Medical Patients as Consumers

One current controversy in medical management is whether our patients are, well, patients or customers. I think this dichotomy is reflective of the delicate balancing act facing today's physician. On one hand, physicians have always cared for their patients as people rather than a simple business transaction, and on the other hand, medicine is increasingly becoming a business.

My personal preference is that my own physician considers me a patient before she considers me a customer. Being her patient implies a level of compassion and professionalism that being her customer does not. That said, I do evaluate her medical practice much like I evaluate other businesses. Is it easy to get someone on the phone when I call? How well are my concerns addressed? Do I get a good value for the time and money I spend? Are the staff friendly?

Recently, I wrote a blog that discussed the importance of customer service. Gone are the days when our patients are satisfied to wait for three hours to see a physician. No longer is our educated opinion taken on face value. While our profession remains respected, there is an element of questioning and evaluating what we recommend that is new and is growing. This feels similar to the manner in which I interact with my landscaper. I listen to his advice, but as the customer, if I want a certain flower planted instead of another, the landscaper will honor our business arrangement and plant what I want. The same is not and cannot be true of medicine.

Our medical organization has become increasingly reliant on customer satisfaction surveys with the implied expectation that every patient is satisfied every time. Physicians and other clinicians recognize that this will never come to pass. Our medical professionalism mandates that we speak hard truths, confront addictions, deliver bad news, call out obesity when we see it, and counsel people to stop engaging in dangerous or unhealthy habits. While we need to strive to do all these tasks with the utmost compassion and respect for our patients, it is unlikely that every patient will accept these exhortations with gratitude or acceptance.

Our health care system faces financial crisis and collapse. It is increasingly difficult for everyone ― government, employer, or individual ― to afford what we offer, yet the expectation remains that every patient gets every benefit every time. While the financial aspects of medicine are demanding an increasingly larger focus in our practices, it is no wonder that the business transactions inherent in providing care to patients assume an equally large role. That said, the best part of medicine is the part in which we treat a patient like a patient, not a customer.

Medicine remains, in my mind, a profession, a calling that compels me to offer much more than a purchased product to my patients. And that is still how I see them ― as my patients.