As defined by the Larousse dictionary, the customer is “A person who receives from an enterprise, against payment, commercial supplies or services”. Conversely, a patient is a user of our health system whose care is generally financed by public money, by Social Security and therefore by employee and employer social contributions and taxes, even when the latter is hospitalized in a private structure.
But in recent years, we have heard more and more people working in the health sector use the word “client” instead of the word “patient”, “patient” or “user”. This semantic shift is dangerous and I will explain why.
Actor and not consumer
The patient must be at the center of his support and he must have complete information on his health problems as well as the treatments prescribed to him. He has the right, of course, to refuse the treatment offered to him. However, this does not in any way mean that the healthcare professional must accept all requests from the patient or his family.
The caregiver has ethical rules to respect and he must perform care in connection with the data acquired from science and with a care plan established in agreement with the patient. Sentences such as “the client is king” or “I pay therefore I have” are not at all applicable to the health sector because the patient is an actor and not a consumer of his care, and he does not pay like a customer would. The care provided to him must be adapted to his state of health and is financed in large part by the State, Social Security, by mutuals which are private non-profit organizations, or even by the departments.
“Some families allow themselves to behave incorrectly towards caregivers. ”
In addition, accepting certain requests from the patient or the family that are not adapted to the patient’s state of health could endanger the latter and push the health professional into illegality. We can cite as an example the relatives of residents in certain nursing homes to whom everything is allowed to pass on the fallacious motive of “they pay therefore they choose”. Some families allow themselves to behave incorrectly towards caregivers and also allow themselves to impose patient support that is not in line with the latter’s wishes and care plan.
These situations are certainly in the minority but have a more than harmful impact on health professionals and patients. Example: “VIP” patients in certain health establishments who have the right to a comfortable single room with minibar, improved meals, bathrobe, slippers, high-end bedding… and who spend their time calling out to and disturbing health professionals for reasons which have no relation to the medical support of the patient.
A commercial question
The concept of customer also refers to a commercial question in which the mechanism of supply and demand as well as economic issues reign supreme. In a system like this, patients with few resources or living in a sparsely populated area, suffering from rare diseases or pathologies with unprofitable technical care acts, would be greatly disadvantaged or even abandoned.
Obviously, we must not fall into an ideological reflection. There must be measures related to the functioning of health facilities regarding their financial viability. However, this should not be done on a purely lucrative basis, because in the long term, this would greatly affect the quality of care and access to care for all French people.
We see today that the pressure is great for our health system to enter into a market operation. The abuses which transform the patient into a client exist more and more in certain health and medico-social structures as well as in the field of liberal medicine. All of this seriously undermines the patient-caregiver relationship.
The hospital is not a hotel
We have seen the emergence, even in many private and public health establishments, of concierge services managed by lucrative private companies, which allow patients who can afford them to afford many services and benefits: massage, meals and small meals. -improved lunches, beauty boxes, fruit baskets, gift cards, dry cleaning, clothing alterations, chocolates, tablets, video games …
There is total confusion between the sphere of sales and the sphere of care. An omerta also rages in certain establishments or on the grounds that doctors bring back many patients “clients”. Management or health executives turn a blind eye to or minimize the aggressive or disrespectful behavior of some of them towards their co-workers. The economic stake is privileged even if this degrades working conditions.
“Once and for all, we must clearly differentiate the hotelier from the treatment”
We often hear that “the hospital is not a hotel”. It’s not false. Once and for all, we need to differentiate the hotelier from care. The first aims at the well-being of customers in a commercial and commercial logic. The second aims at the well-being of patients in a logic where individual health and collective health take precedence over everything. Let’s not forget that!
READ ALSO: “The health system at the mercy of professional corporatism”
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