Consumer-driven health care may take a new twist for urologists

Increasingly, health care providers, either individual physicians or health care systems, are marketing their wares. There is hardly a city in America that does not have a highway billboard touting the benefits of robotic surgery. Patients are bombarded by media outlets extolling the benefits of various hospitals and medical techniques in the same way they are persuaded to buy more soap and beer. Hype on the Internet is no different than hype on television or radio.

Patients increasingly rely on the Internet because of its easy access to extraordinary amounts of information. Valuable health information previously available only from the medical community can now be downloaded by anyone in seconds. Unfortunately, as recently documented by Pruthi et al, much of the information available online is incomplete and poorly edited (see, "Web data on robotic cystectomy overstate outcomes").

Fortunately, patients will soon have another source of information: health care payers. As health care costs rise, insurers are being forced to review the evidence behind claims of efficacy. During the next few years, insurers will begin demanding evidence that different products and services, such as the robot, truly provide added value in terms of better outcomes and shorter hospital stays. If purveyors cannot provide these outcomes data, insurance companies will decline to pay for these services.

Patients will always be free to spend as they wish, but physicians may find that patients are much more skeptical when they need to pay additional costs with their own money. Health care claims promoted on the Internet are no different than health care claims promoted elsewhere. If claims are valid, patients will embrace new therapies; if not, patients will move on.

Dr. Albertsen, a member of the Urology Times Editorial Council, is professor of surgery and chief of urology at the University of Connecticut Health Center, Farmington.