“Consumer” or “Patient” – Roles We Play

I have been involved in many conversations and listened to numerous presentations that use the words “consumer” and “patient” interchangeably, often in the same sentence!  While I will readily admit that we can get hung up on words at the expense of getting anything done, I think that the inaccuracy in our use of language can actually impede progress.    Such is the case, I suggest, with regard to the words “consumer” and “patient”.

While the debate as to whether the individual who is the subject of care is a “patient” or “consumer” may be heated, both sides of the argument seem to be focused on classifying the individual as either a “patient” or a “consumer”.  I contend that “patient” and “consumer” refer to roles that we play and that we can shift between these roles depending upon the situation.  I define these roles as follows:

  • In the consumer role an individual will make choices of about the services that they need, when they need them and from whom they receive them. In this role, the consumer may engage service providers outside the traditional healthcare system such as a consumer health portal or consult with other individuals in on-line communities of interest.
  • In the patient role an individual has made choices regarding the healthcare services that they wish to receive and are engaged with one or more healthcare providers for these services. Just as banks and courier companies are using ICT to streamline operations and engage their customers in ways and at times that are most convenient to these customers so too can healthcare providers use ICT to engage their patients.

Numerous surveys and studies confirm that Internet users have a strong interest in searching for information related to health and medicine and interacting with others who suffer from the same disease or condition.  Yet, despite this strong interest in using the Internet for health related purposes, many so-called “personal health record” applications have floundered.  Examining these successes and failure reveals a pattern of behavior that is best explained by categorizing the role in which the individual operated when using these applications as either “patient” or “consumer”.   Applications that are designed for the role in which the individual is operating are more likely to garner an active and engaged audience.

I think it is time to better define what we mean by the words “patient” and “consumer” and to be more careful about how we use these words.  The distinction is critically important to understanding how best to use IT to help people manager their health.

Mike

 

8 responses to ““Consumer” or “Patient” – Roles We Play

  1. Mike,

    Thank you for this post which fleshes out your thinking on a subject we’ve revisited often together on Twitter – most notably on the #hcsmca chat Dec. 1 http://bit.ly/frTEKA.
    Colleen

  2. The terms are interchangeable. There are many “consumer” relationships that don’t require choices. A patient is a “consumer” of healthcare. In this context the consumer and patient are the same.

  3. Not surprisingly, I strongly disagree, though I think that use of the word “consumer” might be confusing. What I am trying to convey is that there are two fundamentally distinct roles in which people operate when dealing with healthcare providers. One role is characterized by the need to question and make choices – explains use of the Internet to research diagnoses, treatment options, etc. I classify applications that cater to this role as “consumer empowerment” applications.

    The other role is characterized by a willingness to follow directions and recommendations. I classify applications that cater to this role as “patient engagement” applications.

    Mike

  4. Mike,

    In the context of EMR/EHR, I feel that they are interchangeable. Even in the context of actual medical practice, they may also be consumers rather than patients. In the current socioeconomic environment, a customer is one who with “perfect information” / and with minimal switching costs, can choose whomever to receive services. I think the concept of “patients” is anachronistic now because of easy availability of information.

    Of course, time will tell

    Richard Hom, OD MPA

  5. I think we need to be very thoughtful in our use of these terms. In a single-payer system, individuals do not necessarily engage the health sector as “consumers”. They engage as “citizens” and “patients”. I think the use of terms such as “consumer” or even “client” can sometimes dilute the true nature of the relationship between those who seek medical care and those who fund and/or provide it in Canada.

    It may also create unrealistic expectations of control and choice on the part of individuals, particularly given the tendancy toward top-down, centralized control of health care in Canada. I think we should be careful not to absolve the Ministries of their responsibility by diminishing their role as the ultimate controllers of health care by using market terms such as “service provider” and “consumer” when we are talking about the “government” and the “governed”. If Canadians want changes or improvements in health care, for better or worse, they really have to go to the Ministry, not to the market, and their dollars may or may not be able to “get them what they want”.

  6. We can continue to disagree, My view is that patient engagement is a fundamental requirement of being a consumer of healthcare.
    To many applications are designed from the prospective of helping the doctor or clinician to document results, as apposed to help the clinician and doctor to provide optimal care.
    A knowledgeable, engaged patient can they become empowered consumers of healthcare with the ability to make choices. A great deal has been written about informed consent. This is really the starting point of making patients responsible for their health choices and their care choices.

  7. Pingback: Tweets that mention “Consumer” or “Patient” – Roles We Play | eHealth Musings -- Topsy.com

  8. Great topic. I have a lot to say on this but I’ll keep it to one point.

    I think that the most important issue is what do patient’s/ consumers think? I believe that over time they are more and more viewing themselves as consumers. Is it changing times, the google age? The Deloite Centre for Health Solutions demonstrated this trend in a number of countries including Canada. Say what you want about the government calling the shots, but utimately it’s the public who choose government. I think we should be concerned what they think.

    So many of us in the healthcare fields say we care about patient centred approaches but do we really?

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