Next in Line: Lowered Care Expectations in the Age of Retail- and Value-Based Health

ISBN : 9780190626341

Timothy J. Hoff
248 ページ
140 x 210 mm

For all the political branding and rebranding of healthcare in the United States, its fundamental unit of currency remains the doctor-patient relationship. This relationship has undergone seismic changes during the twenty-first century, including the introduction of new players (the so-called healthcare "team") and care delivery in settings like big-box stores and bureaucratic health systems. But are any of us better off?

NEXT IN LINE is the first book to examine the doctor-patient relationship in the context of its new environs, in particular the impact of efficiency-driven innovation and retail-care models on physician mindsets and the patient experience. The overall picture is one of lowered expectations-a transactional, impersonal, and institutionally-limited incarnation of the medical bedside that leaves all parties underwhelmed and overstressed.

By first conducting a macro-analysis of key industry trends (including the widespread use of performance metrics and retail principles), then measuring these trends' impacts through interviews with physicians and patients, NEXT IN LINE is both an examination and a critique of a care system at a crossroads. It is essential reading for understanding why relational care matters — and why it must be saved in a corporatized health system bent on using retail approaches to deliver care.


1. Doctor-Patient Relationships and Our Expectations
2. The Forces Impacting Doctor-Patient Relationships and our Expectations
3. Retail Thinking Comes to Health Care: The Patient as Consumer
4. All Roads Lead to Trust: How Doctors See the Relationship and Our Expectations
5. The Tyranny of Lowered Expectations: How Patients See the Relationship
6. Ceding Care to the Corporation: Making Doctors Disappear
7. Saving the Doctor-Patient Relationship and Raising Expectations
Appendix: How the Study Was Conducted


Timothy J. Hoff, PhD, is a Professor of Management, Healthcare Systems, and Health Policy at Northeastern University, and a Visiting Associate Fellow at Oxford University. He has worked in and studied the U.S. health care system for three decades. His research has won national awards from major professional academic societies, and Dr. Hoff is a nationally recognized expert on physician behavior, health care reform and innovation, primary care system transformation, and health workforce issues.