27 May 2013

Debate On Labels for Patients

This doctor is very conscious of labeling patients. Contrary to many doctors that don't mind stereotyping us, it is refreshing to read a doctor that is concerned. I am surprised that different groups are so eager to put labels on us and this label is unacceptable or should be to most people.

I am very appreciative about Dr. Wen's discussion and her distinctions about labeling us as healthcare consumers. We do consume healthcare, but not in the traditional sense. As Dr. Wen explains, we should not be healthcare consumers this way as it could be very unhealthy to postpone receiving healthcare the way consumers do when purchasing consumer goods.

I have blogged about the types of patients here, here, and here. I feel that we should remain patients, but know there are different types of patients. I do feel that as we move away from some of us older patients, many of whom are passive patients, the term patient will gain in respectability and the patient will gain in knowledge about health and especially the health issues they may have.

Dr. Wen correctly states the following, “I also worry about effects of rebranding on the physician-patient relationship. What happens when the doctor becomes the hired consultant of the savvy shopper patient? Perhaps the doctor will be more responsive to consumer demands—but perhaps this doctor will also feel more obligated to give the consumer exactly what he wants, including unnecessary tests and harmful procedures. And will these physicians still retain their sense of social responsibility, when healthcare is reduced from societal obligation to personal choice?”

Her statement, I feel, states the crux of many of the problems we are facing now with the advertising of new drugs. Then as patients, we are now facing stereotyping and labeling under the “Patient Activation Measure” (PAM). This was not the original intent, but in large part has been bastardized to what the doctors want it to be. Originally it was as a measure to determine how educated we were and if we would use this education to make our health better. Now, unfortunately, many physicians use this to help them determine how compliant we are or will be.

Dr. Wen's last paragraph states some good points. I do not believe we need to change the meaning of patient like she states, but to classify patients at types. We can have the normal patient that we have now. There is the passive patient of which there are far too many. The proactive patient is becoming more in number, but they are still trying out their wings and learning to apply what they are learning. Then we come to the empowered patient that knows how to learn and apply the information to various medical situations. The e-patient is an advanced empowered patient and in addition to having learned about the medical situation that he or she is involved in, knows how to apply this knowledge across a broad spectrum.

A special status called patient advocate applies to people that have likely received education in advocacy and they are trained to provide guidance to the other types of patients. Some will be very specialized in billing, others in medical procedures affecting patients and how physicians and surgeons avoid raising certain issues to not alarm patients and have them consider alternatives to their condition which may be just as effective, but less profitable for the physician or surgeon.

Dr. Wen is also another doctor that is concerned about the consumerism already in place where many believe more is better. She is another that believes healthcare is not a limitless commodity. This is a good thing for many doctors to be concerned about, but we do need to be cautious about unbridled rationing. This is just as dangerous and will often shorten the lifespan of many innocent people. Finding that delicate balance is not for the faint of heart.


  1. I had never thought about the perspective of docs caving to pressures of a patient just to stay in business. Thanks for opening me up to that.

  2. Thanks Scott. I enjoy reading good doctor blogs and I have had some correspondence with her about this topic and she has a very positive attitude on the topic of patients.