The Patient Is More Than a Customer

A patient is any person who receives medical attention, care or treatment. The person is most often ill or injured and in need of treatment by a physician or other health care professional, although one who is visiting a physician for a routine check-up may also be viewed as a patient.


There is a growing trend inside and outside of health care to use the terms “patient” and “customer” almost interchangeably. As far as I can tell, it isn’t done to demean anyone; many people of good will have begun calling patients customers to emphasize the need to pay more attention to the consumer side of the patient experience. By that we mean many of the things that Press Ganey tracks, such as cleanliness of rooms, ease of scheduling and noise on patient floors. I also understand why some people use the phrase “consumer-driven health care” in seeking the kind of information about quality and price of hospital and physician services that is available for other consumer products. And yet, while I see the point of this nomenclature, referring to patients as customers does a disservice to patients and providers alike. It doesn’t adequately represent the emotional nature of the relationship.

It is possible to meet the needs of a customer without making any personal connection. The interaction is transactional, financial in nature. Yet as a clinician, I know that it is impossible to participate in the care of an individual without some degree of personal investment. I don’t know any physicians who talk about treating their “customers.” No neonatal intensive care nurse I have ever met would say she treats her “customers” with kindness and empathy.

Let me use a recent consumer experience I had to illustrate my point. On Jan. 27, the Southeast Iowa Municipal Airport in Burlington, Iowa, launched a new commuter service offering daily flights to Chicago and St. Louis. An exciting new adventure, the expanded service represented growth and potential for the tiny airport.

It was my great fortune to have been the first and only passenger on that maiden voyage to Chicago and as such, at the center of the excitement and attention.

 At 7:15 on that bright and very cold morning in Iowa, the airport manager, regional manager, airline representatives, Transportation Security Administration personnel, airport custodial and other flight support staff all gathered to celebrate launching the new service. There was handshaking, picture-taking and a personal escort to the plane by the co-captain. As we left the ground, I waved from the window to a group of proud and excited individuals. They had made me a part of their special occasion and created a memory for me that I will keep and share.

While I most certainly was a customer of that airline, the $89.99 cost of the flight was less important to them than their focus on me as the passenger. After all, their goal and purpose is to create the best experience possible while providing a trip that is safe, efficient and comfortable.

A smooth landing at Chicago’s O’Hare International Airport brought to a conclusion a most pleasant flight. I was met on the ground by an airline representative who carried my bag and escorted me inside the airport. Later in the day as I reflected back, it occurred to me that everything that happened had been about my being there early that morning as the passenger, without whom the flight would not have taken place; that had defined the relationship.

This experience and the health care experience do have some commonalities. In health care, our goal is to create the best experience possible while providing the optimum care and attention for those who present to us in need - our patients.

And yet, there is also a difference. As great as my flight experience was, it was not about me as an individual. We want, expect and need our doctors and nurses to make that emotional investment in us as patients. Often, that personal investment makes the difference in the quality of care that is provided.

Airlines and hospitals must both place the customer at the center of their business, but in health care, the connection with the patient is, well, on a different plane.

Barbara Burnes has worked in a variety of health care settings, including as a director of patient services for a large, multi-specialty physician clinic. See her full bio.