Monthly Archives: September 2016

30Sep 2016

Are airline frequent flyer programs worth your loyalty? Experts weigh in – Yahoo Finance

Travelers are urged to join airline frequent flier programs with the promise of getting perks and free flights down the road. But while earning status on an airline seems like a great idea, it quickly becomes clear that seeing any real benefits is going to take time…and a lot of money.

So is all of that loyalty really worth it? Or would flying be better if travelers just picked the airline with the cheapest airfare?

That question was a hot topic during a panel discussion with “The Points Guy” Brian Kelly, and Airfare Watchdog founder George Hobica, at Skift’s 2016 Global Travel Forum. Both men have made a living sharing travel advice and tips with travelers, but they had very different views on the current status of airline loyalty programs.

Is your loyalty being returned?

It’s no secret that airline loyalty programs are changing. The days of acquiring points based on distance flown are past, with more airlines now rewarding points based on the amount of money a traveler spends. In fact, American Airlines (AAL) switched over to revenue-based awards programs in July. Delta (DAL) and (UAL) a similar switch in 2015. This model makes it harder for regular travelers to earn perks, while offering more benefits to high-spending business-class travelers.

Airfare Watchdog is an online resource that helps travelers find cheap airfare. At the forum, Hobica announced he recently gave up the chance to earn a higher status on American Airlines because he was able to spend $300 less, per ticket, on another airline. He didn’t want to invest in a program that doesn’t give him much in return.

Why should I be loyal to American?” Hobica said. “From now on, I’m going to shop for the best deal.”

Kelly didn’t agree. “People always say how bad frequent flier programs are, but I think our programs are really lucrative,” he countered. “I think in the US we’re just so used to them being insanely lucrative and now they are less so. But there is no culture of free upgrades in Asia and Europe. So I don’t think it’s doomsday if we don’t get something we didn’t pay for.”

Brian Kelly (center) and George Hobica (right) discuss the relevance of airline loyalty programs.

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Brian Kelly (center) and George Hobica (right) discuss the relevance of airline loyalty programs.

While Kelly makes a valid point, it seems some consumers are feeling disenchanted with programs and their ever-changing rules concerning how travelers earn miles or reach status. According to U.S. News and World Report, American Airlines was the second-most popular frequent flier program in 2015. After switching to a revenue-based program, the airline dropped to seventh on 2016’s list, which was released in August.  

When it comes to airlines giving travelers the best quality, Alaska Airlines (ALK) topped the ranking, due in large part to the fact that its program still uses a distance-based rewards model. The Alaska Airlines program is also a member of several carrier alliances (OneWorld and Skyteam), so travelers have more freedom to transfer miles to other airlines.

JetBlue’s (JBLU) TrueBlue loyalty program was a close second, which Kelly attributes to its simplicity.  “Jetblue is adding to their program. They aren’t promising free upgrades, but they are promising better experiences, enhanced earning, change flexibility, and same-day confirmations,” he said.

Southwest’s Rapid Rewards Program wrapped up the top three, being labeled as the program most beneficial for budget-minded travelers.

What about those credit cards?

Airlines spend a lot of time and money trying to gain customer loyalty. Personally, I get a flyer from an airline almost every day in the mail, offering me a credit card and promising bonus miles in the airline’s loyalty program if I sign up. The same credit cards are offered to me at the airport and even on the plane during flight attendant announcements.

The offers are certainly tempting: I mean, who doesn’t want a free ticket to a far-off destination? But getting those rewards typically requires card users to spend thousands of dollars in a short amount of time, which Hobica says can lead consumers to spend recklessly in order to earn travel perks.

“I think the people who get those credit cards and spend $3,000 or $4,000 in a few months, they probably buy stuff that they don’t really want, and the banks know that,” he said. In other words, travelers are overspending to earn a “free” plane ticket, instead of budgeting their money to pay for a trip when they can actually afford it.

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On the other hand, Kelly says the most popular stories on his website are those centered around how to get the most out of credit card perks. He is adamant that customers can benefit from the spending as long as they know the rules.

“I disagree that consumers are racking up debt,” Kelly said. “These cards are good for smart consumers, and we’re able to educate credit card holders on benefits of the card in ways to maximize the points.”

The conservation quickly turned to the new Chase Sapphire Reserve card, which is being touted by many as the best travel credit card on the market. This is the one time Kelly suggested that straying from frequent flier programs and opting for a bank credit card could be better for consumers because they are less restrictive.

“Why would you put money on an airline card? When you’re investing into one program, you’re overexposing yourself to risk when that program inevitably makes changes,” he said.


Unfortunately, there isn’t a clear cut answer on this one.

“I think frequent flier programs have outlived their usefulness,” Hobica said. “They’re expensive to administer for the banks, for the airlines, and I don’t think they provide the value that they did when they were founded.”

For Kelly, the rewards far outweigh the risks.

“I think frequent flier programs are the greatest loyalty marketing instrument ever created. They drive business, they drive jobs, they’re good for consumers when you know how to use them,” he said. “I don’t see a doomsday scenario approaching, they are too much of a big business.”

Where do you stand? Do you think frequent flier programs are worth your time and money?

Brittany is a writer at Yahoo Finance.

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30Sep 2016

To Priceline, VR Will Become Key to Millennial Travel Planning – Bloomberg

The future traveler to London, Paris or Jerusalem may easily plan a trip on the go, avoid changing currencies, and don augmented-reality goggles to see how the bustling alleyways of the Old City looked 200 years earlier.

This is the future imagined by Priceline Group Inc.’s Executive Vice President of Group Operations Maelle Gavet in a world where people are no longer booking tickets six months in advance, and the largest growing market of millennials arrives at a destination with only a vague notion of what they want to do.

“The key word in the travel industry now is ‘explore,’” said Gavet, adding that Priceline, through, rolled out a new smartphone product called Booking Experiences in July in Amsterdam, that helps travelers go some way to achieve this.

Booking Experiences works within’s local smartphone apps to send travelers a pop-up notification on their devices as they walk past attractions, asking if they want to reserve a ticket and bypass queues. Last week, Booking Experiences went live in Paris, Rome, London and Dubai. A rollout in New York and Orlando is planned for later this year.

“We are seeing interest in the product so far. More and more customers are taking advantage of it,” the company said in an e-mailed statement.

Priceline is working to maintain revenue growth reported in the last two quarters and face down challenges that include new players such as Google stepping up presence in the market, as technology plays a larger role in how young people arrange travel.

The 17 to 34-year-old age group is expected to spend more on travel services through 2017 than any other age group, Expedia Media Solutions said in a February blog post. A Priceline survey concluded that almost half the world’s millennials would use digital headsets to preview a destination they are planning to travel to.

“Augmented reality will allow people to go into a city, and as they walk around get information on their glasses. And at some point, as you go through a building, the glasses will be able to show you how the building you are in looked 200 years ago, creating a completely new layer of tourism,” said Gavet.

Artificial intelligence software is also helping the travel industry “provide content relevant to a specific user and allows for a smoother booking process,” said Gavet. Automatically listing only hotels or airplane tickets in the user’s price range is one example of this.

With technology at the forefront of the industry, travel startups raised $1 billion in the third quarter of this year through Sept. 21., a 72 percent jump over the previous three-month period, a CB Insights blog post said last week. The most well funded include AirBnB, which raised $555.5 million this month and travel search site Skyscanner, a British startup unicorn based in Scotland.

Before it’s here, it’s on the Bloomberg Terminal. LEARN MORE

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30Sep 2016

The Biggest Debate in Retail: Should You Pay More to Use a Credit Card? – Wall Street Journal


Phil Canup and Lisa Reading, owners of Beale St. Smokehouse BBQ in Fenton, Mich., recently introduced a 3.99% fee on customers paying with credit cards. The Supreme Court agreed Thursday to decide if it is legal to ban merchants from charging such fees.


Doug Coombe for The Wall Street Journal

The Supreme Court’s decision to take up the question of whether retailers can charge more when shoppers use credit cards has put it in the middle of a growing international debate.

Merchants in markets from Chicago to Australia are sparring with lawmakers and their own customers over efforts to defray the fees levied by card companies by tacking surcharges on to customers’ bills. Ten U.S. states and some countries ban the practice outright. The Supreme Court agreed Thursday to decide whether those bans are legal.

The debate is taking place internationally. The European Union says retailers can’t discriminate among customers based on payment method and will ban surcharges on consumer credit cards starting next year. Regulators in Australia this month also clamped down on surcharging for credit-card payments by setting limits on how much they can tack onto a bill. The move followed widespread complaints from consumers about surcharges being placed on everything from airline tickets to groceries.

The situation is more complicated in the U.S., where surcharging is still fairly rare even though it has been largely permitted by major card networks since 2013.

Earlier this year, Chicago’s city council passed a measure allowing cab drivers to impose a 50-cent surcharge on credit-card payments. “Our cab drivers operate on very tight margins” and face competition from ride-sharing services such as Uber Technoogies Inc., says Chicago Alderman Anthony Beale, who introduced the legislation.

A sign offering a cash discount to customers at Beale St. Smokehouse BBQ in Fenton, Mich.

A sign offering a cash discount to customers at Beale St. Smokehouse BBQ in Fenton, Mich.


Doug Coombe for The Wall Street Journal

Residents sued over the surcharge, saying cabbies were adding the extra fee before the city council introduced the ordinance. The two sides ended up settling the case, and the cab companies refunded some of the early charges.

Visa Inc.


and MasterCard Inc.


now permit surcharges of up to 4%, although states including New York, Florida, California and Texas have banned the practice.

In Michigan, Phil Canup imposed a 3.99% fee last month on customers who pay with a credit card at his Beale St. Smokehouse BBQ restaurants in Fenton and Hartland. The fee is aimed at recouping some of the $30,000 that he pays in credit-card processing fees each year, he says.

“We’re just trying to recover some of that cost,” said Mr. Canup. “This will help us a lot in the long run.”

The case that is going before the Supreme Court was filed in New York, where merchants including a hair salon and ice cream parlor are challenging the state’s surcharge ban. The merchants say the ban violates their free-speech rights, because it prevents them from communicating freely with customers about pricing.

A sign outlines the pricing policy at Beale St. Smokehouse BBQ in Fenton, Mich.

A sign outlines the pricing policy at Beale St. Smokehouse BBQ in Fenton, Mich.


Doug Coombe for The Wall Street Journal

A federal appeals court last year rejected the merchants’ claims and sided with the state. The Supreme Court will review that ruling during its new term, which begins next week and runs through June 2017.

Customers often push back when a merchant tacks on a fee. “Doing anything that makes it more difficult for your customers to do business with you …is a bad idea,” says Vic Doucette, an occasional diner at Beale St. Smokehouse.

Merchants are required to disclose surcharges at the point of sale and on receipts, according to card-network rules.

Tension has grown around the issue because consumers have been flocking to credit cards that offer rich rewards. For merchants, the problem is that those cards carry higher fees than basic cards. Visa and MasterCard set the processing fees that are collected by card-issuing banks.

A restaurant owner pays card issuers 1.54% of the transaction price, plus another 10 cents, when a customer pays with a nonreward Visa credit card, according to a Visa fee chart. The fee rises to 2.4%, plus 10 cents, if the customer uses a high-end credit card that comes with perks like free checked bags on an airline.

The surcharges are only permitted on credit cards and can’t be levied on debit cards, which are tied to checking accounts and carry lower fees for merchants. The number of merchants adding surcharges has grown slowly since 2013, due in part to a lack of awareness among retailers that the practice is sometimes allowed.

“This is an option for them, and many of them don’t know it,” says Craig Cooper, sales manager for Zero Fee Solutions, which processes credit-card transactions on behalf of merchants and helps them arrange a surcharge.

So far, mostly small mom-and-pop merchants have added the fees in the U.S. Gas stations have long been permitted to charge less to customers who pay with cash.

Las Vegas-based Allegiant Airlines charges an extra 3.2%, or a maximum of $8 each way, for credit-card purchases. A spokeswoman for the discount carrier, a unit of Allegiant Travel Co.


, says roughly 48% of its customers pay with a debit card, avoiding the surcharge.

Visa and MasterCard don’t disclose numbers on surcharges and declined to comment on specifics.

It has been about a year since Dennis Freyvogel started adding a 2% surcharge on liquor purchases made with credit cards at his two Arrow Wine and Spirits stores in Dayton, Ohio.  “We were going in the hole because we don’t make money on liquor,” Mr. Freyvogel said.

He says that more customers have switched to cash since he imposed the credit-card fee, but “in a year, only one person was really upset.”

Write to Robin Sidel at

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29Sep 2016

HotelTonight launches loyalty rewards program – VentureBeat

HotelTonight has launched a loyalty program to reward guests who frequently use its service. With this feature, called HT Perks, the company will provide additional discounts based on how much you’ve spent. This program is available to everyone  who has booked and spent at least $100 through the app.

Thousands of hotels are said to be participating in the program, including Soho in New York City, Calamigos Guest Ranch in Malibu, Hotel Triton in San Francisco, and the Orlando Hotel in Los Angeles. You can find the hotels that offer these discounts by looking for an HT Perks badge next to their listing.

There are three tiers to the HT Perks program. Level 1, which is applied to anyone who has spent $100, provides further discounted rates on hotel rooms. Level 2 is awarded to customers who’ve spent $750 and builds on the previous tier with a 5 percent additional discount, along with additional offers and “surprises” to encourage more adventures. Lastly, those who spend $5,000 achieve Level 3, which adds to Level 1 a 10 percent additional discount and includes exclusive offers and surprises, along with VIP customer support — complete with a dedicated phone number.

Everyone is automatically enrolled in the program, and there’s no need to sign up or pay membership dues. What’s more, you can use the discounts any time you like — there are no blackout or expiration dates.

HotelTonight aims to provide guests with a last-minute place to stay and is especially suited to those who aren’t staying multiple days. This model has served the company well, but, over the past year, HotelTonight has evolved to allow two-night stays at a discounted rate and has enabled searches based on “magic” words. And we can’t forget the launch of HotelTonight’s Aces concierge service, which provides you with advice on places to visit and things to do in the surrounding area.

Traditional accommodations are facing fierce competition from the likes of HomeAway and Airbnb, and HotelTonight is designed to not only instill loyalty in the hotel brand but to increase overall bookings. Of course, HT Perks is an effort to maintain the company’s lead in this space, one that has recently been entered by the Standard International hotel chain, which recently launched its own one-night stay app.

HotelTonight’s HT Perks program is available within the service’s iOS and Android apps, starting today.

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29Sep 2016

Dallas lands on travel writers' list of unfriendliest places in the world –

Texas is known for our southern hospitality and for many it just come naturally – you treat others how you would want to be treated.

Regrettably, Dallas isn’t living up to that reputation, according to the Independent. The online British publication gathered its top travel writers to ask them what city left the most sour taste in their mouth. Dallas was one of the cities named.

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Travel writer Simon Calder minced no words:

“Texas is a land apart, a big-hearted state with three warm and welcoming cities: Houston, Austin and San Antonio. But not Dallas.”

He goes on to explain that he has visited several times, the first being in 1994, but every time he feels unwelcome. After all, he points out, his tourism is bringing income into the city.

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One commenter, blu_texas, noted at the bottom of the Independent article:

“Have you ever stopped to think that if all these cities seem so unfriendly that maybe it’s not them, it’s you? In my experience you get as good as you give. When you approach people in a friendly non-judgemental way, people treat you the same way. But when you go into a room with a chip on your shoulder, should you wonder why people don’t embrace you? BTW, there’s lots to do in Dallas, but you have to get in a car and move around. We aren’t here to entertain you.”

Yeah, bro. You’re not helping Dallas’ reputation with that comment.

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Another American city, Miami, landed on the list because of the “dead-eyed” service the writer experienced. He attributes it to the years of Spring Breakers taking over the city every springtime.

The other cities on the list included a few from Eastern Europe and one Asian capital. Click through the gallery above to see the full list and the travel writers’ reasons for including them.

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29Sep 2016

Credit card sign-up bonuses have hit record highs – MarketWatch

If you’ve been hearing a lot of buzz about credit cards with tempting sign-up bonuses, there’s a good reason why.

The value of initial rewards bonuses hit a record high in the third quarter of 2016, at an average of $101.48 in cash or more than 15,000 points or miles available to new applicants, according to a recent study by WalletHub, a personal-finance website. WalletHub compiled data from more than 1,000 credit card offers, which it monitors daily.

That’s more than a 300% increase in sign-up bonus cash and about a 120% increase in points and miles since 2010.

Although the end of a calendar year is typically a good time to look for lucrative sign-up bonuses if you’re in the market for a new credit card (because of banks trying to hit year-end goals, among other reasons), this year has been groundbreaking in terms of the rewards the banks are offering.

“What we’ve seen is this arms race when it comes to sign-up bonuses that doesn’t show any sign of ending anytime soon,” said Matt Schulz, a senior industry analyst for the credit-card website

Sign-up bonuses for credit cards that require high credit scores help banks attract customers who are reliable spenders; after creating that initial relationship with them, it may be easier to sell them additional products, including mortgages or car loans, Schulz said.

Credit-card growth has slowed in recent years as debit cards and mobile payments have risen in popularity (worldwide, debit card use grew 8% last year, whereas credit card use grew 5%), which may be part of the reason for the large bonuses, said Rob Markey, a partner at Bain & Company, who is the head of the company’s customer strategy and marketing practice.

The rise also may be due to banks figuring out that large sign-up bonuses are effective, and directing funds to those instead of other forms of marketing, Markey said.

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General Motors Chairman and CEO Mary T. Barra and JPMorgan Chase’s Jamie Dimon explain why the “Women in the Workplace” survey is valuable to corporations for prioritizing where they need focus.

For example, Chase JPM, -1.59%  has been a frequent topic of conversation in recent weeks because of its popular Chase Sapphire Reserve card, which debuted this summer; it charges a $450 annual fee and comes with perks including a $300 annual travel credit, application fee credit of up to $100 to cover TSA PreCheck or Global Entry fees and 100,000 bonus points for spending $4,000 in the first three months after opening the card account. Chase approved tens of thousands of applications for the card in the first two days of its release, a company spokeswoman said.

“If your product is good enough to generate buzz and word-of-mouth, why not just turbocharge it?” Markey said.

Still, despite the temptation of a large sign-up bonus, it’s important to choose your card carefully: At least one in five people who have a credit card chose one that doesn’t actually align with their spending patterns, according to a survey of more than 20,000 credit-card customers from the marketing information firm J.D. Power and Associates.

Consumers should weigh the sign-up bonus and any future perks against cards’ annual fees, and the risk that they could overspend while using the card, said Sean McQuay, a credit-card expert at NerdWallet, a personal finance website.

(NerdWallet offers an online tool to help calculate this, although McQuay pointed out it doesn’t take into account free checked bags, or other perks along those lines that are specific to particular credit cards).

Consumers should also consider long-term benefits and rewards of the cards in addition to any sign-up bonuses, McQuay said.

In fact, consumers seem to have caught onto this; rewards programs are the primary reason consumers choose which credit card they want (not sign-up bonuses), according to a survey of 1,500 consumers that Citi C, -2.28%  conducted with research firm Wakefield in April 2016.

About two-thirds of those surveyed said rewards programs influence which card they pick, compared with about half who said they consider interest rates, and a quarter who consider the sign-on bonus.

“You want to make sure you’re optimizing for where you spend your dollars and also that the points are useful for you,” McQuay said. “You can narrow the whole universe of cards from thousands to those that optimize best for you.”

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29Sep 2016

Periscope's VIP program rewards popular livestreaming users – Engadget

If you’re popular on Periscope, the livestreaming app will soon reward you as part of its new VIP program. The three-tier initiative is designed to incentivize creators who have invested time in using Twitter’s live video option with tools that will help them make their audiences even bigger. In other words, it gives livestreamers a reason to use the platform more and make an effort to pad that follower total. Gold, Silver and Bronze levels require follower counts of 10,000, 30,000 and 100,000, respectively. There are also benchmarks for average viewer tallies and you’ll need to be broadcasting at least twice a week.

So, what are the perks? All three levels will get badges attached to their profile so everyone will know they’re a VIP. The Bronze tier includes care packages to help you look your best, a boost in search results and a list of tips and tricks. Members of the Silver level gain prioritized support, access to “future discovery products,” private streams with Periscope for a behind-the-scenes look and a Slack channel for fellow VIPs. The top Gold tier includes all the stuff from Bronze and Silver levels with the ability to collaborate directly with the Periscope team.

If you meet the criteria, you can apply for Periscope’s VIP program right here. It’s free, but those are some hefty requirements you’ll need to fulfill in order to gain access. Though the program was announced this week, the sign-up page officially lists it as “coming soon.”

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29Sep 2016

These Travel Agents Are Staying A Step Ahead Of Google – Forbes

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Travel Market Report

These Travel Agents Are Staying A Step Ahead Of Google
IBM has Watson. Google has its vast secret development labs. Both strive to bring to market technology that will improve our lives and use data to increase the power of marketers. In some cases, the technology is also meant to replace the need for a
Travel Agents Tell How They Save Clients Money & AggravationTravel Market Report

all 6 news articles »

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29Sep 2016

Jordan's Furniture switching credit card providers – New Haven Register

Jordan’s Furniture is switching providers of its private label credit card for purchases at its six stores, including the one in New Haven.

The Massachusetts-based furniture retailer has signed a multi-year agreement with the Cards and Merchant Solutions division of TD Bank to provide the chain’s private label credit card. Jordan’s has offered a credit to customers for over 25 years, most recently with Capital One Finance, said Heather Copelas, a spokeswoman for the chain.

Eliot Tatelman, Jordan’s president and chief executive officer, said TD Bank’s Credit Card offering “directly aligned with our mission to make furniture shopping manageable and exciting.”

“Customer experience is of the utmost importance to us,” Tatelman said in a statement. “It is crucial that we offer a credit card with a range of affordable financing options to meet the ever-changing needs of our customers.”


Copelas said customers who have private label credit cards typically spend more than customers who either don’t have a charge card with the retailer of use another brand of credit card.

“That’s due mostly to special financing offers associated with the program,” she said.

TD Bank’s Cards and Merchant Solutions division is one of North America’s top 10 card issuers with over $24 billion in card receivables. Among the private label credit cards clients that the TD Bank serve are two of rivals of Jordan’s Furniture in the Connecticut market, Raymour & Flanigan as well as Pilgrim Furniture City.

Call Luther Turmelle at 203-680-9388.

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28Sep 2016

How Health Tech Can Reinforce Biases Against the Mentally Ill – Slate Magazine

Maybe she can’t wait.


Imagine it is 2 a.m. in the ER at High Tech University Hospital. The charge nurse turns to his computer monitor to see who waits in triage. Three new patients. Alongside one of their names sits the dreaded red airplane icon. This means the patient has visited the ER more than five times in the past 30 days—she’s a “frequent flyer.”

He doesn’t remember her, but her name is Mrs. Simmons. She has bipolar disorder, an illness that affects about 4 percent of the population and is characterized by extreme emotional swings and sometimes psychotic episodes. Though she arrived before the other two patients, our nurse decides to go to her room last, thinking it’s likely not an urgent problem since she’s here so often.


The nurse finally gets to Mrs. Simmons at 4 a.m. and takes her to a bed. Soon, she is shouting, “My head hurts!”

“OK, Mrs. Simmons,” the nurse answers with a note of contempt in his voice. As he leaves the room, she falls back, clutching her head.

Mrs. Simmons is familiar with this emergency department. Usually, she walks in when she runs out of psychiatric medications and slips into a frightening psychosis and hears a cacophony of disturbing voices in her head. Other times, the police bring her in, agitated and yelling about people stealing her ideas for revolutionary inventions.

As Mrs. Simmons waits, she gets confused. Nurses and doctors pass by her room noticing her frenetic state, with arms flexing uncontrollably. Many think, “It’s just Simmons being Simmons; she’s just manic. She can wait until the next shift after she calms down.”


But Mrs. Simmons can’t wait. By the time the doctor on the next shift reaches her room, her brain is bleeding and she has lost consciousness. Mrs. Simmons was not just being Mrs. Simmons. She has severe meningitis and is near death.

This story—though fictional—reflects a certain all-too-common reality. Patients with chronic and serious mental health problems often receive poor physical health care. Clinicians tend to assume physical symptoms are related to their underlying psychiatric conditions. Those arm movements Mrs. Simmons was having? A seizure related to the brain infection—not bipolar disorder.

The evidence of this disregard is striking. Study after study has shown that this phenomenon—known as diagnostic overshadowing—is real and it is dangerous. It happens when a patient’s mental illness overshadows her other medical conditions. Many hospitals now aim to improve this situation and have made strides in integrating psychiatric and medical care. But subtle factors continue to undermine this effort, at once cordoning off mental health care from medical care while also stigmatizing people with mental health problems.


The airplane icon—which is a feature of a widely used electronic health record system—is a simple case in point. It symbolizes the concept of the frequent flyer, but this isn’t about racking up free travel miles. Instead, it is a derogatory phrase used among clinicians that tacitly communicates: “watch out, this is a problem patient.” It implies the patient is a “drug seeker,” “a liar,” or a patient looking for “two hots and a cot.” In the parlance of Samuel Shem’s novel The House of God, the frequent flyer is a GOMER—“get out of my emergency room.”

The intent of the airplane icon was probably innocent enough. Computer programmers likely created it to help clinicians know that someone comes to the hospital often. They may have thought the icon could help hospitals provide better care by pointing out individuals in need of extra resources or close follow-up plans. And it is hard to imagine a computer programmer deciding to draw upon the concept of the frequent flyer without advice from clinicians who know and use that colloquialism.

Here is the problem. For one, the icon could worsen health care delivery—essentially announcing “this patient is here all the time, it’s likely not a critical problem.” The fact is many of the people who repeatedly visit emergency rooms have mental health problems, and they wait anywhere from eight to more than 24 hours longer for care. Sadly, studies have found that, compared with the general population, people with serious mental illness are 3½ times more likely to die than the general population, losing about 30 years of life on average, largely due to physical health problems. They don’t have time to wait.

Furthermore, the airplane symbol derogatively tags this population. By labeling individuals as “frequent flyers,” the icon reinforces the stigma of prejudice and discrimination against people with psychiatric disorders. Symbols aren’t benign. They communicate meanings, including values, judgments, and morals. We are aware of this when battles over the confederate flag arise or someone displays a swastika tattoo. But it’s taking new, subtler forms in the era of digital technology. For example, Americans perceived Apple’s recent decision to replace the pistol emoji with a squirt gun as a major political statement triggering some rather vocal backlash.


Technology and health care have long been bedfellows. But in recent years, advances in big data and social media technologies have prompted the development of powerful solutions to inform clinical practice and empower patients. For instance, new applications provide clinicians with real-time updates on their patients’ well-being and medication adherence. We’re seeing a particular rise in technology intended to help patients with mental health problems: Some social media platforms now provide crisis intervention tools, and researchers are now investigating the potential to use artificial intelligence to diagnose and treat mental illness.

But we also need to be mindful that people designing algorithms and computers systems insert intentional and unintentional biases into the way they function. Recent allegations that Pokémon Go and Snapchat reflect underlying racial biases are prime examples. On a larger scale, author Cathy O’Neil asserts that algorithms and big data are bolstering racism and inequality through mechanisms such as criminal sentencing, insurance rates, and employment opportunities. Technologies order the world according to the priorities and values of those in power. And unsurprisingly, patients with mental health problems often wield less power.

The airplane icon on a hospital’s records system is a small example, albeit one with important consequences. But one could imagine that such biases may begin to play out more broadly in the health technologies of the near future. Social media posts and your smartphone can glean all sorts of information about you—think speech patterns, routes traveled, and body movements. How can that data be used to detect behavioral health problems? One could envision positive outcomes, like being able to alert an individual to a potential looming manic episode or alcohol relapse. But prejudices could also complicate these programs in ways that limit care, enhance stigma, reduce privacy, or make other harmful choices for individuals with mental health problems.

Health IT developers should be aware of potential biases and create systems that at the very least minimize harm to patients. While technologies may not be able to escape values, they don’t need to reinforce damaging ones. By collaborating with patients, consumers, clinicians, social scientists, and ethicists, perhaps new technologies can encourage ethical behavior and respectful treatment no matter a person’s symptoms or diagnosis.

This article is part of Future Tense, a collaboration among Arizona State University, New America, and Slate. Future Tense explores the ways emerging technologies affect society, policy, and culture. To read more, follow us on Twitter and sign up for our weekly newsletter.

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