Monday, March 13, 2006

Shrinkwrapped has thoughts on why those of us in the mental health field are supposed to call our patients "clients" instead of "patients." Go take a look.

Update: So from the comments thus far, we have differing opinions as to whether readers wish to be called clients or patients--personally, I don't give a damn so long as my doctor treats me with respect and is competent. That is what I do for my patients--uh...clients, or whatever. What do you think?

Update II: Ice Scribe has some more thoughts on doctors being called "providers."

40 Comments:

Blogger Dr. Deborah Serani said...

I see "patients", not "clients". I don't see the term "patient" as perjorative, but rather indicative of the healing relationship.

8:29 PM, March 13, 2006  
Blogger Maj.BertramPudgeman said...

How about all medical professionals (and their snarky support staffs) adopting the term customer? I would much rather be in that relationship than the usual "you have entered the realm of minor deities in white coats. Be grateful we even deign to gaze upon you for you are a simple supplicant."

8:11 AM, March 14, 2006  
Anonymous Anonymous said...

It's not just in the mental health field. Nurses are routinely expected to refer to "patients" as "clients" and for the same "empowerment" reasons. Interestingly, no one has asked the patients what they would like to be called – it’s just assumed they would prefer “client”. In my experience they don’t. Client evokes too much of a business atmosphere and they prefer a term which denotes a more caring relationship – patient.

10:53 AM, March 14, 2006  
Anonymous Ice Scribe said...

You're behind the times, Dr. Helen: it's not "doctor" anymore, it's "provider". And the patient is "client". Transform it into a regular old business relationship instead of something personal and sacred and it's a heck of a lot easier to control...

12:58 PM, March 14, 2006  
Blogger gs said...

I have no strong preference either way. As long as you don't call me a specimen, we're fine.

1:56 PM, March 14, 2006  
Anonymous Alan said...

Wow. Thanks for the link to Shrinkwrapped. It is an interesting blog -- both because of its insights and its self-indulgences.

I think he often is exactly right with his psychoanalytical evaluations -- as far as he takes them. What I find even more interesting, however, is Shrinkwrapped's apparent inability to take his analysis beyond the point that it would interfere with his clear Right-Wing views.

It's too bad -- he sabotages the impact of his often useful observations about Left-Wing ideology by using them to promote an apparently unthinking acceptance of Right-Wing ideology. It would be great if he was willing or able to apply the same insight to both sides of the political fence.

3:20 PM, March 14, 2006  
Blogger Helen said...

Alan,

Newsflash, these are personal blogs we are writing on--why do you insist that everyone be "neutral" i.e. left wing on our personal blogs? If you want this type of chatter, turn on all media except Fox news and Rush Limbaugh and satisfy your urge for your daily dose of liberal ideology but please do not keep coming by insisting that bloggers write about what interests you. Do you pester the MSM with applying more insight to "both sides of the political fence?" I doubt it.

3:31 PM, March 14, 2006  
Anonymous Anonymous said...

I see patients. Hookers have customers and clients. OK, it is just a joke! Since I see some TennCare patients, the analogy does not hold up under scrutiny.

I see patients because I ascribe to the medical model of care and expertise. Not that I am an expert in what my patients should do, but I am an expert in how they might accomplish their goals, how I might help, and things concerning human change. There is a bit of the sacred in the term patient, it evokes trusted care. Client is an economic term. Since I see my patients as brave people struggling with difficult changes, I do them the honor of calling them patients. And I honor my approach to them as well.

I do some work as a photographer. They are clients. I do a job. As a psychologist, as a therapist, I have some sacred responsibility and the term patient honors that.

And it is not a power trip issue either. The people that work for me call me Dr. Monroe. The patients I work for call me Trey.

Trey

4:04 PM, March 14, 2006  
Anonymous Anonymous said...

I see patients. Hookers have customers and clients. OK, it is just a joke! Since I see some TennCare patients, the analogy does not hold up under scrutiny.

I see patients because I ascribe to the medical model of care and expertise. Not that I am an expert in what my patients should do, but I am an expert in how they might accomplish their goals, how I might help, and things concerning human change. There is a bit of the sacred in the term patient, it evokes trusted care. Client is an economic term. Since I see my patients as brave people struggling with difficult changes, I do them the honor of calling them patients. And I honor my approach to them as well.

I do some work as a photographer. They are clients. I do a job. As a psychologist, as a therapist, I have some sacred responsibility and the term patient honors that.

And it is not a power trip issue either. The people that work for me call me Dr. Monroe. The patients I work for call me Trey.

Trey

4:04 PM, March 14, 2006  
Blogger Dr. Sanity said...

I hated it when the community mental health organization I work for insisted that our patients were now "clients". Even worse, they changed "community mental health" to "community support and treatment services". Thus expurgating all aspects of mental health and patienthood so people feel "empowered". I suspect it only encourages more of a sense of entitlement rather than empowerment.

4:21 PM, March 14, 2006  
Anonymous Alan said...

Helen says:

Newsflash, these are personal blogs we are writing on--why do you insist that everyone be "neutral" i.e. left wing on our personal blogs?

First of all, I hardly come here expecting a Left-wing viewpoint (nor do I think that comparatively self-assured Left Wing views would in any fashion be "neutral"). But, what I do hope for is something insightful and compelling whose arguments do not seem based upon a priori assumptions that a particular ideological viewpoint is correct. Basically, I want to see some compelling argument that has the potential to broaden and even alter my own views – all the more so given my own interest in psychology.

What I would hope to see is material with a particular point-of-view that proceeds from the attitude that it still has to prove its case and therefore takes the time to do so. Likewise, I’d like to see those arguments built upon a foundation of fact and reasoned argument. What immediately causes me to doubt or even discount a post is when it goes for easy victories based on some combination of convenient assumption, logical fallacy, and demonizing. The more blogs become so transparently one-sided they more they sabotage their own efforts by taking what are otherwise potentially insightful and useful observations and dressing them up as ideological propaganda.

To put it another way, it makes the posts look like prime examples of psychological compensation, ways to inflate the egos of the "faithful" at the cost of demonizing perceived ideological enemies. It may make the average “believer” feel better about him or herself, but it will turn-off everyone else – in this case most especially those on the Left who will see the posts in question as just confirming their worst fears about the Right.

Basically, it comes down to perceived objectivity. It doesn’t matter what the author believes or how strongly, if the reader thinks the writer retains enough objectivity to treat the subject fairly while still being open to the possibility of error they will give the writer the benefit of the doubt and read the blog. If, however, they perceive the blog as being little more than an echo-chamber for the writer’s own ideological rantings then (assuming they don’t already believe) they are apt to just go elsewhere.

4:56 PM, March 14, 2006  
Blogger Helen said...

Alan,

I think what you are describing is really a personal preference. Some people may like "objectivity," others not and some like controversy. I just write about what interests me--if others are not interested, they have over 30 million other choices according to Technorati!

7:11 PM, March 14, 2006  
Anonymous Alan said...

Helen says:

I think what you are describing is really a personal preference. Some people may like "objectivity," others not and some like controversy.

I would think it also a matter of purity and accuracy of intent. After all, your blog isn't entitled, for example, "An Uncriticial Celebration of the Correctness of Right Wing Views". Likewise, you give the clear impression of someone who believes she is giving out her best understanding of "objective" information.

You don't, for instance, give notice that your posts are meant to be taken as, say, comedy or that they are just personal gripe sessions meant to relieve stress. Instead, you are a psychological professional talking about serious (often psychological) topics. There seems every indication that your intent to offer some combination of instruction and persuasion.

Assuming that is the case then I stand by my criticism -- your approach is sabotaging your ultimate aim (for reasons already stated).

9:33 PM, March 14, 2006  
Blogger Assistant Village Idiot said...

Name changes are supposed to influence the way we see things. I think that effect is overrated. The cluster of building up on North River Road were called the State Industrial School when I was a boy. Before that it was Juvenile Detention, and before that, some variation of "Reform School" (and look at all the images from "reform," "re-form"). Since then, it has been the Youth Detention Center, then the Youth Development Center. Now I think is something with the initials SAS.

What it is called has never changed what it is in people's minds. It's kid's jail, plus some lost souls no one knows what to do with. Has been for decades.

10:50 PM, March 14, 2006  
Anonymous Teri Lester said...

AVI is right, name changes accomplish nothing. My son has been a "client" of many providers for years.

Doesn't matter. It really didn't take long to infuse the word "client" with the same disdain that accompanies "patient" or "cripple" or "retard." The word "client" now conjures up the same pathetic, hopeless, white-trash image as any other word that has ever been used to mean "person who is dependent on our largess for survival."

11:42 PM, March 14, 2006  
Blogger Helen said...

Alan,

In the "About me" section, one can read about my take on things--I assume readers can make up their own minds if they want to stay.

http://drhelen.blogspot.com/2005/11/about-me.html

7:42 AM, March 15, 2006  
Anonymous Teresa said...

I'm with you Helen - these people should quit worrying about "labels" and just do their job. No matter what - there must be labels to identify people... if people are treated well and with respect that is what is needed.

The "label" thing has always struck me as a "feel good" measure by people who think they are inadequate in some way. Someone feels slighted - they blame it on the "label" rather than on their own behavior or the bad behavior of the other person.

2:00 PM, March 15, 2006  
Anonymous Katherine said...

This is fascinating - it never would have occurred to me that being called a "client" would be seen as more "empowering" than being called a patient. I personally hate the idea of being called a client or, even worse, a customer! It makes it seem as if the doctor is trying to sell me something and just make money off me, rather than heal me. My cellphone service is a "provider", not my doctor! I prefer the idea of being "treated", rather than being sold, or "consuming" my healthcare.

The change in terminology just seems like one more step towards commodifying healthcare. Although I prefer the terms doctor/patient even in instances where a doctor *is* selling a purely unnecessary consumer commodity (i.e. cosmetic surgery).

I can see from the comments that some people are uneasy with what they see as an unbalanced power dynamic between doctor and patient. Some people apparently feel that the word "patient" connotes submissiveness or inferiority. Again, this never would have occurred to me. I've always felt that as a patient, I have the ultimate control to make decisions about my health care and course of treatment - I go to a doctor for his opinion, but that doesn't mean I have to take it.

3:10 PM, March 15, 2006  
Anonymous Jephnol said...

When it comes to dealing with doctors, counselors, therapists, and such, I think it would be more accurate to call me impatient.

Seriously though, changing labels won't change perception. I'm not going to feel empowered by being called a client. The difference comes with being treated with respect.

For all of you Docs out there--it's the respect, stupid.

3:59 PM, March 15, 2006  
Anonymous Teresa said...

Katherine said...
"It makes it seem as if the doctor is trying to sell me something and just make money off me, rather than heal me."

This made me laugh because I've had several doctors over the years who made me feel just this way. Like I was there to provide their next car payment! Needless to say I didn't stick with them long.

One guy is even considered to be one of the Top 100 doctors in the Chicago area... I felt like it was assembly line medicine - most unpleasant. Needing a doc is bad enough. I don't want to feel like I'm a car chassis waiting for him to stroll in just long enough to add or remove something before moving right on to the next "client".

5:05 PM, March 15, 2006  
Anonymous Mary in LA said...

I prefer to be called a "patient" when being treated by an M.D. Otherwise, "client" is fine -- but what I really hate is the terminology used, as I understand, by health insurance companies: To them I am neither a patient nor a client -- I am a "cost unit."

Oh, and Alan? If Helen doesn't run her blog according to your taste, the remedy is simple: Get your own blog! (Blogspot is free, y'know...)

7:03 PM, March 15, 2006  
Anonymous Alan said...

Mary in LA said...

Oh, and Alan? If Helen doesn't run her blog according to your taste, the remedy is simple: Get your own blog! (Blogspot is free, y'know...)

This isn't a matter of me or anything else infringing on Dr. Helen's right to post whatever she likes. The problem isn't that she isn't blogging to "my taste", but that she doesn't even seem to be blogging to her own (at least given the public persona she otherwise projects).

8:04 PM, March 15, 2006  
Blogger Bob said...

At least, patient and client both recognize a person on the other side of the relationship. Compare that to residents on rounds who introduce the case as, "What we have here is a cancer in the left lobar region...."

8:55 PM, March 15, 2006  
Anonymous Mary in LA said...

I don't know what you're trying to accomplish with your critique -- hold Dr. H. to some kind of objective standard? Sorry, you're not the blog police (may there never be such a thing).

Seriously, get your own blog. Some of us would probably even read it. You do write well, I'll give you that.

8:57 PM, March 15, 2006  
Anonymous Mary in LA said...

Above was for Alan -- sorry, all.

8:58 PM, March 15, 2006  
Anonymous Umbilicus said...

Frankly, I know how my "provider" refers to me. She retains an old school ethic and chooses to call me a patient. I rather fancy that, myself. All these neologisms, nowadays, are unrelieved baloney.

10:10 PM, March 15, 2006  
Anonymous Alan said...

Mary in LA said...

I don't know what you're trying to accomplish with your critique -- hold Dr. H. to some kind of objective standard? Sorry, you're not the blog police (may there never be such a thing).

Is offering criticism honestly the same thing as being the "Blog Police?" After all, I have no power nor interest in enforcing any "blog" rules. I'm just offering a critique. I hope you aren't suggesting that is somehow inappropriate. If you are, isn't that a lot like arguing for political correctness?

I am, honestly, trying to be helpful -- I think she has the tendency to sabotage her own efforts by being so transparently partisan (and thereby seemingly committing the same sorts of offenses she often rails against). It's sort of like listening to a powerful sermon on the ills of drink only to then watch the speaker heave back a couple shots of tequila. It makes the argument hard to take at face value.

Her approach also makes it hard to offer criticism or mere counterpoint in general. She typically presents her arguments in the form of a fait accompli -- that is, as if she she is merely pointing out the painfully obvious. How does one respond critically to that sort of contention without having to pretty much question its very basis?

10:20 PM, March 15, 2006  
Anonymous Brian said...

Alan, you're violating a basic rules of commenting decency: don't hijack the author's thread. This post wasn't about Shrinkwrapped's political neutrality, it was about the trend of medical professionals calling patients "clients." You had to turn it into a screed of your own. You're a jerk, and a troll, and should be banned from this forum.

11:41 PM, March 15, 2006  
Anonymous Anonymous said...

Alan,

You say exactly what I have tried to say here, only more politely and much more artfully.

As for you, Brian, and all your ilk here, who quickly resort to that ridiculous word "troll" when anyone goes against the party line here, you act like a juvenile. "Banned from this forum"? Please, grow up.

11:33 AM, March 16, 2006  
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10:40 PM, June 07, 2009  

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