Client vs Patient

[srercg]

I have to say this is my pet peeve! I absolutely hate it when they call patients "client" - can NOT STAND IT.

I got out of sales because I hated the greed, and the corporate feel.

Now there is a push somewhere - not sure where its coming from to call patients, "client". Client is a BUSINESS term. It is indicative of someone you have a FINANCIAL contract with. Attorney -CLIENT relationship. Realtor -CLIENT relationship.

I know hospitals charge money for their services, but in a MEDICAL setting - these people should not be called CLIENTS. These are PATIENTS - people who are sick, have an ailment, and are coming for MEDICAL attention.

Calling them CLIENT is a COLD term that ignores their reason for needing medical attention.

I see this on NCLEX questions, and study books as well - calling the patient CLIENT instead of PATIENT.

They are PATIENTS. Grrrrr

[djh123]

Thank you. I too hate 'client'. And many other words, terms, slang, etc. today - but that's another topic. :^)

[James W.]

One hilarious euphemism in the local neck of the woods is..

Mental Health Consumer. To replace the - 'unpleasant' term - Mental Patient.

I suggested that if the patient had was a 'mental health consumer' already,

& was in difficulty '- would the next step be Tx Addict?

I certainly regard the term 'client' for those forced by state sanction

- to receive compulsory Tx, as plainly wrong.

After all, are we clients, or subjects - of the BON?

[Ladyscrubs]

Last night I took care of 2 sufferers, 1 invalid, 1 tedious, bromidic, victim due to a life time of gluttony, and 1 dyspenic, discombobulated, malodorous, coxcomb. They consumed my time, drained my energy, tried my patience, and tested my faith. Not one of them was a client, or even a consumer, because not one of them could or was in the position to make any decision about their care or treatment at that time.

No matter who they are or how I just described them, I gave care to five patients. I attempted and I hope I succeeded in relieving their suffering and making them feel a little bit better.

My patients are sufferers, and I am obligated to help them, and when necessary, to put their needs above my own. If they are a client—they wait their turn.

[cjcsoon2bnp, MSN, RN, NP]

I have never been a big fan of the term "client" versus "patient" personally but I could see why some people might like it or how it might be more appropriate in certain care settings (such as home health or private duty nursing).

!Chris

[nursel56]

I've been a nurse for 17 years. This is not a new "push" or trend.

I agree. As I recall, the idea was not so much to level a imbalanced power relationship but sort of a reverse psychology to convey the idea that the patient will somehow be more invested in the plan of treatment if they view themselves as a client, or as it's said, "compliant", but that term is now verboten as well, I think.

I do hear the word client quite a bit in private duty/homecare, but I've never encountered an issue where someone's documentation was unacceptable based on that alone.

[Shayli80]

i agree, it makes the patient feel uncomfortable.I have been working in Community Nursing now for the last 15 yrs....still call my "clients" patients,which they are,They are elderly sick,often,frail people,but they are still my patients....I am very old school(54 yrs now).

[CKPM2RN, ASN, EMT-P]

Worse, we are supposed to call them "customers". Idiotic.

[Spidey's mom, ADN, BSN, RN]

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

That's what I learned as well.

But still . . . they are my patients. I too hate the word client.

When I have hospice patients in LTC I still say "patient" even though the LTC nurses say "resident".

I'm just a rebel that way . . .

[srercg]

my use of words was not meant to be taken that literally. I in no way was talking about "power". I am referring more toward the comment someone else made here - the term "client" is what started the "satisfaction survey" push etc.

Patient =sick person in need of medical attention INVOLUNTARILY -due to illness, check up, etc, but necessarily. People don't WANT to go to the doctor -EVER. Even for a check up - that's required by insurance co's now or employers even. (I know not always -don't have to point it out) This is an expense they would rather NOT have to pay for, and often feel why should they - its not their fault they are sick.

Client /Customer - someone coming in to make a purchase or sign an agreement for goods/services. Often this is done by CHOICE. However, if they are not satisfied with the product or service, they often are allowed to RETURN IT, cancel the contract, or take other avenues. Other avenues being LAWSUITS. complaints about the good/services.

NOW - the push for health care organizations to use more of a business model - is trying to also turn nurses and doctors into "sales people". Smile and greet your customer, kiss their feet, and make sure you get good customer satisfaction surveys or else. So, in effort to build this new model - they want to push the term "client/customer" into health care.

by opening the door to make them "clients" they are also setting up the expectation that they can complain about the services and get free stuff, or get out of paying, or return something, or cancel their contract. We are opening the door for lawsuit happy people.

health care orgs - think this is a good way to measure themselves against their competitors - things they can use in marketing and advertising - numbers they can brag about - and customer satisfaction surveys will give them that, PLUS they will have a "paper trail" they can use against employees when needed as well. However - they are forgetting about the flip side of a patient becoming a "customer" - i.e. what I mentioned above - returns, complaints, lawsuits, freebies - and if its a "freebie" related to a complaint - proving the health care org didn't do something right according to whatever promise they've made -not only are they out the money -BUT they can no longer get this back from gov funding, insurance, or other methods they traditionally have in the past.

As patients - they don't think in those terms. They are happy to be taken care of, and they trust the judgment of the medical professionals. As clients, they are opting to be taken care of, and if they don't like the service, they won't pay, and feel free to second guess, and distrust medical professionals making our job even harder

I think its tacky. I think we are turning the long honored tradition of what it is to be a nurse, into making them nothing more than a used car salesman.

I do not think health care professionals should be treated like sales people - and I never want to be put in that position of constantly worrying if my patient is going to make a bad review if I make them upset - which is easy to do - especially if you don't get them their pain meds (lol).

We have to be able to maintain a certain amount of control of the situation - absolutely - because we have to use our nurses judgment to protect both the patient, and our licenses - in lieu of what many patients would often choose for themselves which may not be the right thing - hence the reason they are there in the first place.

Allowing health care orgs to create this business/client relationship, and involve licensed medical professionals - puts their licenses on the line. And, the further down the road it goes - true to most other businesses, the health care org will protect themselves and sacrifice an individuals license any day of the week should the occasion arise. That is why it is so important to not let this "client" atmosphere take over the way we do things. We won't be able to steer the ship the other way in time.

Nurses can not be put in the position of salesperson/client. We are nurse/patient. Period.

[Elvish, BSN, DNP, RN, NP]

All through undergrad (17+ years ago) they were clients. Now that I'm in NP school they are called (thank God) patients.

[nursel56]

srercg, I believe the majority of us understand exactly what you're talking about. Nursing, like schools in general are subject to trying out the latest theory in real life, and subsequently dropped when they get a lot of negative feedback or people entering the field begin to ask "why are you doing that?" If nobody can come up with an answer that makes sense, it will eventually fade away.

The patient as a customer idea really bugs me, because I'm old school and like my nurses to be bossy (within reason, and not synonymous with "bully" ). A customer sends their meal back to the kitchen if it's not to their liking. When that is applied to nursing, it's a dilemma. I don't want a family to complain to management because I was mean to their dad, when I didn't say pretty please and offer to fluff the pillows instead of adding a little authority to that tone when it's time to get up and walk.

[Anonymous865]

my use of words was not meant to be taken that literally. I in no way was talking about "power". I am referring more toward the comment someone else made here - the term "client" is what started the "satisfaction survey" push etc.

Patient =sick person in need of medical attention INVOLUNTARILY -due to illness, check up, etc, but necessarily. People don't WANT to go to the doctor -EVER. Even for a check up - that's required by insurance co's now or employers even. (I know not always -don't have to point it out) This is an expense they would rather NOT have to pay for, and often feel why should they - its not their fault they are sick.

Client /Customer - someone coming in to make a purchase or sign an agreement for goods/services. Often this is done by CHOICE. However, if they are not satisfied with the product or service, they often are allowed to RETURN IT, cancel the contract, or take other avenues. Other avenues being LAWSUITS. complaints about the good/services.

NOW - the push for health care organizations to use more of a business model - is trying to also turn nurses and doctors into "sales people". Smile and greet your customer, kiss their feet, and make sure you get good customer satisfaction surveys or else. So, in effort to build this new model - they want to push the term "client/customer" into health care.

by opening the door to make them "clients" they are also setting up the expectation that they can complain about the services and get free stuff, or get out of paying, or return something, or cancel their contract. We are opening the door for lawsuit happy people.

health care orgs - think this is a good way to measure themselves against their competitors - things they can use in marketing and advertising - numbers they can brag about - and customer satisfaction surveys will give them that, PLUS they will have a "paper trail" they can use against employees when needed as well. However - they are forgetting about the flip side of a patient becoming a "customer" - i.e. what I mentioned above - returns, complaints, lawsuits, freebies - and if its a "freebie" related to a complaint - proving the health care org didn't do something right according to whatever promise they've made -not only are they out the money -BUT they can no longer get this back from gov funding, insurance, or other methods they traditionally have in the past.

As patients - they don't think in those terms. They are happy to be taken care of, and they trust the judgment of the medical professionals. As clients, they are opting to be taken care of, and if they don't like the service, they won't pay, and feel free to second guess, and distrust medical professionals making our job even harder

I think its tacky. I think we are turning the long honored tradition of what it is to be a nurse, into making them nothing more than a used car salesman.

I do not think health care professionals should be treated like sales people - and I never want to be put in that position of constantly worrying if my patient is going to make a bad review if I make them upset - which is easy to do - especially if you don't get them their pain meds (lol).

We have to be able to maintain a certain amount of control of the situation - absolutely - because we have to use our nurses judgment to protect both the patient, and our licenses - in lieu of what many patients would often choose for themselves which may not be the right thing - hence the reason they are there in the first place.

Allowing health care orgs to create this business/client relationship, and involve licensed medical professionals - puts their licenses on the line. And, the further down the road it goes - true to most other businesses, the health care org will protect themselves and sacrifice an individuals license any day of the week should the occasion arise. That is why it is so important to not let this "client" atmosphere take over the way we do things. We won't be able to steer the ship the other way in time.

Nurses can not be put in the position of salesperson/client. We are nurse/patient. Period.

If you want to argue that you don't like the way calling a patient a client/customer makes you feel about the relationship, that is a valid argument.

It sounds like you are arguing that by calling a patient a client/customer, you make them aware that they are a client/customer. I don't think that is a valid argument. Being asked to pay for services before they are even treated, makes them very aware that they are in fact a customer.

The push to control rising insurance premiums by increasing the deductible, co-pay, and out-of-pocket maximum is also making people aware that they are paying customers.

You are also arguing that calling the patient a client/customer opens the door for "lawsuit happy people." Other service industries refer to the people paying them for services as clients or customer, yet they are sued much, much less than the healthcare industry. The healthcare industry has always referred to the people paying for their professional services as patients, yet it is probably the most sued industry. I don't see how calling patients clients/customers will make that worse.

The satisfaction survey push was not started by healthcare organizations. It was started by the Centers for Medicare and Medicaid Services to enable healthcare consumers to make informed decisions about where they get healthcare services. It was seen as a way to control healthcare costs while improving healthcare services. CMS publishes not only how well a hospital does on the survey, but also how well the hospital compares to other similar organizations on CAUTI, CLABSI, SSI, readmission rates, etc. The goal was to allow an apples-to-apples comparison.

You also argue that healthcare professionals should not be treated like sales people, because you don't want to worry constantly that you will receive a bad review. Hospitals and physicians were reviewed long before surveys and the practice of referring to patients as customers/clients. It was just more informal. Patients told their relatives and friends about the horrible hospital or the fantastic physician. Social media made it even easier to tell more people what they thought of a hospital/physician/nurse. Physicians in private practice have long been aware that building a practice depends largely on word-of-mouth.

You also argue against allowing healthcare orgs creating a business/client relationship and involving licensed medical professionals. The minute a licensed medical professional accepts money for the service they provide, they have voluntarily entered into a business relationship.

I would accept the argument that a licensed medical professional has both a business relationship and an ethical relationship of beneficience and non-malfeasance. As long as you are accepting payment for professional services you cannot argue that you do not have a business relationship.