May 5, 2015

Are Patients Customers or Not?

I thought I knew the answer and had settled for myself that a patient is a patient, is a patient. However, some that are also declaring that patients are not customers are doing an excellent task of making me doubt myself.

The definition used for customer is a person or entity that obtains a service or product from another person or entity in exchange for money. Customers can buy either goods or services. The stickler (any puzzling or difficult problem) is that health care is classified by the government as a service industry because is provides an intangible thing rather than an actual thing.

Here is why the patient shouldn’t be considered a customer, at least not in the business sense.

#1. Patients are not on vacation. They are not in the mindset that they are sitting in the doctor's office or the hospital to have a good time. They are not relaxed; they have not left their troubles temporarily behind them. They have not bought room service and a massage. They are not in the mood to be happy. They would rather not be requiring the service they are requesting.

#2. Patients have not chosen to buy the service. Patients have been forced to seek the service, in most cases. Whether the quality of service is excellent or poor, often the patient has to accept what is provided.

#3. Patients are not paying for the service. At least not directly. And they have no idea what the price is anyway. This is where the insurance industry and the health care industry are in collusion to hide information from patients.

#4. Patients are not buying a product from which they can demand a positive outcome. Sometimes the result of the service is still illness and/or death. This does not mean the service provided was not a good one. Yet many doctors and hospitals insist that they did nothing wrong, when in fact, the service was loaded with errors and adverse events.

#5. The patient is not always right. A patient cannot, or should not, go to a doctor or hospital demanding certain things. They should demand good care, but that care might mean denying the patient what the patient thinks he or she needs. The doctor is not a servant, the doctor or hospital does not have to do everything the patient wants. The doctor or hospital is only obligated to do everything the patient needs.

#6. Patient satisfaction does not always correlate with the quality of the product or the quality of care. A patient who is given antibiotics for a cold is very satisfied, but has gotten poor quality care. A patient who gets a knee scope for knee pain might also be very satisfied, despite the fact that such surgery has been shown to have little actual benefit in many types of knee pain.

Hospitals are presently promoting (not focusing) what they call “patient centered” care. Some doctors are doing the same and the result is anything but patient centered. It is profit centered and promotes what the hospital and the doctors want, not what the patient needs in most cases. It involves unnecessary tests and procedures which often results in harm to patients. The hospitals and doctors make everything sound rosy and great, but everything is done to satisfy hospital dollar needs.

This is one reason not to use the term customer but keep the term patient, as the patient needs the service. They don't need the service often demanded by many doctors and hospitals, but they still need health care. While health care workers and providers are exposed to all the human foibles of temperament, background, values, and expectations, the patient needs health care, but does so under duress and health needs, often to remain alive.

If doctors and hospitals would treat patients with care and respect instead of with dollar signs the patient represents, doctors and hospitals would not need to constantly be inventing new terms to describe patients and confuse issues.

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