Client vs Patient

amoLucia · May 18, 2016

I need to clarify my statement re nsg knowledge of healthcare financing. The upper echelon nsg - the CNOs and VPs of Clinical Services with their MBAs and MHAs do know & understand the financials. But it took me (as a line staff nurse in HOME CARE) quite some time to begin to see the dollar signs.

Just the monies wasted in pharmaceuticals and supplies alone blow me away.

So 'client' is a two-edge sword for me.

Anonymous865 · May 18, 2016

totally can see in home health care that they don't want to be called "patients" and on one side you want to make them happy BUT on the other side - to me anyway - that is the first step toward them running the show, which is their goal. As nurses we allow autonomy and respect that - but in some cases this is just the patients way of keeping control of everything you do, and reserving the right to say you did it wrong so you they don't have to pay you if they have a "complaint" - its like smoking is the gateway drug -= calling the patient "client" is the gateway to making nursing like shopping at the store.

Nurses do not "allow autonomy." Patients/clients/customers have a legal right to autonomy.

Patients are clients and customers. A client or a customer is someone who is paying for goods or services. In this case the client is paying for your professional services. The hospital would not provide medical services to the individual without the expectation of payment. As a nurse you would not be starting an IV, doing an assessment, etc. if you were not being paid. That makes these patients clients and customers.

Patients/clients/customers aren't running the show, but neither are the doctors or nurses. Patients/clients/customers are equal members of the health care team. The nurse/doctor cannot do anything without the consent of the patient/client/customer. The nurse cannot give a drug without an order from a provider. The nurse cannot implement a nursing intervention without the consent of the patient. The patient can't get a prescription drug without an order from a provider. The patient is dependant on the nurse for her/his knowledge and skills. A provider cannot force a nurse to give a drug that the nurse judges is inappropriate. A patient cannot force a nurse to perform an intervention the nurses judges is inappropriate.

NO ONE holds all the power.

Client may seem like a cold term to you. To others calling someone a patient is akin to you trying to assert power over the individual.

Regarding Attorney/Client relationship - An attorney does have a finanacial relationship with a client, but so does a physician or nurse. An attorney has an ethical and legal responsibility to act in the best interests of his client just like a physician or nurse.

INN_777, BSN, RN · May 19, 2016

I have, actually, given this quite a bit of thought over time. I don't like either term. As someone whose first career was business, I hate CLIENT. I think this represents the relationship as transactional and it is absolutely not. On the other hand, not a huge fan of PATIENT either because it sounds too dis-empowered. We are educating patients, honoring their choices etc, so they are partners in their treatment, not PATIENTS. That said, I don't have a better term, so since I have to choose, I choose PATIENTS.

RNperdiem, RN · May 19, 2016

Once, long ago someone here broke the nomenclature down for me.

Client = outpatient, home health, clinic

Patient = inpatients in hospitals

Resident= residential long term care

NotYourMamasRN · May 19, 2016

I think this would make a fabulous concept analysis. This is a perfect example of how no true definition or agreed upon context exists to the body of nursing for what constitutes 'patient' or 'client'. We all may have different feelings or ideas on the subject, but I wonder what theory says about it. Good food for thought, for me! Thank you!

Pangea Reunited, ASN, RN · May 19, 2016

I don't like the word "client" for the simple fact that so many people pay nothing for their own healthcare. I'd feel like I was giving them undue credit if I used it.

A&Ox6, MSN, RN · May 19, 2016

Once, long ago someone here broke the nomenclature down for me.
Client = outpatient, home health, clinic
Patient = inpatients in hospitals
Resident= residential long term care

I also heard this with the addition of

Consumer = MRDD, congregate housing, supportive housing and services

Anonymous865 · May 19, 2016

I don't like the word "client" for the simple fact that so many people pay nothing for their own healthcare. I'd feel like I was giving them undue credit if I used it.

The vast majority of people do pay for their own healthcare.

According to the US Census as of 2013 16.4% of the US population were covered by Medicaid

15.7% were covered by Medicare

Everyone else is either paying out-of-pocket or covered by insurance.

People covered by Medicare paid for their healthcare through medicare taxes for over 40 years and continue to pay taxes.

People who are covered by insurance paid for their insurance, so they paid for their healthcare through their insurance premiums.

You could argue that people covered by medicaid don't pay for their care. That still leaves 83% of the population paying for their health care.

Medicare and Medicaid, Age and Income | Random Samplings

OldDude · May 19, 2016

I don't like the word "client" for the simple fact that so many people pay nothing for their own healthcare. I'd feel like I was giving them undue credit if I used it.

This is what I'm talking about...I'm paying more for you to receive medical care at this facility than you are, which is nothing, and I'm expected to refer to you as a client?????

Pangea Reunited, ASN, RN · May 19, 2016

The vast majority of people do pay for their own healthcare.
According to the US Census as of 2013 16.4% of the US population were covered by Medicaid
15.7% were covered by Medicare
Everyone else is either paying out-of-pocket or covered by insurance.
People covered by Medicare paid for their healthcare through medicare taxes for over 40 years and continue to pay taxes.
People who are covered by insurance paid for their insurance, so they paid for their healthcare through their insurance premiums.
You could argue that people covered by medicaid don't pay for their care. That still leaves 83% of the population paying for their health care.
Medicare and Medicaid, Age and Income | Random Samplings

I would imagine those percentages vary greatly by hospital/region/unit, etc. I would bet my life that nowhere near 83% of the patients I work with are paying for anything.

OldDude · May 19, 2016

The vast majority of people do pay for their own healthcare.
According to the US Census as of 2013 16.4% of the US population were covered by Medicaid
15.7% were covered by Medicare
Everyone else is either paying out-of-pocket or covered by insurance.
People covered by Medicare paid for their healthcare through medicare taxes for over 40 years and continue to pay taxes.
People who are covered by insurance paid for their insurance, so they paid for their healthcare through their insurance premiums.
You could argue that people covered by medicaid don't pay for their care. That still leaves 83% of the population paying for their health care.
Medicare and Medicaid, Age and Income | Random Samplings

Haha...take another drink of the koolaid...our local pedi hospital get 96% of it's income from medicaid...

Anonymous865 · May 19, 2016

I would imagine those percentages vary greatly by hospital/region/unit, etc. I would bet my life that nowhere near 83% of the patients I work with are paying for anything.

I'm sure that you are correct. Areas with more unemployed or under employed people will have more people on medicaid. Public / safety net hospitals will get more medicaid patients. Some states are more generous on who they give medicaid to.

The numbers I provided are national.