Why Doctors Don't Have Clients
by R. Pies, MD; psychiatrictimes.com; 4/22/15


Numerous years prior, I heard a psychiatric partner joke, "The main individuals who have customers are legal counselors and hookers!" Depending on your perspective, he was by and large terribly unjustifiable to either attorneys or hookers. Regardless, he was attempting to make a genuine point: doctors don't see "customers"—they treat patients. Furthermore, specialists are not "suppliers"; they are—or should be— healers. This point was fittingly made by Dr Barry L. Farkas, a geriatrician and family doctor, in a letter in The New York Times on April 6, 2015.1 Dr Farkas was grumbling about a late piece in the Times (March 29) with respect to in critical condition youths. Dr Farkas distinctly notes

When you over and over utilize the expression "supplier" to depict those experts in the minding expressions and yes, on our greatest days, the mending expressions it turns into a smoothly miserable analysis on the condition of medicinal consideration . . . the expression "supplier" for clinical parental figures, similar to the expression "customer" for patients, depersonalizes and commodifies that which is neither and [is] so all that much more.

I hail Dr Farkas for getting out the Times on this, yet he was distinguishing a semantic pattern that has gotten to be endemic in our way of life in purported shopper arranged productions, as well as, too bad, in some medicinal circles. Also, in the UK, patients are routinely alluded to as "administration clients"—apparently in light of the fact that they are dealt with inside the freely supported National Health Service. In any case, as Dr Hugh McLaughlin,2 Director of Social Work and Social Policy at the University of Salford in the UK takes note of, the expression "administration client" really developed out of the "consumerist convention of the 1990s and the majority rule custom of creating support to guarantee the suitability of administrations." And yet, in one investigation of psychiatric outpatients in the UK, "patient" rose as the unmistakably favored term when specialists and medical attendants were administering to the individual; "customer" and "patient" were similarly satisfactory terms when a social laborer was the assigned clinician.3 (In light of my associate's harsh comment, I was interested to see one study member cited as saying, "'I don't care for customer its reminiscent of whores.")

My impression is that most analysts and social specialists in the US lean toward the expression "customer" to "patient," despite the fact that this may not be the situation among some clinic based clinicians. (I have regularly thought about whether the self-destructive, crazy customer, once hospitalized, turns into an "in-customer.") I accept this custom developed out of the true conviction that "customer" is an additionally "enabling" term than "patient"—which some non-doctors partner with a paternalistic or tyrant "medicinal model." From this point of view, "customers" are seen as self-ruling operators, "patients," as subservient to the power of the doctor. From the angle of historical background, this is an unexpected bit of turnabout. In antiquated Rome, a "customer" was a plebeian under the assurance of a patrician; that is, an everyday person under the support and security of an aristocrat.4 Thus, a "customer" was basically a ward individual with practically zero independence.

Interestingly, the expression "patient" is gotten from the Latin verb, pati, signifying "to endure" or endure.5 This point, it appears to me, is of more than scholastic hobby. At the point when a doctor treats a patient, the last is regularly enduring. In fact, I have contended, over numerous years, that our extremely idea of "illness" emerged from the perception of human enduring and insufficiency, attributable to some obsessive interior state.6 True, not all persons with psychiatric infection report enduring, and numerous have the capacity to live full, prospering lives regardless of their illness.7 But for others, the affliction is exceptionally extraordinary for sure a point scarcely recognized in a late British give an account of psychosis.8 For a large number of us who went into psychiatry, diminishing the tolerant's anguish is not a business undertaking, but rather a moral and profound calling. The clean, heartless terms "administration client" and "supplier" do bad form to the quiet's hopelessness and the doctor's ministrations.

But maybe there is a superior term than "patient." The Schizophrenia Awareness Association of India gives an astute and sympathetic alternative.9 To make certain, the SAA obviously perceives the brutal reality of schizophrenia while likewise reassuring a cheerful and conscious mentality toward those burdened with this sickness. Notwithstanding the expression "persistent," the SAA frequently utilizes the Sanskrit term "shubharthi"—actually, a "seeker of prosperity." The comparing term for the parental figure is "shubhankar"—truly, "an individual who is devoted to others' welfare." Perhaps American doctors would do well to look eastbound whenever they experience such a seeker.




“Under the care of Leo J. Borrell, M.D. since December 2001, I have seen a remarkable improvement in my mother’s condition. She is responding dramatically to the new regiment Dr. Borrell has prescribed”

- Beth Rose


Feb 3, 2008

The Interdisciplinary Team; The Role of the Psychiatrist

by Dr. Leo J. Borrell, featured in Assisted Living Consult for November/December 2006. A HealthCom Media Publication