Reclaiming The Power Of Words
Reclaiming the Power of Words
Thursday, 07 June 2007
Responder Rant
by Dr Bianca Felix
Brace yourselves – this month’s Rant is probably the most politically incorrect yet! Anyone with easily offended sensibilities had better skip to the next column.
I treat patients.
I do not have ‘clients’.
My patients may be clients of a health service but, frankly, that does not concern me.
Once, when I was an intern dealing with a busy Short Calls shift on the weekend, a member of the public berated me (as I sat at the nursing station writing patient notes before heading to the next call) for my “poor customer service”. I just looked at him, informed him that I worked in a hospital not in retail, and got on with the job.
Call me old fashioned (a benevolent paternalist, in fact) but I became a doctor because I wanted to be in the business of healing. Several years older and wiser, I am now content just to relieve suffering. Hence, the people I treat are my patients (from the Latin patientem – to suffer or endure).
Actually, I think that the bulk of what we do in Psychiatry is to relieve distress and suffering, so “patient” is an apt term for those that we see.I understand that patients and their families have endured the arrogance of the Medical Establishment in the past, and that there has been a backlash in response. And so now, especially in Psychiatry, “carers” and “consumers” (ugh!) are held in higher regard – in fact, are considered important partners in the delivery of mental health care.As part of this movement, the language has changed. I no longer have ‘patients’ but ‘clients’ or ‘consumers’. Other aspects of the language of health care delivery has changed too, with a foundation in Business and Economics, rather than Medicine.
I strongly feel that this movement risks further marginalising Psychiatry from mainstream Medicine, and thus potentially compromises patient care.
You know what I mean when I say that Psychiatry is becoming marginalised. We are laughed at, for not being “real doctors’. (Quite rightly too, in some cases, which I think is a disgrace!) Our speciality does not appear to be regarded with the same respect as O&G… or Paediatrics… or Opthamology… by our general surgical and medical colleagues.
Yet I think we attempt to relieve the suffering of a far greater disease burden than, for example, our ophthalmological brethren.
Can you really imagine an eye surgeon referring to his “clients”? (Perhaps, if he/she had a purely cosmetic practice, it may be appropriate?) No wonder Psychiatry struggles to be taken seriously!
Does O&G struggle to deliver well functioning services, in the same way that mental health constantly struggles with dysfunction? They too must manage chronic conditions, outreach into the community, and handle acute emergencies. They too have doctors working alongside highly trained non-medical personnel. They too have an active “consumer movement” – O&G is riddled with ideological debates.
Yet the services I have worked in have remained firmly grounded in the medical model.
McCallum?
Oops, that’s right. “Deinstitutionalisation” is the politically correct word of the century.
So while other specialities embrace the concept, we have run from it and just look at the mess we are in now!
So come on Psychiatry! Dust off your self-respect. Remind yourself that you are a noble discipline, which deals with Psychological Medicine! Affirm daily that “patient” is not a dirty word.
Most importantly, get on with the business of relieving the suffering that is out there, rather than bowing to all those ideologically-driven interest groups.riven interest groups.