22nd September, 2007
Patient or Customer?
I have heard the debate go on about what to label consumers of eye care. Doctors and even opticians can get down-right petulant when discussing the topic. Often, the argument is made that the word customer should be stricken from the optical practitioner’s vocabulary because it implies a profit motive whereas the word patient implies a nobler more caring motive. Some of this touchiness may stem from the desire of many optometrists and opticians to take on a larger health care role, however I believe the argument is as pertinent, if not more so, to general health care, as it is to eye care.
As usual, I have a different take on the subject. I believe both health care practitioners and consumers of health care would do well to strike the word patient from their vocabulary. I would even go as far to say that use of the word patient and more importantly, the patient mindset, lies at the root of what is wrong with health care in the U.S.
While the term patient may have a noble connotation for health care professionals, it has far greater implications than mere provider intent; it assigns positions of power and control. The word patient is derived from the Latin pati which means to suffer. Merriam-Webster defines patient as 1b: the recipient of any of various personal services or 2: one that is acted upon. In essence, patient refers to a sufferer acted upon by a practitioner. Our use of the word places the practitioner in the position of control and establishes a mindset of dependency on behalf of the patient. On the surface this might not seem problematic. The practitioner is after all a caregiver, someone who is supposed to treat his patients with the same care he would give his own mother. Problems arise however when the practitioner is not that caregiver; the practitioner views the patient as someone who needs him rather than the reverse; or the patient submits to the care of a practitioner and abdicates himself of further responsibility.
Customer on the other hand is an empowering word. Customers look out for themselves while patients need to be taken care of. Customers have the power to choose where and how to spend their money while patients are told where to go for care. Health care consumers could have a significant impact on the heath care industry, if they only wielded the power of the customer and armed themselves with knowledge and knowledgeable advocates. I personally know several individuals who have benefited from and perhaps even saved their own lives by educating themselves and taking an active role in deciding the course and type of care they received rather than relegating themselves to the role of the patient. I know this to be true in optical as well, since not all optical professionals take the time to educate their patients about all their options. I understand this might not sit well with some who prefer to think of their customers as patients; those that would rather dictate to their patients than listen to their customers. But the simple fact remains there exists a sizeable profit motive for most practitioners (which is not always a bad thing). Therefore, it could be of enormous benefit to practitioners, their practices, and their patients, if they would think of their clientele as customers and employ the tenets of good customer service rather than use lexicon to maintain authority.
Holding on to the argument that using the word patient is somehow nobler because it does not imply a profit motive is quaint; reminiscent of a bygone era, but in today’s world is almost trite. How many people do you know believe health care practitioners are not motivated by profit on some level? For that matter, how many practitioners do you know that are not motivated by profit on some level? Keep in mind profit motive is not inherently evil. If profit motive leads to better care and more respect for your customers, and those customers return or even tell their friends as a result, everyone wins. I think insistence upon use of the word patient can consciously or subconcsiously be more righteous than noble. Moreover, the patient mindset whereby consumers give up responsibility for their own care is detrimental not only to themselves but to the industry as a whole.
Update:
Interestingly, I came across some comments from Paul King of Opticourier who passionately argues the opposing point of view from an optician’s perspective, even stating:
I feel that “customer” should be stricken from our optical vocabulary. I would like to start a grassroots push to change this mindset in the industry…
Paul King’s comments (last two paragraphs on the page)
Popularity: 29% [?]
Posted at 1:12 am |
On October 26, 2007 at 4:14 pm Paul King said:
October 26, 2007 at 4:14 pm
Keith, your writing is eloquent and to the point, but you have, in my humble opinion, have missed a key point, caring, the care of the eye care provider for his or her patient. You have approached your views as one who is calculating, but most of the patients are not. You sir, are an engineer, you are use to looking at all sides of an equation to come up with a distinct, unwavering answer. Most of us are not wired that way. Making recommendations, guiding, and educating people for most Optical professionals does not come from a need to be superior, quite the contrary, it comes form an overwhelming desire to SREVE. To be a servant to our patients and their eye care needs is why most of us in the optical trenches stay where we are. God knows it’s not the money.
You spoke of the practitioner thinking that the patients NEED them. They do, just as we need the patient. The relationship is very symbiotic, with out the patient we would not exist and with out us, they would not see. With out the three O’s making suggestions and educating the patients on the latest developments to improve their sight, most new technologies would have never gotten off the R&D floor. Our patients would still be wearing Franklin bifocals and waiting for the local “glimmers” to come by.
The “patient mind set” is not what is wrong with the US heath care system, what is wrong is the “business” of health care. The business of health insurance companies that tells practitioner what he can and can not do for the patient. When the world was “quaint” we did what was right and good for the patient. These thoughts might be old fashioned; by I’m an old man. Keith, spend some time dispensing glasses, making adjustments, helping people fill their visual needs, then come back and lets us know what you think.
Remember folks, take care of your patients and send the customers to the other guys!
On October 26, 2007 at 6:35 pm keithbenjamin said:
October 26, 2007 at 6:35 pm
Thanks for your response, Paul.
Respectfully, I have not missed the point. Caring IS my point; caring not only for the health care needs of the patient but also for the needs of the customer.
Caring for the customer’s need to know all his options.
Caring for the customer’s need to feel like she has been part of the process.
Caring for the customer’s need to be treated with respect.
Caring for the customer’s desire to enjoy the experience (whenever practical).
(And for good measure, I’ll throw in caring for the health of the optical industry.)
This is caring with which customers are often treated. This is not often how patients are treated. I don’t need to dispense glasses to know this.
In most cases, the health care practitioner’s role stops at meeting the needs of the patient and does not include meeting the needs of the customer. This is why I advocate the abandonment of the word patient in favor of the word customer.
Furthermore, the business of health care is not what is wrong with health care. In fact, it is sadly what is missing from health care. Health care practitioners no longer compete in a free market. Health care choices have been taken from the hands of the patients and placed in the hands of third-party payers.
The patient mind set encourages people to abrogate responsibility for payment and treatment decisions to third-party payers. The third-party payers then in turn propagate the patient mind set; a feedback loop that continually takes more responsibility from the health care consumer and increases dependency on the third-party payer.
Great for the insurance companies.
Bad for the industry and the health care consumer.
If health care consumers thought of themselves as customers instead of patients they wouldn’t take it lying down.
Optical folks need to stop looking to the health care industry as a model for running their businesses and treating their customers, if they wish to succeed in the long run.
On November 28, 2007 at 2:12 pm Seeing Purple » ECP Mag Misses the Point said:
November 28, 2007 at 2:12 pm
[…] Magazine has published in this month’s issue a blog entry I made awhile back regarding my argument for use of the word customer over patient in optical. Paul King, an optician and column writer for ECP thinks I missed the key […]
On July 4, 2008 at 3:07 pm Seeing Purple » How Not to Run Your Optical Practice said:
July 4, 2008 at 3:07 pm
[…] answer is: the doctor’s time is more important than my own; the doctor is a “Doctor” and I am merely a patient not a customer. Customers aren’t made to wait, if they are, they usually just get up and […]