Cognitive Surplus & Tough Economic Times: An Explosive Cocktail?

The growth of the e-Patients movement may be experiencing surprising strength from a completely unexpected source, with many people growing the ranks of the movement because of the greatest motivator of all: saving money.

Clay Shirky’s cognitive surplus observation, made in April 2008, keeps on resonating as I see more and more evidence that, contrarily to what some naysayers would want us to think, the internet and social media are fundamentally important to a significant percentage of Americans looking for answers about wellness or sickness, health or disease.

In his speech Shirky noted :

“The value in media is no longer in sources but in flows; when we pool our cognitive surplus, it creates value that doesn’t exist when we operate in isolation. The displacement of TV watching is coming among people who are using more of their time to make things and do things, sometimes alone and sometimes together, and to share those things with others.”


Last Friday, the Wall Street Journal published a sobering article about a completely unexpected situation developing this year: “Patients Cut Back on Prescriptions, Doctor Visits Amid Tough Times”.

I have always heard that healthcare is one of the very few recession proof areas and that stocks from companies whose businesses are mostly in the healthcare realm are great safe bets when the markets go south. What a surprise to read “last month Walgreen Co. Chief Executive Jeffrey Rein said the U.S. is experiencing the “tightest prescription market” in his 27-year career, as more cash-strapped patients skip their pills or take half doses.”

I also learned that the “a recent analysis of claims from 250,000 people in several dozen mid-Atlantic employer health plans suggests even people with coverage are cutting back on care. The study, conducted for The Wall Street Journal by research firm D2Hawkeye, found that a number of preventive or nonacute areas of care saw declines despite little change in benefits or employee cost-sharing.”

Sure the stories in the article sadly show that many people are just delaying care to save money but I can’t help thinking: “is the economic downturn one more reason for people to turn to the internet and social media to help them deal personally, as e-patients usually do, with non-essential medical problems?”

The explosion of available social media to help individuals obtain responses to many of the questions they have can surely have a deep impact in lowering the number of unnecessary visits to doctors’ office. Add to the mix the explosion in the cost of transport and all of a sudden you have a real accelerant. As a doctor interviewed in the article brutally admits: “”It’s hard to get people to follow up when they’re having to decide between the gas bill, the electric bill or deciding to come in and see the doctor.”

Previous studies have tended to demonstrate that informed patients can be less compliant. Patients trying to limit their financial exposure seem to be clearly less compliant. Or are they just getting smarter? This promise to be a great academic debate for years to come! But the shock of the current financial turmoil, called this morning by former Federal Reserve Governor Frederic Mishkin “worse than what was felt during the Great Depression” can only have an accelerating function on the phenomenon covered by the Wall Street Journal article.

The American public is known for its incredible resilience. I am convinced that many more people will be using the panacea of Health 2.0 resources as a natural solution to this crisis of epic proprotions. And, as we all know, once new users discover the benefits of good online medical resources there is just no way back. It is very conceivable that many of the new companies offering access to new tools, from PHR and automated compliance agents to social networks, are going to significantly benefit from these traumatic events. After all many pundits are already saying that real innovation comes easily in tough times.

What do you think?

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One Response to “Cognitive Surplus & Tough Economic Times: An Explosive Cocktail?”

  1. Once again you provoke thought. I have several reactions.

    First, I wonder how this is playing out in Massachusetts, with its mandatory insurance coverage.

    Second, the naysayer post you cite (re the demise of Revolution Health) is well worth reading for background on John Grohol’s post here on the same subject.

    But, third, I wonder how that cynic defines “Health 2.0.” It’s hard for me to imagine that he means Revolution Health’s situation means the demise of what Ted Eytan crowdsourced:

    Health 2.0 is participatory healthcare. Enabled by information, software, and community that we collect or create, we the patients can be effective partners in our own healthcare, and we the people can participate in reshaping the health system itself.

    Presuming his definition is different, I wonder where he got it: perhaps not from patients who are actually participating in it, as Ted did.

    I strongly suspect you’re right – this could be the combination of circumstances that leads to a surge in people seeking freely available healthcare information.

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