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Patient or Client in 2021?

What we call the person is not as important as the relationship we have with them and most importantly, the outcome of that relationship.

Since the earliest days of medical care, a person was seen as in a doctor patient relationship. The person was called patient as the Latin origins of the word implied; one who endures or is suffering. Indeed, the trust was in the doctor and the knowledge and skills they had to change the suffering of that person.

The word patient is still relevant today. Arguably, a person who arrives unconscious following an automobile accident to the local emergency department is closest to the origins of the word patient. They may have a next of kin ready to decide for them or another person with them, but the presumption is that they are needing care and that is decided by the person with the knowledge and skills entrusted with their needs. This person is very ill, or so sick or injured that they are deemed a more passive recipient of care.

If the person arrives and sees themselves as not “sick”, are they a patient?

As an example, if informed by their healthcare professional they have a chronic health condition with test results indicating added health risks they are an active participant when informed this way.  This become more of a ‘client’ relationship with the healthcare system; their healthcare professional has made them ‘armed and active’ with this information.[i]. But they must act for their health status to change; they have an active participant role. Their own decisions and behaviors are determinants in their healthcare outcomes, nothing will change if it is a passive relationship with their healthcare professional.

There is an argument that the term ‘patient’ is a more respectful one, whereas the term ‘client’ is one of that is fiduciary in nature; logic being that the healthcare exchange is not a financial one[ii]. However, the modern healthcare system and its relationships or encounters do serve the economics of its financial management.

It can be said that the current healthcare experience of the more developed societies is more complex. There are new levels of healthcare relationships with more “forks in the road” to be navigated; no longer only a trust relationship of doctor-patient exchange.

There is a possibility that this increasing complexity may require some new measures of trust for the person as they build a relationship with the healthcare system. A transparency of information and a measure of accountability may engender a new trust for the person in their journey through the healthcare system.

Finally, there is no consensus as to an alternative word for patient. What do you think?

We will continue to explore these relationships for a person in their total experience of healthcare in 2021 in this weekly blog.


[i] Shades of grey: patient versus client. Ratnapalan, S. CMAJ.2009 Feb 17;180(4):472 doi:10.1503/cmaj.081694
[ii] Patient, client or customer: what should we call the people we work with? Brinkman, J.T April 2018 retrieved from www.opedge.com
[iii] For whom do you care – patients or clients? Bonsall, L. April 13 2016 blog retrieved from www.nursingcenter.com/april2016

 

by Dr Sue-Ellen McKelvey PhD MBA DC DO  

 

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