Why patients are not customers

It used to be that the person who seeks care from a doctor was called a patient.

The word?patient?originally meant 'one who suffers'. This English noun comes from the?Latin?word?patiens, the?present participle?of the?deponent verb,?patior, meaning 'I am suffering,' and akin to the?Greek?verb?π?σχειν?(paskhein, to suffer) and its cognate noun?π?θο??(pathos).

Now they are called partners, clients, guests, consumers, prosumers, or customers. Regardless of what you call them, most are suffering in an insufferable sick care system of systems.

Whichever you choose depends on how you define a "customer". For example, a person or organization that buys goods or services from a store or business focuses on the person who actually buys, not just chooses, the product. On the other hand, a person or thing of a specified kind that one has to deal with includes anyone who is part of the sick care system e.g. hospital decision makers, information technologists, clinicians, or others who influence the person who prescribes something or the ultimate payer.

Here are some other reasons why patients are not customers.

In his book?The Practice of Management, Peter Drucker declares there is only one purpose of a business:?to create a customer.

The kicker: it was published in?1993?1954. Nearly?20?60 years have passed, and it still seems many businesses are struggling to understand this fundamental concept.

A customer is defined as a person who?pays?a business for goods and services. If a person does not pay, they are not a customer. The nebulous term of “user” is assigned when a person is accessing goods and services without directly paying for them, like most patients. Call them a visitor, a prospect, a constituent, whatever you want. Until they pay you, they’re no customer of yours — and you have not fulfilled your purpose as a business. The purpose of a sick care business is not to create patients, but rather to care for them when they are suffering from something.

In fact, in the US sick care system of systems, there is one payer-we the taxpayers, either in the form of taxes, insurance premiums, foregone wages, or out of pocket payments. The middle people just redistribute the money and try to keep as much of it for themselves in the process.

In most instances, "patients" are in the latter category since, 8% of Americans are uninsured recognizing that being insured 1) does not equate to equitable access , and 2) does not mean the entire cost of care is paid by insurance since you have deductibles, copayments, and the costs of uncovered or out of network care.

Here's why we should not consider patients as customers:

1. They often don't have a choice where to get care
2. The term "customer" emphasizes the profit motive of medicine
3. The patient is not always right
4. Opaque pricing and lack of clear quality transparency precludes making an informed value-based decision
5. The business purpose of sick care is to get someone to buy something from you instead of your competition. Healthcare should be about not having to buy something because you have prevented illness.
6. Sick care marketing is different from other industries
7. How you define and measure patient engagement is different from other industries. Patient engagement should result in changed behavior, not the number of clicks on your website or likes on social media.
8. In many instances, in the face of a critical illness or emergency, patients and their families are so emotionally overwhelmed, they have no choice but to trust "the system", even recognizing the potentially catastrophic economic consequences.
9. Sick care is complicated, and marketers use words patients can't understand
10. Patients have low health and insurance IQs
11. Patients have demonstrated they are lousy consumers of care
12. There are no restrictions on advertising by physicians except those that can be specifically justified to protect the public from deceptive practices. A physician may publicize him or herself as a physician through any commercial publicity or other form of public communication (including any newspaper, magazine, telephone directory, radio, television, direct mail, or other advertising) provided that the communication shall not be misleading because of the omission of necessary material information, shall not contain any false or misleading statement, or shall not otherwise operate to deceive.?But when was the last time you saw your doctor hawking her femtech procedure on TV? Any thoughts why?
13. The power dynamic between the doctor and the patient is different from other consumer product transactions, particularly if you have a serious illness. In fact, most patients put their trust in the ability of their doctor to do the right thing after participating in shared decision making.
14. Words matter. What you call someone reflects your mindset, either positively or negatively
15. It is hypocritical for doctors to say, "it really doesn't make a difference what we call people we treat", and then bristly when someone calls them a "provider".

Retail is the sale of goods and services to consumers, in contrast to wholesaling, which is the sale of goods and services to business or institutional customers. As traditional retailers, like Amazon and Walmart, enter the sick care market, things get more muddied.

Here is another result of calling patients customers.

Here is how to practice retail medicine.

That said, patients and their doctors certainly want a better experience, and we should do what we can to provide it.

When I was practicing medicine, I never referred to someone who came to me for care as anything other than a patient, except the ones who were "tough customers". Now that I practice physician entrepreneurship, I don't plan to change that.

Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs on Substack