Patient… Clients… Consumers… Guests???
26 March 2009Call me paternalistic, but the people in the bed (or on the trolley) that I am charged with looking after are my patients.
They are are not, as far as I am concerned, “clients” or “consumers”. To me, these labels are pissy PC labels that unknown wankers have decided are more appropriate; designed to give patients a sense of control in what is otherwise an alienating system. By labeling patients in such ways, it gives the sense that they are somehow customers who have the ability to pick and choose the type of care and the place that they recieve it. It gives the sense that such “consumers” are empowered to make the sorts of decisions about their health akin to those made when going out and making a consumer purchase like a TV or lounge suite.
Now granted, in the Australian context, if you’ve got private health cover you have the ability to choose your doctor. But really, unless you really know anything about the doctor you choose, and about the implications of choosing them over another doc, this really doesn’t mean much.
Then, I begin to wonder. Should we treat our patients as consumers? Check their credit before dispatching an ambulance, as in the novel Jennifer Government?
I’ve looked after a lot of lovely people. But given the number of complete tards that I have nursed, I can assure you that “the customer is always right” does not cut the mustard with me.
I guess my biggest objection to such terminology is the idea that such labels mean that patients are somehow falsely empowered with the notion that they truly have choice and control over their “health transaction”. The drunk guy with the sub-dural that comes through the doors is incapable of exercising his consumer power – he needs to be cared for. Little Esme who has tripped over in the garden and done her NOF isn’t in hospital to shop for a new hip, followed by a coffee and boob job. She is there to receive medical attention and be cared for. I look at the patients that come into ICU and do not see a single one who is there out of choice, or who is capable of shopping for a treatment in their size & colour.
When I look after someone, they are my patient.
When I am sick, I would rather be someone’s patient, than their customer, consumer, or client.
And as if these terms didn’t irritate me enough, now there appears to be “guest”. WTF? That’s right. I came across this one recently in a journal article:
Reishtein, J. (2005) ‘Sleep in Mechanically Ventilated Patients’, Critical Care Clinics of North America, vol.17, pp251-255.
Hospitals are infamous as places where people cannot sleep, and critical care units seem to be the worst offenders in denying thier guests rest and sleep.
I don’t want to be looked after by a doctor or nurse that thinks of me as a “guest”.
I wonder whether the doorman, concierge, or manager at the next hotel/motel/resort that you stay at will have as much concern/responsibility for the the health & welfare of you, as their guest, that a doctor or nurse has for their patients.
Somehow, I think not…
amen to that.
:]
Very true. I have seen the “client” handle used a lot in mental health care – to reduce the stigma I suppose. All this talk about client and stakeholders etc can sometimes distance us from the fact that disease/accidents happen and we are simply trying to help them get better.
Also, that word “empowered” gets used and abused in relation to health.
And re Reishtein in CCCNAm – so many people who have been or had loved ones in an ICU seem to resent all the noises and interventions so much. Obviously maintaining sleep wake cycles is ideal, but people are in hospital (let alone ICU) because we don’t live in an idea world. I’ve also heard people saying how they wanted to spit at the medical and nursing students who were around (whether a lack of sensitivity was displayed or not). It often seems to be forgotten that noone is “denying” sick people sleep/comfort/freedom (well, unless the health care worker involved is a sociopath). It is very easy to blame the system, the nurse/doctor/lab staff/radiographer and try and get away from the reality – people get sick/injured (and sometimes die), and sometimes interventions (not a minibreak in the Sheraton Noosa) are needed to halt/prevent this.
I am still at uni, and it irks me every time a patient is referred to as a “client” in case study briefs, etc.It is out of touch, airy fairy academic PC bullshit!! Brothels have clients. Hospitals have patients. Although some dirty old patients have to be reminded of the difference…
Re “brothels have clients”. ROFL.
If we are forced to call patients “clients” then they better start paying better
Thank G where I work they don’t bother with that silliness.
Re. “some dirty old patients have to be reminded of the difference”.
Don’t even get me started! We had a patient who was NOT demented, confused, etc, who was trying to grope female staff members when they took his vitals, and saying things like “now you’re finished there, how about a f*!k?” I was soooo close to my first episode of patient abuse!
Thing is though, I reckon even if we had’ve complained about it, the only thing that would’ve happened is we would have been told to suck it up and deal with it. “All part of the job when you’re a nurse.” Gotta keep those “customers” happy, after all!
I agree with you completely. We are constantly haveing meetings about excellent customer service. It angers me. I agree that we should treat our patients well. But to the degree that they want us to is not ok. When I am expected to drop everything to get the family member a soda what happens to the patient in severs pain who has to wait on her pain med? Or the patient who is anxious that must wait on ativan until I have found that crossword puzzle for her neighbor? I was actually told in a meeting once to treat our patients as if they are in a luxury hotel. I cried on the way home after that meeting for sure.