Game Change

Cat VaskoThe month we’ve all been counting down to has finally arrived. It’s January 2014, and the individual mandate of the Patient Protection and Affordable Care Act is—at long last, and after many legal battles—in effect.

I know quite a few people who’ve gone on the exchange. Some had trouble signing up, and many were surprised to see prices comparable to what they would have paid for one of those much-maligned independent health plans. They were also surprised, however, to get better coverage than they ever would have thought possible, and I’ve already seen a lot of cheerful Facebook posts about physicians’ visits. For some, this is the first time they’ve seen a primary-care physician since college.

How will this new consumer base shape health care, going forward? I recently got a glimpse, and even as—or maybe, especially as—someone who earns her living writing about the field, I was stunned.

It started when my friend woke up with vertigo. She had felt fine when she’d gone to bed, but the next morning, even brushing her teeth was a challenge. As members of our demographic tend to do, she decided to forgo an expensive and time-consuming physician visit in favor of waiting a few days to see whether the problem would go away on its own. By the end of the workweek, she’d had it with the constant dizziness and nausea—but it was already Friday, meaning that an appointment with her primary-care physician was at least three days away (if not more).

Early on Saturday morning, we found ourselves parking on a shabby Hollywood side street to visit a retail clinic headquartered above a medical-marijuana dispensary. I was in a better humor about this adventure than my friend was, but any trepidation that either of us might have felt dissolved immediately when we entered a sleek, modern waiting room, where we were promptly and cheerfully greeted by a friendly receptionist.

Common services (including radiography) and their prices were clearly posted, and we could exchange our driver’s licenses for iPads to play with while we waited—using complimentary Wi-Fi, of course. Cool music was playing. Vintage movie posters decorated the walls. My friend was immediately taken back to see a physician, while I was offered a cup of freshly steeped green tea.

Twenty minutes later, I’d caught up on my favorite food blogs and her vertigo had been cheaply and effectively Epley-maneuvered into oblivion. She’d been treated and discharged in less time than it would have taken her to drive to her regular physician’s office. The visit cost $69, while her copayment to see her regular physician would have been $40. As you might imagine, she felt that the extra $29 had been well spent.

We’d found our new favorite place on, where the Hollywood Walk-In Clinic is the highest-rated medical facility in the entire city of Los Angeles. Anyone who doubts the growing influence of consumerism on health care should look up his or her own organization on Yelp, where patients go to gripe about long waiting times or the dirtiness of facilities, but also to share sentiments such as “I got the same level of customer service and care that I do at my primary physician’s office” and “This, ladies and gentlemen, is the future of medicine in our decentralized, inhumane, hospital-behemoth age.”

Hip, high-tech amenities; a commitment to customer service; and transparent pricing: Is this the future of medicine? I don’t know—yet in a way, I do—because the next time I need health care, I won’t be waiting on hold for an hour so that, two months later, I can inch down to Cedars-Sinai Medical Center (in punishing traffic) and pay $15 to park in a garage a half-mile from my physician’s office, where I’ll see her for five minutes and then receive an incomprehensible bill in the mail for a seemingly arbitrary amount, such as $143. Patients like me are discovering that there’s more than one way to deliver care—and our growing influence just might turn out to be a game-changer.

Cat Vasko is editor of and associate editor of Radiology Business Journal.