expensive, it is important that they are adequately informed and don't feel that they are wasting their money.

One way healthcare providers and brands can capitalise on this trend is to supply health information online that is authoritative, reliable and trustworthy. While consumers are cautious about what they read online, they generally don't want to give up the convenience of fast, easy access to what they need to know. This opens up a channel to communicate the principles of your brand and which services you offer to these consumers.

And it's not just websites. In some countries, blogs, chat rooms and social media platforms are increasingly used for health advice. Yelp-style review websites for doctors and medication opens them up to greater scrutiny.

Globally, websites still have some way to go before they become the primary source of information. Only 7% of people globally placed websites as their most preferred source of information, but 59% have consulted websites in the past year.

This changes the dynamics by which people engage with healthcare. Adapting to these dynamics and making the most of these new sources of information should be a priority for healthcare brands and providers.

What does this mean for brand communication?
With a clearer picture of how healthcare consumers think, feel and behave, we have a greater opportunity to review the way in which brands communicate with them.

Consumers are more informed than ever before. They want to know what's happening and they expect to be spoken to in a calm, engaging and non-disruptive way. This is consistent across all segmentations of our study - everyone now wants and expects to know as much as possible about their health and their options.

The key distinction comes from where and how they are spoken to. And here, understanding the different segments is really useful.

For physician-loyalists, it is important to maintain a strong connection with patients. They are the most likely to have trust and confidence in the healthcare they are receiving, and are most open to trying out more innovative treatments or something that gives them greater comfort. Messages that emphasise that trust, the authority of the advice and the availability of additional treatments would perform best with this audience.

But physician-sceptics need to be handled differently. As they sit in the doctor's office, they are thinking through the costs and benefits of the treatments that are presented to them. They are more likely to challenge the options that they are given, and give greater emphasis to information they have received elsewhere.

For this audience, it would be wise to emphasise the independence of patients and that the role of the healthcare provider is to give authoritative advice, but not be too demanding. Focusing on the affordability of treatments would also be a priority for this group, while more expensive alternatives have to show very clear benefits.

The channels brands use to communicate with their audiences should also be carefully evaluated. We've already mentioned the growing importance of online platforms in getting across information to patients. But other sources should also be paid attention to.

Friends and family continue to be a key source of information for people, with 34% consulting them for health advice in the last year and 5% placing them as their number one source of health information. Pharmacists are used to varying degrees across the world, with 53% of people in Egypt consulting them in the last year but only 10% in Japan. These additional sources need to be thought about: what sort of advice do friends and family usually give? How much of a priority should pharmacies be in our communications efforts in the markets we are targeting?

Ultimately it's a question of connecting with people. When people are anxious and unwell, they need to be treated as warmly and respectfully as possible. And to do that, you need to understand what they're thinking and feeling. We hope this research will go some way to filling this gap in our knowledge and will challenge the industry to be as helpful and accessible as possible. Brands and healthcare providers should be careful to avoid making assumptions about their audience, and seek to understand their behaviours, needs and wants.