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

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, ext 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.

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.