The informed consumer has long been with us. Higher disposable incomes, increased choice in a more global economy, the 24-hour culture and the information explosion driven by the internet - all these changes have enabled and encouraged consumers to be more vocal and demanding, and rightly so.
Today, consumers expect full, clear and simple information on the choices available. They require high-quality products and service, prompt delivery and value for money. They demand transparency and, for many, a firm's ethics and its contribution to the community are important considerations.
Supported by interest groups, and armed with information from the media, consumers are aware of their rights and are not afraid to exercise them; if expectations are not met, they take their business elsewhere.
Companies have responded by investing huge amounts of money, time and energy in listening to customers, developing products and services tailored to their needs and creating a customer-focused ethos. With the increasingly consumerist approach to health, providers of healthcare are recognising the need to adopt a similar attitude.
But it hasn't always been that way. Health is an important issue for consumers. Most people can do without a car, or even a house, but without health little else has value. Yet the arrival of the informed customer has come as a shock to the world of medicine, presenting healthcare professionals and providers with challenges and opportunities.
It can still be easier to get information on the specification of a new car than on a life-threatening condition, but we in healthcare are getting there, slowly. Now, instead of a white-coated world in which doctor knows best and medical services are provided to patients without question or challenge, we are moving into one in which informed customers demand to be fully involved in decisions on their treatment. There's no doubt that new, more equal relationships are developing between doctors and patients.
And there is evidence that patients who are fully involved in decisions on treatment respond better and faster than those who are not.
As in other sectors, the internet has resulted in a bewildering mass of information and advice for people seeking out medical information, products and services. In a recent case in Britain, a patient, told that his cancer was terminal, searched the internet for more information. He contacted a doctor in the US who specialised in his condition, went for treatment and now has a good prognosis. This is an extreme example of 'doctor shopping', but patients often arrive at their GP's surgery with printouts from web sites on their condition and possible treatment.
With so much unregulated information available, some of it potentially dangerous, consumers must be able to trust the information they source. The issue of how we regulate this information is an important one. So far, we don't have an answer. Some healthcare providers are increasingly offering customers help by providing impartial medical and health information.
One challenge that the advent of the informed consumer in health poses both the public and private sectors is to manage contradictory demands for higher quality and lower price. Every sector faces this dilemma, but it is perhaps harder to reconcile in healthcare. If you are uncomfortable with the cost of a new extension or a winter coat, you can buy cheaper bricks or wait for the sales. This is not the case with an urgent hip replacement or cataract operation. The issue for the health sector is whether informed consumers demanding the newest or best will drive up cost, or whether more information and greater involvement in decision-making will produce more informed choices.
It is in everyone's interest to encourage consumers to become informed, no more so than in the corporate world. It has always seemed odd that firms should put more effort and money into maintaining their car fleets than their employees' health, even though the latter delivers much greater returns.
Today, companies understand that they need employees who are creative, energetic and enthusiastic and highly productive. That means they must be healthy - not just breathing! Many companies are revisiting benefits to employees, focusing on work/life balance. Employers are increasingly placing physical and mental health higher up the agenda, developing attractive health-related programmes for employees, including health information, gyms and childcare facilities. Successful delivery of these services, whether providing education and advice or support and treatment, can bring significant returns for businesses and employees.
As this new century unfolds and life expectancies increase, health is becoming one of the fastest-growing social and economic concerns. With more information available, consumer demand will increase. But a word of caution ... providers must not lose sight of the essential human values when responding to increased demand. These values - building long-term relationships, providing a flexible and understanding service and recognising the unique, emotive nature of health 'purchases' - place customers at the centre and can make an important contribution to national and individual health.