Written by Frank Tucker
I absolutely love this debate. I believe health care providers are more passionate about this than the recipients of health care services. By its very definition, it would seem that the term patient is very fitting. The word originates from the Latin “patiens” which essentially means “to suffer” or “one who suffers”. Of course today, that has changed and the term patient doesn’t necessarily mean suffering or person receiving health care.
Take for example behavioral health which often refers to the patient as a client. This situation is the same for those receiving home health care. In nursing homes, patients are referred to as residents however they too fit the very definition of a patient. Certainly in all these situations the individual is receiving care and they may indeed be suffering therefore fit the term patient. The question is then why not just universally refer to them as patients? There are a number of influencing factors which include culture, dignity, political correctness, and many others. I always thought the “provider-patient” relationship is something sacred, personal, and essential for high quality care. Though I am not a Physician, I am a practicing Physician Assistant and my education was founded on building relationships based on ethics, professional rapport, empathy, respect, dignity and more importantly…CARE. Terms like client appear to imply a business relationship, removing the human factor in the delivery of CARE – don’t they? So what is wrong with calling a patient…a patient?
Now that I have your attention, this is where I think consumerism has changed this relationship. Much like various aspects in other markets, consumerism has changed the traditional relationship in both our vertical and horizontal marketplaces. For example, take the smartphone and how disruptive it has been to what we previously considered as the norm, in particular the Information Technology (IT) department. There was a time where theCIO and their staff would determine what mobile equipment the organization should have then everyone was issued the same device. Before the rapid emergence of the smartphone, devices issued by the IT staff were indeed top of the line while at the same time addressed organizational needs like security. However, as with any disruptive innovation, the widespread adoption of the smartphone by consumers changed the organizational behavior and policy to adopt commodity consumer devices like the smartphone and tablet into the corporate environment. It was hard for a company to set a policy for everyone to use the corporate phone when those in corporate headquarters were having their IT staff provision their consumer phones as corporate devices. This is one of many examples of how consumerism drove change in an industry who had many reasons why it wouldn’t work.
Let’s now look at the healthcare context. The term patient can be viewed as the passive part of the health care process. That is, they are given care for their “patior” or suffering because they had limited ability to help themselves. The term implies a state of desperation and dependency rather than an active part of the process. It also sets a stage where the care provider is the position of superiority and power. The consumer on the other hand is empowered. They are educated and making informed decisions in their best interest, not just receive treatment. They are in control with shared responsibility, taking major responsibility of their care. They have the right to make their own choices and the ability to act on them. Just as the consumer drives decisions about their products and services, they also drive the service for their health. I love that TV commercial that depicts the doctor trying to play a cello while the cellist switches position and tries to play the doctor. While there is some truth and caution to that notion, I think it was taken to the extreme.
The Health Care Consumer is not trying to be the provider or play one; they are trying to play a vital role in the decision-making process. How do we embrace, empower and channel that energy into better health care outcomes? There is a lot of empowerment and individualism when we refer to one as a consumer or customer, particularly the latter as I would imagine we can all relate with receiving great customer service. The problem is that the word consumer is one used often in the economic sense. Yes, the practice of medicine is a business but it is the business of taking care of the individual. The concern is that if we shift to labeling the individual as a consumer or customer, the sacred relationship of provider-patient will be one of that gets reduced to just dollars and cents. On a number of times, I’ve read how the consumer is only worried about cost. In my experience, that is absolutely not the case. More true in economic hardship, but for the most part it’s about best value of which cost is certainly a component – particularly in managed care.
Consumerism is as much of a social order as it is an economic order. The movement and activism seeks to protect and inform consumers with things such as honest packaging, advertising, safety standards and guarantees. Yes, its origins were indeed born out of capitalism but have evolved into one of advocacy for those receiving goods or services. Isn’t that what we do in health? We have evidence-based medicine, the Joint Commission, and patient advocacy among other best practices.
The truth of the matter is I believe the patient is still a patient and the provider-patient relationship of trust and caring is to be expected. However, the dynamics of that relationship have changed as consumerism drives change within the industry. Being a realist, that relationship alone won’t pay the bills and a health care organization has to be run as a business to continue to exist and provide valuable health care services.I’m not sure a label really matters if what you are looking for are better outcomes for those whom you provide care. That means, they are a patient, they are a consumer, they are your customer and they need you to understand their needs on multiple levels. Embrace the cultural shift and empower them. To do so means you must have better insight and trust them with their own health information. Businesses practice customer relationship management to gain better insight on providing better goods and services to the customer. Does your health care institution practice patient relationship management to better understand your holistic health care needs not just on an aggregate basis, but to the individual level of granularity? In the age of managed care, personalized medicine was somehow lost. Certainly the prospects of genetics has reinvigorated the model, but what I’m referring to is leveraging other information outside of long established methods to gain better insight to treat the individual…not just the illness or injury.