When Did "Patient" Become a Dirty Word?

The line between healthcare and consumerism must be respected

Posted Oct 07, 2019

As I spend more time interacting with the administrative leadership in healthcare in 2019, I find myself asking again and again, "Why can't we call them patients?" I am hearing words like customer, client, patron, and member used in place of the word "patient" more and more. Yesterday I heard a managing director of a healthcare consulting practice speak about disruption in the market place. There was nothing surprising to me in her well put together a presentation about innovators like Marriott and Starbucks and customer service industries that healthcare can and should learn from. But what I kept waiting for from her was the aha moment. I was sure she would acknowledge the differentiator, that healthcare is different. That we are in the business of caring for our patients, not selling goods to a customer.

I took the opportunity to ask her to comment on her choice of the word "customer" instead of "patient." I was disappointed with her answer. She told me that as a physician she would not recommend that I call my patients "customers". I reassured her that this would not ever happen. But she did tell me to let the people who get them in the door call them "customers." 

The dichotomy suggested by this consultant gets to the heart of healthcare in the United States in 2019. Language matters. If healthcare administrators define themselves as people selling healthcare, and patients are customers, then physicians and clinicians are relegated to employees on the assembly line of production. I hold the doctor-patient relationship sacred. But in the era of 2019, it is frightening to witness the transition from doctor to provider and patient to customer.

When did my profession decide to fall into step with consumerism? I am as enamored with the innovations of 2019 as anyone. Starbucks and Amazon and Nordstroms and Uber have so much to teach us about evolution and meeting people where they are. These people are customers of these companies. But I cannot advocate a leap to allow people to be termed "customers" by organizations that care for the sick.

If one side of the house, the administration, calls the people seeking healthcare "customers," the consumerism story bleeds into direct patient care. The paradigm that allows for mutual respect between doctor (or clinician) and patient, for shared decision-making, for compassionate care, cannot be confused with consumerism. Perhaps the differentiator that healthcare needs in 2019 is to reignite our north star, the doctor-patient relationship. And the crux of this may live in the language. The reinvention of language will not modernize the delivery of healthcare. Healthcare can learn from customer service industries. Healthcare can adapt and evolve, to improve convenience and access. But please, let us differentiate ourselves. Let us respect the delicacy, intimacy, and sacred nature of the bonds of medical professionals to those we care for. We are doctors. And we take care of patients.