What's in a Name?

In recent years, a debate has emerged regarding what we as psychiatrists, psychologists, social workers, and counselors should call those who seek our services.  While the term “patient” had logical linguistic origins (derived from the Latin word, patiens, meaning one who suffers) and therefore sufficed without question heretofore, it now seems to be rejected by some because it somehow connotes the idea of one who assumes a demeaning submissiveness to a dominating medical authority.  This perception appears to have started in the mental health arena... understandably so, considering the years of mistreatment many experienced at the hands of a draconian state hospital system. With that in mind, a new title apparently had to be created in order to overcome those painful memories, and we’ve seen several over the years, none of which appear to be universally satisfying to those seeking a change of terminology.

  
Not long ago, I attended a "behavioral health summit", a rather lofty title assigned by the hosting policymakers, in which this and other controversial topics were addressed in a panel discussion.  Most of the panel members were administrative types. Others included so-called "stakeholders", "consumer advocates" and "psychiatric survivors".  To my knowledge, none were current patients. The audience consisted primarily of mental health professionals. The overall tone of the panel was politically charged, rancorous and condescending. Minimal time was allotted for a question and answer period at the conclusion of the presentation. Clearly, there was never any interest nor intention by the organizers to foster a healthy dialogue. 


Isn't it fascinating that it's typically the enlightened bureaucrats and their minions who inflame, if not instigate, rather than resolve such disputations? Ironically, though not surprisingly, they are the outsiders in this instance, yet presume to know and arrogantly decide what to label the actual participants in these relationships!

 

Quite frankly, it’s never been an issue with the thousands of “patients” I’ve had the pleasure of serving for over 30 years. (Yes, I still prefer that term because it represents a sacred trust by Hippocratic oath I swore to uphold... “The health of my patient will be my first consideration.”)  Simply stated, I call them by their personal names, and the only question I have is whether they prefer me to address them by their first, last or other names...no different than how I would engage in conversation with any other person upon first meeting. 

   
What really matters, in my humble opinion, is how we treat people during our therapeutic encounters, and not how we technically refer to them in policy manuals.  If some of our misguided predecessors (and regrettably, some of our colleagues still practicing)  had respected our patients as suffering individuals in need of compassion, comfort, and guidance, rather than as wild animals or in some other dehumanizing way, I don’t think this semantical argument would have ever begun.  Unfortunately, changing the time-honored and appropriate designation of “patient” to “consumer” or “customer” really misses the point and will not empower those so named to affect sincere attitudinal change of those who treat them. On the flip side, passive practitioners, who don't seem to mind being rebranded as "service providers" by the authorities (add insurance companies to that list) run the risk of denigrating and abrogating their professional responsibilities to their patients...or has that already happened??


Final thought...Perhaps we would all be better served by burying the hatchet and honestly examining the real issue underlying this apparent conundrum; that is, our own identities!  Speaking for myself, as both a provider and recipient in various capacities, I have always considered myself as a physician first while acting in the provider role.  As a recipient, however, my orientation has been based on my particular need, which I will candidly summarize as follows:


  1. When I'm ailing, I visit my doctor.  
  2. When I'm seeking advice, I meet with my accountant or attorney.  
  3. And when I'm consuming, I turn to my refrigerator.


Scott Zentner

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