The last time you ordered a book, did you get in the car and drive 500 miles to the author’s house?
Of course not. You probably ordered it on Amazon, and it came to you via a truck driver who brought it to your door. Before that, it was in a warehouse, but not before it was sent there by a printer, who got it from the publisher, who received it from the author.
Each of those intermediaries facilitated a critical next step in the process. They’re middlemen, and that’s their superpower: brokering efficiency. We celebrate it in online shopping, grocery stores (most people don’t milk their own cows), and cars (you go to a dealership, not Detroit), but in healthcare, it’s often slandered as a barrier to accessing affordable care.
I’ve spent almost 20 years working in senior executive roles as a corporate and brand communications professional, and have seen the inner workings of the healthcare industry as both a patient and a caregiver. It’s clear to me that middlemen such as case workers, lab technicians, hospital support staff, and many other essential roles, power the system and bring significant benefits across the care continuum.
As a communicator, I can also see how the term has a negative connotation. That’s a problem though, when the most important stakeholders – patients – have a deeply personal journey through a complex industry that often requires middlemen to navigate.
Healthcare industry insiders like us understand the complexities of scheduling treatments and tests. Even from our perspective, the approval processes can be a bit daunting. When you’re outside looking in, as a patient or caregiver, it can seem absolutely insurmountable. That’s where middlemen become indispensable resources. Navigating the labyrinth of medical professionals, prior authorization decision makers, claims managers, and support representatives isn’t something you need to do on your own, because they are expediting everything you need and creating measurable efficiencies like saved time and reduced frustration and fear.
Care navigators are another example of important middlemen for patients dealing with medically and emotionally complex issues like cancer or rare diseases. They can handle the paperwork, humanize complex medical terminology, and ensure patients are comfortable as they take each step in the care journey.
Healthcare middlemen also provide expertise in dangerous circumstances. Often, in operating rooms, the people most qualified to run complex machines are not the physicians, but the medical device sales representatives. These intermediaries are called upon to advise the surgical team when general hospital technicians aren’t certified to operate certain equipment.
Middlemen add tangible value. For those in the healthcare industry, they see this from an insider’s perspective. In the course of my work, I’ve heard directly from consumers, patients, and caregivers who are confronting high-stakes situations fraught with tension. They helped me understand how they saw themselves in these scenarios; they’re reliant upon others, and therefore, they feel unable to fully help themselves.
Being sick or infirmed can lead to a loss of independence, and for patients, that’s a frightening feeling. Middlemen help restore patients’ control over their lives by arranging for home health aids through Medicare, ordering necessary home medical supplies so patients don’t need to remain hospitalized, and arranging medication deliveries. This removes the element of fear, restores a level of comfort, and enables patients and their loved ones to focus on recovery.
It’s natural for people to look at complex, often frustrating systems like healthcare and assume the middleman is adding cost and complexity. The truth is, middlemen are expediting efficiency. Remove them from the process, and saving money, time, or even lives, becomes more difficult.
The world’s most effective systems, from treating disease to global shipping and even search engines, have at least one middleman. Some of them can be cut if they’re adding cost without value, but replacing them usually requires unique innovation, like Amazon’s global supply chain, which has taken on the roles of several middlemen in its pharmacy delivery service.
In healthcare, each middleman should be evaluated on the outcomes they enable. If a result is improved, credit them individually, rather than judge an entire profession holistically. Because middlemen aren’t standing in the way of progress. They’re advancing it.
