The Commodification of Medicine and Fitness: The Good, the Bad, and the Ugly

The need for medical and fitness services/products continues to grow.^{(10, 11)} In the United States, and around the world. The corporate and industrialized delivery of medical and fitness products/ services continues to grow to meet increasing demand.^{(8, 9)} Innovations in medical diagnostic technologies, surgical procedures, biomaterials, and medicines help individuals live longer, and with a higher quality of life.^{(7, 12)} Technology and scientific research are propelling fitness product/service innovation with digital activity monitoring apps, interactive exercise programming (In-Home Peloton, The Mirror), and virtual reality experiences.⁽¹³⁾ This progress is pointing toward a healthy future for the human population.

Given this trend, how can the following statistics and survey results be explained?

• Physicians are dissatisfied with the practice of medicine.⁽¹⁴⁾
• Growing patient distrust of the healthcare system.^{(7, 15)}
• Younger patients are increasingly dissatisfied with the healthcare they receive.^{(16, 17)}
• Americans are getting sicker.^{(18, 19)}
• Americans are getting fatter.⁽²⁰⁾
• Chronic diseases like diabetes, heart disease, etc., are growing.⁽²¹⁾

The apparent contradiction between improved medical and fitness products/services, and the increasing dissatisfaction of physicians and patients, along with increasing chronic disease, is most likely the result of the complex interaction of economic, cultural, behavioral, and political factors.

I suggest that one possible contribution to the problem is the commodification of health care and fitness products/services.

Let’s start with some definitions:

• Commodity (n.) an article of trade or commerce, especially a product as distinguished from a service.⁽¹⁾
  • Traditional Examples: Coffee, Bananas, Rice
• Commodify (v.): to turn into or treat as a commodity.⁽⁵⁾
• Fitness (n.) – Good health or physical condition, especially as the result of exercise and proper nutrition.⁽⁵⁾
• Healthcare (n.): efforts made to maintain or restore physical, mental, or emotional well-being especially by trained and licensed professionals – usually hyphenated when used attributively.⁽²⁾

When products and services within a category (e.g. oil, orange juice, electricity) are treated with fungibility, the market the consumer tends to treat all sources of the product or service as nearly equivalent, if not fully equivalent, which means that the primary issue is the price, not who produces or delivers it.⁽²¹⁾ This often leads to prices dropping and results in lower profits. An additional consequence is that a professional, on-going, relationship with producers, brands, and deliverers of products/services is not as important to the consumer. The purchasing decision becomes about convenience and the lowest possible price.

The Good

In free market economy systems, commodification creates privatization. This allows greater access to products/services and profits can be generated from their sale. When profits are managed properly, investments in research and development, jobs, expansion of delivery mechanisms, and greater availability are generated.

The profits generated from medical and fitness services/products can drive innovation and technological advances that contribute to improving human health.

The Bad

Professional services (e.g. physician, exercise trainer, dietician) perceived by consumers as commodities – where efficiencies in time to buy and delivery are expected – contribute to a satisficing decision model. Considering the complexities of human health, this can be problematic. Solutions may take more time, and require higher levels of education, thinking, and problem-solving, rather than just going to a retail store, picking an item off of the shelf, and concluding the demand has been supplied. This leads the consumer to expect nearly instantaneous results, when this is impossible for many complex health issues that require a patient and disciplined approach over many months, if not years.

What is missed is a professional relationship with an educated and experienced professional, employing a maximizing decision process, learning – over time – the unique needs and interacting complexities (biological, psychological, social) of an individual patient/client in order to progressively find, deliver, and manage solutions.

The Ugly

As the professional service becomes widely available at a lower cost, more accessible, and with lower profit margins, professional service practitioners become inundated with more patients or clients. This leads to less time and analysis allotted for thoroughly assessing, and thinking through, the problem, let alone actually delivering a reasoned solution. Patients and clients are underserved, their health issues do not improve, and in fact, may worsen. Dissatisfied, the patient/client seeks out unscientific and poorly researched methods, and/or unqualified individuals, which propagates increasing dissatisfaction, and possibly progressively worsening health.

The growing dissatisfaction with working in healthcare leads to educated and experienced practitioners leaving the field, unable to contribute to the education of new practitioners, leaving them unprepared to bring potent solutions to complex human health issues. They may be replaced with less costly technicians who may be less educated, excessively specialized, and placed as an assembly line worker in an increasingly industrialized healthcare delivery model.

A Partial Solution

• Increase the education of the consumer regarding the risks of commoditizing medical and fitness care, especially in the face of disease. Tell them the truth about the current state of healthcare and fitness.
• Practitioners will need to take a stand, re-establish their professional autonomy, escape the corporatization of healthcare, and decrease patient/client volume.
• Corporations delivering healthcare and fitness services need to get creative about balancing delivery in order to increase gross sales/profits, and ensuring their customers are getting the results they seek.
• The development of patient/client advocates who partner individuals to gather the big picture and provide expert guidance helping the patient/client leverage the innovations and education of providers, thus avoiding chasing pseudo-scientific practices that pander to their dissatisfaction.

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Greg Mack is a gold-certified ACE Medical Exercise Specialist and an ACE Certified Personal Trainer. He is the founder and CEO of the corporation Fitness Opportunities. Inc. dba as Physicians Fitness and Exercise Professional Education. He is also a founding partner in the Muscle System Consortia. Greg has operated out of chiropractic clinics, outpatient physical therapy clinics, a community hospital, large gyms and health clubs, as well operating private studios. His experience in working in such diverse venues enhanced his awareness of the wide gulf that exists between the medical community and fitness facilities, particularly for those individuals trying to recover from, and manage, a diagnosed disease. 

 

References

1. Dictionary.com
2. Merriam-Webster.com
3. https://www.marketing91.com/commodification-advantages-and-disadvantages/
4. https://www.investopedia.com/terms/c/commoditize.asp
5. Oxford Dictionary
6. Tracey Fieber, Commodities & Services: What is the Difference? LinkedIn, February 18, 2016
7. Bernard Lown, MD The Commodification of Health Care
8. https://www2.deloitte.com/global/en/pages/life-sciences-and-healthcare/articles/global-health-care-sector-outlook.html
9. https://blog.gyminsight.com/859-most-current-fitness-industry-statistics/
10. http://health-medical-economics.imedpub.com/consumers-and-their-demand-for-healthcare.php?aid=21061
11. https://www.franchisehelp.com/industry-reports/fitness-industry-analysis-2020-cost-trends/
12. https://www.telegraph.co.uk/business/social-innovation/innovations-in-healthcare/
13. https://www.self.com/story/fitness-tech-innovations-from-ces-2018
14. https://www.nejm.org/doi/full/10.1056/NEJMsr031703
15. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1484714/
16. https://www.modernhealthcare.com/article/20190212/NEWS/190219989/younger-patients-more-dissatisfied-with-traditional-healthcare
17. https://academic.oup.com/intqhc/article/15/1/23/1797067
18. https://www.theguardian.com/world/2013/jan/10/americans-sicker-die-younger
19. https://link.springer.com/article/10.1007%2Fs10943-006-9062-5
20. https://www.cdc.gov/chronicdisease/resources/infographic/chronic-diseases.htm
21. Wikipedia