It’s funny how things turn out sometimes. Lately I’ve written a lot here about e-patients taking an active role at a new level in healthcare, not just engaging in their care, but actually defining what it should be.

Well, wouldn’t you know it, life has provided me with a case study – myself.

Last week I learned I have a basal cell carcinoma, the least threatening kind of skin cancer. On my personal site I wrote about it, and said my approach would include …

• Connect with a patient community (skin cancer patients), if I can find one…. [Update: I’ve already had people submit four communities there]
• Learn what I can about the disease: what is basal-cell carcinoma, anyway? …
• Assess my treatment options. … what are my options for different providers?
  • I have $10,000 deductible health insurance, so this will come out of my own pocket, and you can bet I’ll be asking around: “Hey doc! What’s my cost going to be? What-all will I be billed for, line by line? And what’s your outcomes data? Thanks! :-)”
  • And yes, I will negotiate – like many Americans today, I pretty much have to. “Can you do any better on the price?” I won’t choose based on the cheapest bid (that can be suicidal), but price will definitely be a factor.
  • “Bidders,” note: I’m willing to travel if I find a great clinic at a great price. If I can save $3,000 with $1,000 of travel costs, you bet I will! This is the glory of consumer mobility: as we fall out of the insurance system, we can go “out of network” as much as we want, because we’re on our own. At last.

Then, Saturday morning I realized I want to do the same thing businesses do (including hospitals) when they want to buy something: issue a Request For Proposal (RFP).

With an RFP, the buyer (a company, or me in this case) doesn’t know from whom they’ll buy, but there may be differences that matter a lot. So they write a document that says what’s important to them and circulate it, hoping to find a really good fit for their needs.

A second post announcing my RFP, and linking to it in Google Docs, is here.

I must say I’m surprised at some of the reaction – a couple of people have referred to it as a “reverse auction,” which is a method purchasing agents use to get the lowest price. Price is important to me, but as it says above, I am not lookin’ for the low-price bidder!  I’m looking for the care I want. 

Please, before you comment on this idea, please look at what I wrote – both my rationale in the first post, and the RFP itself. Thanks!