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.