Consumers vs. patients: How healthcare leaders talk about the people they treat

Healthcare is no longer a simple binary relationship between a patient and a clinician. As providers shift how they deliver care to encompass more opportunities for value and quality, those receiving care are expected to become more involved and engaged.

Healthcare terminology is also evolving to reflect these changing dynamics. The term "patient" doesn't adequately encompass the spectrum of activities through which an individual interacts with the healthcare system.

To address the changing dynamic, the industry has started to call these individuals consumers to reflect the push toward empowerment and control in making healthcare decisions.

And, while the terms "patients" and "consumers" are now most widely used, new labels are entering the healthcare lexicon, referring to such individuals as customers, or even referring to the delivery system as "person-centered" opposed to patient-centered.

Here, healthcare leaders share their thoughts on the terminology and how they refer to the individuals they treat, serve or inform.

Note: Answers have been edited for length and clarity.

Jan OldenburgJan Oldenburg, senior manager at EY and vice chair of the HIMSS Connected Patient Committee: "Coming from the patient empowerment movement, one of the problems with 'patient' is in its very nature it implies a subordinate role, that of a person who needs to be taken care of as opposed to having autonomy. It's probably true that at the time you are hospitalized, you perhaps have the least autonomy of any time in your life, but at the same time, people still have agency, preferences and needs in that setting that are not always the same as those assumed by the hospital or caregiver.

I tend to use the term customers, and that's what I've heard used more frequently in healthcare, rather than consumers. While the term consumers does get used occasionally in the healthcare space, I think there's a lot more sensitivity about it because it implies that the relationship is just about the money rather than the organizational mission.

One of the things carried by the 'customer' term [is] ideally it's a negotiation. It's a partnership where the customers' needs, wants, desires and concerns are reflected as well as the best judgment of the physicians, nurses and staff who are trying to do the right thing for the person's health."

Nancy.HughesNancy Hughes, vice president of communications and marketing, National Health Council: "It has to do with your focus, your perception of the individual. We [the National Health Council] represent people with chronic diseases and disabilities….For that reason, we see patients as people who rely on the healthcare system to live longer, better lives. They are dependent on the healthcare system after they're diagnosed. A consumer, on the other hand, is someone who can jump in and out of the healthcare system as needed. That said, we also like to talk about patients as people rather than trying to apply a label to them."

dr. deane waldmanDeane Waldman, MD, board member of New Mexico Health Insurance Exchange, professor of pediatrics, pathology and decision science at the University of New Mexico in Albuquerque: "They are most definitely both consumer and patient, but with an emphasis on the latter, for two reasons. Of course patients 'consume' care services and goods, but how a provider treats a patient is different than a consumer of, say, coffee or a car buyer. For the provider as opposed to the salesperson, the patient's welfare comes before all things from money to the provider's own comfort.

'Consumer' implies a one-way interaction, just like 'delivery' of healthcare. The provider 'delivers' and the patient consumes, but that is not the best way to heal a patient. The proper and best relationship is a two-way interaction: The doctor helps the patient and the patient helps the patient, accepting responsibility for his or her own good health. The issue of personal responsibility is vital and yet has been lost in the entitlement mentality.

Good doctors are not delivery persons: They are therapeutic partners. That only happens with patients, not with consumers."

dr. ben tichoBenjamin Ticho, MD, ophthalmologist, Advocate Christ Medical Center (Oak Lawn, Ill.): "I would make the case to retain the word 'patients.' Consumers 'consume' resources, as do patients. Consumers are sensitive to and entitled to good service, as are patients. Consumers and patients each have provider options and make choices regarding where and how to spend. But the medical mission of the hospital demands that administrators, providers and each employee remember the unique nature of being a patient.

Patients are dependent and vulnerable in a way that consumers are not. Patients need advocates in a way that consumers do not. To categorize patients as consumers allows or even encourages an economic perspective, which inevitably will distort and compromise patient care. And if patient care is compromised, the hospital business model will ultimately suffer."

Michael McCoyMichael McCoy, MD, Chief Health Information Officer, Office of the National Coordinator for Health IT: "I hate the word 'consumer' and I hate the word 'patient.' It's a person. It's an individual. The individual could be the person receiving care or it could be the person who's caring for someone receiving care. Consumer means you're buying something, but I don't necessarily want to buy health; I want to have good health. From an individual- or person-centric perspective, that's the frame."

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