PEOPLE, NOT PATIENTS

One principle I believe in, and frequently preach to any of the professionals who will listen in our office, is that we should never think of the folks that come through the door as patients. 
They are people.  The two are quite different.  For that reason, I will do my best to avoid using the term “patient” in these posts.  This will be more difficult than it seems, because our electronic records almost demand that we use the word “Patient,” so it becomes habitual.

Calling you a patient makes us think of you as a patient.  The term patient assigns you to a certain role with certain expectations.  You are expected to act in certain ways and you are treated in certain ways.  You may think of yourself, or be thought of, as being a “good patient” or a “bad patient,” or maybe “compliant” or “noncompliant.” 

But this role is not the real you, is it?  You are a person, with a busy life to lead, to whom coming into a physician’s office is, at best, an inconvenience.  A good patient” would not be late for an appointment.  A real person, however, will have a slew of other responsibilities and life events that interfere.  This certainly does not make you bad.  It is just real life.  How many times have I seen your Boss’s unexpected demand take precedence over an appointment?  This is just real life.  You are a person, not a patient.

Similarly, a patient is expected to listen to the Doctor’s instructions and follow them, no matter how unrealistic they may be in the setting of your real-world life.  You are a unique person, and you should be able to take what a “patient” would accept as instructions as merely suggestions, and an opening for discussion of how the principles they are based on can best be applied in you real life. 

I can’t tell you how many times I have given fairly standard “textbook” advice, only to discover that it just will not work for the person in from of me.  For example, say I thought you would benefit from a diuretic medication to get rid of excess fluid by increasing your urine output for a few hours.  Naturally, I would advise you to take the med in the morning, because if you take it in the evening, you will be heading to the bathroom several times during the night.  Who wants that? This is great advice, unless you are one of those people who works outside with no available bathroom for many hours on end.  Anyone who took my suggestion as gospel will quickly realize why it was a bad idea for him.  A “good patient” will follow directions.  A smart person will think about it and discuss with me how we can apply the principles to his real-life situation.

Similarly, I have written for meds to be taken with lunch for people in jobs that do not really allow lunch to be taken on any regular basis.  How about directions for people who work the night shift or rotating shifts?  You don’t necessarily want to be taking your “morning meds” right before you go to sleep, and your “evening meds” when you get up and head to work.  Our directions need to be, and almost always can be, adjusted to your real-life schedule.  We should not expect your life schedule to revolve around our directions.  You are a person, not a patient.

What about all of those unexpected events of life?  Everyone experiences them, ranging from the minor ones like traffic tie ups through sick children or parents being taken to the hospital, and on to the real catastrophes of life.  All of a sudden, you really cannot do what we asked you to do, usually because you are helping someone else.  This does not make you a bad patient.  It makes you a good person.  And, yes, you are a person, not a patient. 

A good way to handle these problems is to make sure you understand the principles behind our suggestions, so you can adjust intelligently.  Please, ask your doctor for the rationale behind his suggestions or directions so you can apply the principles intelligently.  You cannot always count on being able to call the doctor for advice when you face the vagaries of life, so try to understand enough that you can use your own common sense. 

So, people, as I stated at the start, I will try to avoid using the term “patient.”   Actually, it will be difficult to totally avoid using the term, because “patient” is so ingrained in our medical system.  It is traditional, and almost obligatory, to refer to patients in our notes in the medical records, and we must use the term so often that it really takes a conscious effort to reset our language and to continually remind ourselves that you are not a patient. 

You are a person.  Celebrate this wonderful fact.