Doctor and Patient or Provider and Consumer?

The two physician-authors, Pamela Hartzband and Jerome Groopman, do not wish to be called “providers,” thankyouverymuch. Nor do they want their patients to be called “customers” or “consumers.” Instead they prefer specific job titles: doctors, nurses, physical therapists, etc., to describe specialized medical professionals.

The root of the new vocabulary, as they see it, is a focus on the industrialization and standardization of medical care in the pursuit of cost control. They write:

The relationships between doctors, nurses, or any other medical professionals and the patients they care for are now cast primarily in terms of a commercial transaction. The consumer or customer is the buyer and the provider is the vendor or seller. To be sure, there is a financial aspect to clinical care. But that is only a small part of a much larger whole, and to people who are sick, it’s the least important part.

(We’ve seen this debate before, specifically with regard to high-deductible health policies and other proposals that urge making patients into more cost-conscious consumers of health care.)

Groopman and Hartzband — here’s a review by the WSJ’s Laura Landro of the most recent book they wrote together — also mourn the replacement of “clinical judgment” with “evidence-based practice” in the medical nomenclature. Data, on its own, will never indicate one clear way to proceed even with many common conditions or diseases, they say.

To wit: conflicting guidelines over things like prostate-cancer screening, even when everyone is looking at the same studies.

“When we ourselves are ill, we want someone to care about us as people, not as paying customers, and to individualize our treatment according to our values,” they write. To that end, they urge a return to “doctor,” “nurse” and “patient.”

Readers, do you agree?