In recent years,
a controversy has existed as to 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.
In
my observations, this conundrum arises most often in meetings or lectures I've attended, some of which have included
in the audience "consumers", "clients", and indeed "patients", among the many names by which they have
referred to themselves in such venues. It's really the advocates, academicians and administrators who
seem to wrestle with this subject the most. That makes sense...Policymakers like consistency and abhor ambiguity,
but I'm afraid the matter will never be resolved to everyone's liking, at least not through discussions of an epistemological
nature.
Quite frankly, it’s
never been an issue with the thousands of “patients” I’ve had the pleasure of serving for over 20 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”, “client”,
et al really misses the point and will not empower those so named to effect sincere attitudinal change of those who treat
them. Moreover, to persist in this unproductive dialogue runs the risk of promoting the proverbial equal and opposite
reaction of stubbornly insensitive practitioners renaming themselves as “service providers”, thereby further 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 examining candidly the real issue underlying the identity confusion;
that is, reanalyzing our role as mental health professionals based on the honest feedback from the recipients of our
care.
Scott Zentner
