Physician and Patient; or Service Provider and Consumer?

I don’t “get” chronic Patients who refuse to see themselves as “Consumers” but rather as some separate classification of mere “Patient” and thus seemingly subservient to the never wrong (but usually late) Physicians or, worse, as a Person who’s been dealt some rough cards in Life and as a result should be treated by Physicians in some special standard required of a classification even higher than that of a Consumer.  Candidly, I think those folks are transferring their self-pity about their plight in Life onto third parties so as to at least derive some benefit from their chronic illness. Admittedly, this a strange perspective from a Patient Activist and from someone whose chronic medical problems has left him disabled and in dire financial hardship: perhaps; but I don’t blame Patients for taking either approach because I can certainly relate and I understand that human nature plays a big role in how we subconsciously handle our grave disappointment at having parents with bad genes, getting too caught up in the moment to wear a condom or being made into a chronic patient in some other manner.

However, let’s be objective at least for the purpose of this article and all admit that being a chronic patient is extremely expensive, at times painful, lonely and certainly life-altering.  But these downsides are ours to bear and all we can expect from our physicians, nurses and medical professionals is their respective best professional efforts and in the “transactional” patient process to be treated compassionately and with dignity.  It is not exactly the definition of being a “Consumer,” but for the purposes of establishing “Rights” that can be supported by our Legal System, besides those sought by suing too often for Medical Malpractice, being labeled as a “Consumer” seems to be the best fit and it also properly details the responsibilities and obligations of both Patients and Medical Professionals.

This question comes up a lot lately as the potential for “choice” and Web “recommendations” from patient communities in and around the health care social media world provides patients with viable options.  Moreover, physicians and hospitals are providing services which can be replicated by other local comparable medical professionals so the phrase, “Accountability,” is becoming the more appropriate measurability standard than simply suing for “Medical Malpractice” and hoping for the best.  I believe that is a GOOD development for all parties involved as thanks to the thorough work of effective Consumer Activists such as Ralph Nader, Elizabeth Warren, etc.,  Patients, by analogy, are beginning to be afforded the same legal rights as a Consumer and the work of Physicians is being held to a standard more in-line with that of a Service Provider.  However, due to the stakes involved, Medical Malpractice is still a viable option but only under the appropriate and extreme  circumstances.

I worry, though, that if a patient is never classified as a consumer, healthcare reform will never happen unless it is looked upon solely as a moral right.  Then if that happens, the patient’s consumer rights will likely be minimized just as they are in socialized medicine.  That’s just the Yin and Yang of Life.  Personally, I happen to think BOTH classifications should be attributable to the patient-physician “transaction” but I’d prefer the moral scale be used only in a “macro sense” to ensure healthcare reform so as to not place unreasonable patient transactional responsibilities upon medical professionals.  But as long as patients are paying for a medical service and there are several choices of service providers with whom they can spend their hard-earned money, I can’t see how patients cannot be considered consumers and thus protected by Consumer Law.

This classification of consumer will also start dismissing the myth that doctors are gods and knowledgeable about EVERYTHING besides what they dedicated their careers to studying and practicing.  In practicality, I respect Doctors for their skills just like I respect my Auto Mechanic for his but generally both are only more knowledgeable than most on the matters they have been educated on – as they should be. Notwithstanding the foregoing, some, however, act as if they are impervious to criticism EVEN IF that criticism is quietly done by “walking” to another provider-physician and NOT by “talking” via some posted emotionally-charged unfair opinion of that Patient-Physician transaction on the Web.  In that regard, and in my humble opinion, disapproval of professional transactional services is best made with your FEET and NOT with your MOUTH especially in this technological era where simple “word of mouth” is akin to whispering into the Grand Canyon and seeing your words on some Asian website only a few days later (I visited the Grand Canyon a few years ago and there were more Asians there than Americans, hence my Dennis Miller metaphor).  Medical Professionals who challenge these unrealistically disappointed patients in Yelp-like Web “Physician Rating Forums” should think twice before stooping to that level of “Technology Self Importance” UNLESS they are being libeled to such an extent (e.g., allegations of physical or sexual abuse) that they must seek LEGAL COUNSEL to preserve and protect their respective professional reputations.

The answer to this question is also significant from a LEGAL perspective because thanks to the work of the aforementioned Consumer Advocates and many like them, Consumers have TANGIBLE RIGHTS which can be enforced by various laws attributed to different industries which provide for REAL FINANCIAL DAMAGES and sometimes TREBLE DAMAGES (i.e., 3X the amount of the actual damages) such as in the case of Consumer Fraud.  Sure, a Patient has the basic MORAL RIGHTS stated above regarding professional dedication, compassion and dignity but at present there is no Legal Recourse for them. Instead the Patient must simply change Medical Professionals just as they would Auto Mechanics.  This will send a bottom-line message to the offending medical professional and at the same time it will cut down on frivolous Medical Malpractice lawsuits because patients hopefully will feel powerful enough as Consumers with choices to make as to whom shall provide them with their medical services.

Having said all of this on behalf of patients, it is important to point out that doctors have rights also and just because a Treatment Option does not turn out as expected is not necessarily grounds for a medical malpractice nor is it fodder for patients to share with some Web “Physician Rating” Site trashing the Physician for trying to help them.  While I have experienced instances of arrogant doctors failing to LISTEN who treat their patients like chapters in a textbook, more often than not the problems are caused by patient expectations of positive outcomes which  cannot be met due to the constraints of modern medicine or because of the limitations of that particular physician.  Hey, not everyone graduates first in their class.  If that is the case, patients need get second opinions and more closely evaluate their initial decision-making in establishing their Doctor-Patient relationship.  After all, if you brought your car into a Transmission Shop for repair and afterwards your car was actually worse for the wear or you waited longer than contractually promised or the price was much more than contractually bargained for, you’d simply go to another transmission shop and as a consumer sue for the tangible damages, if any.  You might even go on Yelp.com and negatively rate that initial contract-breaching Transmission Shop based on that experience but you would NOT “attack” the Transmission Owner or the person working in your car.

Come on, it’s just a Business of Service Provider and Consumer.

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