Understanding the Terminology: Patient vs. Customer
While businesses refer to people who buy their goods and services as customers, the medical field uses very different terminology. This distinction is not arbitrary; it's rooted in the historical, ethical, and practical realities of the doctor-patient relationship. The idea of a 'customer' implies a commercial transaction between equals, where the customer is always right. In contrast, the 'patient-physician' relationship is built on a foundation of trust, vulnerability, and a fiduciary duty, where the physician is ethically and legally obligated to act in the patient's best interest.
The Etymology of 'Patient'
The word 'patient' comes from the Latin word patiens, which means 'one who suffers' or 'to bear, endure'. This root etymology suggests a traditional, paternalistic view of medicine, where the doctor is the active party (the healer) and the patient is the passive recipient of care (the one who endures). While modern medicine has moved towards a more collaborative, shared-decision-making model, the word has retained its significance. It signifies a relationship centered around the vulnerability of illness and the compassionate care required.
The Rise of Alternative Terms
In recent decades, a growing movement has advocated for changing the language used in healthcare to reflect a more empowering and egalitarian relationship. Terms such as 'client,' 'consumer,' and 'health service user' have been proposed as alternatives. Proponents argue that these terms shift the focus from a passive, illness-centric model to an active, wellness-oriented one.
- Client: Popular in the mental health field and counseling, the term 'client' suggests a collaborative, professional relationship. It was adopted partly as a rejection of the more medical-model-focused 'patient.' However, some medical associations argue against this, stating it overly emphasizes a commercial relationship.
- Consumer: The term 'consumer' has gained traction with the rise of managed care and the commodification of healthcare services. It frames the individual as an active participant who makes informed choices in a healthcare marketplace. While some see this as empowering, others worry it diminishes the unique, compassionate nature of medicine by reducing it to a business transaction.
- Health Service User: A more neutral term, 'health service user' focuses on the action of using a service rather than the individual's state of being. It's often used in public health settings and research to encompass anyone who interacts with the healthcare system.
The Patient's Preference
Does the terminology matter to the individuals receiving care? A 2019 scoping review synthesized studies examining terminology preferences across various healthcare contexts. The findings revealed that 'patient' remains the preferred term for many individuals in general clinical settings. However, some mental health patients did express a preference for 'client.' Ultimately, preferences can vary, and open communication is key.
The Legal and Ethical Ramifications
From a legal standpoint, the establishment of a 'patient-physician' relationship carries specific legal and ethical duties. This relationship is distinct from a commercial vendor-customer dynamic. For example, the American Medical Association's Code of Medical Ethics highlights the ethical responsibility of physicians to place patients' welfare above self-interest. The use of the term 'patient' reinforces this special, fiduciary relationship built on trust.
A Comparative Look at Terminology
| Feature | Patient | Client | Consumer |
|---|---|---|---|
| Etymology | Latin 'patiens,' meaning 'one who suffers' | Latin 'cliens,' meaning 'dependent of a patron' | From 'consume,' meaning to buy or use |
| Relationship Dynamic | Fiduciary; doctor is expert and patient is vulnerable | Collaborative and professional; seeker of expert advice | Transactional; customer in a marketplace |
| Primary Context | Medical and clinical settings, general practice | Mental health, counseling, social work | Managed care, healthcare business, policy |
| Implied Role | Recipient of medical care | Active participant in professional services | Informed buyer of healthcare services |
Conclusion
While the healthcare industry continues to evolve and embrace more patient-centered approaches, the term 'patient' remains the standard and most widely accepted term for individuals receiving medical care. The debate over terminology, however, is a valuable exercise that highlights the changing dynamics of healthcare, emphasizing the need for a collaborative relationship that respects patient autonomy and dignity. Ultimately, the best approach is to listen to the individual's preference whenever possible, though 'patient' is a universally understood and appropriate term in clinical settings. For further reading on the ethics of the patient-physician relationship, you can consult resources from the National Institutes of Health.
