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Dabbling with definitions

Patient or client? Service user or healthcare consumer? Dr Ian Beasley offers his personal take on a long-lasting debate

13 Sep 2017 by Ian Beasley

2017 heralds my first 20 years as a qualified optometrist. But my journey in optics goes back even further. A permanent fixture in the same independent practice for 28 years, I started out as an optical technician, before making the move from optical assistant, to dispensing optician, to undergraduate Saturday lad, to pre-registered optometrist, and through to the fully-fledged optom – and occasional tea maker. The one enduring factor? Seemingly the butt of all jokes in practice.

A ‘lifelong’ commitment to the same practice affords certain privileges that come only with the stripes earned by service time. A lasting presence in the heritage of the practice; a strong link to the wider community; but, most of all, a bond with the familiar faces that pass through the consulting room door year-on-year.

My clinical time has slowly eroded over time due to commitments to teaching and research, not to mention my responsibilities to the AOP. As such, my limited availability in practice sees appointment slots almost exclusively occupied by loyal followers, and subsequent generations in their respective family trees. In many cases, we greet as old friends, spend almost as much time catching up on ‘news’ as addressing any ocular concerns, and are certainly on first name terms in most instances.

As the theme of September's OT is the knotty questions that occupy the sector, my attention was caught when I stumbled across a debate relating to doctors purportedly in favour of scrapping the term ‘patients.’ Apparently, the reference is widely disliked: it places the individual as a passive recipient of the doctor’s munificence. But is that really the case in modern practice? And, in any case, what is a suitable alternative? 

On a personal level, I admit to despising the much-proffered term ‘service user,’ while any reference to ‘customer’ is surely only appropriate when the journey transitions from clinical through to retail. 

‘Client’ seems a reasonable substitute – until you delve into its origins, with connotations of obedience and subservience. Healthcare consumer is perhaps relatively palatable, but then I try to picture Sandra on reception having to ask: ‘And, are you a new or existing healthcare consumer with the practice?’ Far from ideal in reality.

"On a personal level, I admit to despising the much-proffered term 'service user,' while any reference to 'customer' is surely only appropriate when the journey transitions from clinical through to retail"

It appears that the Latin derivation of the term ‘patient’ may be driving the call for change, given that its historical roots lie in ‘one who suffers.’ However, as most of those in the consulting room chair are suffering in some way, either with blurred vision, headaches, or discomfort, perhaps the term is appropriate. And as the optometrist’s remit broadens through delivery of enhanced services, conceivably the term patient has never been more apt, with an avalanche of suffering likely to be arriving at our doorsteps in the future. 

While on the subject of appropriate terminology, it got me thinking about what the ‘patient’ should use when speaking to their optometrist. I should say that I respond to most things, but typically I am referred to in order of frequency: Ian/the optician (yes, I know, I know… a debate for another time)/Dr Beasley/Beez – my childhood moniker/and on one occasion, that weird little man with the big nose. True story. Bit rude.

Taking a step back from the semantics for a moment, do we need a term at all? After all, even on occasion when I encounter a person attending a consultation with me for the first time, they are just that – a person. After a simple first name introduction on my part we are ready to proceed with the consultation proper. 

I have a feeling the debate will go on endlessly – and to be frank I have more pressing matters in hand, with a clinic full of suffering old friends, waiting to catch up on the latest gossip.

Image credit: Getty

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