Let’s get rid of “patients”

The passive user or active participant

I got into a discussion about the word “patient”. My colleague mentioned that the word has a negative connotation. She mentioned that the word makes us focus only on the disease rather than on the person as a whole. I was taken by surprise by this statement. It’s interesting how I’ve been using this word without truly realising how others might view it. It made me curious how others think about this issue…

The word derives from the Latin word “patiens”, meaning suffering or enduring.

Julia Neuberger argued, in an article in the British Medical Journal, that

“The word “patient” conjures up a vision of quiet suffering, of someone lying patiently in a bed waiting for the doctor to come by and give of his or her skill, and of an unequal relationship between the user of healthcare services and the provider. The user is described simply as suffering, while the healthcare professional has a title, be it nurse or doctor, physiotherapist or phlebotomist.”  Deriving from this thought process she argued that, “The active patient is a contradiction in terms, and it is the assumption underlying the passivity that is the most dangerous. It is that the user of services will remain passive in sickness, allowing the healthcare professional to take the active part and tell the user what to do.”

I would agree that a passive user of health services is not the way to go in modern medicine. However, regardless of the etymology of the word, I’d find it a far stretch that the term patient would promote or provoke passiveness. For example, healthcare professionals usually don’t address the patient itself with this word, most often it’s used in communication with colleagues. This article received several rebuttals.

One of them was from Raymond Tallis who argued against changing the word “patient” into something else:

“Would change mean improvement? Even if there were a case for change, and a satisfactory alternative, would there be any reason for thinking that this would drive improvements in doctors’ attitudes and behaviour? Most linguistic reforms reflect rather than bring about changes in attitudes.”

I side with Tallis on the practical reasons for not changing the word patient, nevertheless for me this is not the main topic to be highlighted. Neuberger raises an important issue which can’t be overlooked, namely that the patient must be an active participant in their whole medical process. More importantly each person must be an active participant in their health before and after being diagnosed with a disease and being labelled as a patient. That’s what this newsletter is about after all. Being health conscious is not just about a moment in time or a period in your life, it’s a lifestyle. I would argue that being health conscious doesn’t stop when stepping into the doctor’s office. In most situations you will have options and hopefully you can decide the best treatment together with your doctor’s advice (i.e. shared-decision making), rather than being forced to choose something you don’t feel good about. I would like to urge you to stay engaged in your own medical pathway, try to understand what the pro’s and con’s are and ask questions if something isn’t clear. Try to be an active participant, rather than the passive patient.

Photo by Yaopey Yong on Unsplash