Is It Shameful to Be a Patient?
It’s hip right now to call your patients anything but patients. Psychotherapists and acupuncturists refer to themselves as doctors, but those they treat are “clients.” I used to work at a membership-based medical practice where we called our patients “members.” And I get it. There’s something a little cringe about the word “patient.” But why? I think it’s because a patient is inherently vulnerable, and we’re uncomfortable with that.
There is a power dynamic built into the doctor-patient relationship. The patient is sick or injured and needs help. Even if they don’t have a health problem—at an annual check-up for example—they’re sharing intimate details about their health and allowing the doctor to see and touch their body. Being a patient requires surrender and trust, and it’s vulnerable.
But despite all of Brené Brown’s efforts, we don’t like vulnerability. There is a tendency in the culture to replace that which implies weakness with something not just neutral but emphatically strong. Somebody who has experienced sexual assault isn’t a victim, they are a survivor. Someone with autism doesn’t have a disability, they have superpowers.
It’s not necessarily wrong to re-frame a painful or challenging dynamic to make it more empowering. But I worry that we sometimes do so as an avoidance tactic. On the surface it seems like we’re supporting the injured party, but on a deeper level we’re ignoring their truth. It puts a pretty bow on something difficult and messy, and sends a signal not to talk about such things.
A friend of mine was in a terrible accident. I sent her a care package in the hospital with a note telling her she was strong. She came out with a song years later called “Strong.” It was about how, at that time in her life, everyone kept telling her she was strong when she truly did not feel that way. I realized how crass it had been of me to tell her she was strong. What I meant was I believed in her ability to get through that hard time. But “strong” was not the word for that moment. I was skipping ahead to something easier for me to handle, and in the process making her feel more alone.
Once we’re able to be with the truth of vulnerability, then we can begin to actually support someone. What we long for when we’re sick or injured is not just to be well, but to be cared for. That’s part of being human. It’s also part of the healing process itself. When we shy away from using the word “patient,” we send a subtle message that it’s shameful to need others and it’s shameful to be weak. It’s a vestige of the patriarchal “boys don’t cry” idea.
Another part of the move away from “patient,” I believe, is that many have felt mistreated by the medical system. In an effort to acknowledge patients’ dignity in a system that often exploits or diminishes them, well-meaning marketing people attempt to elevate them by making them clients instead of patients. A client is a more like a customer than a sick person. But the problem was never their vulnerability; it was our failure to meet them in their vulnerability.
Whether we like it or not, there is a power differential between doctor and patient. Calling someone a client doesn’t take that away. What patients need, and what we all need (because we’re all patients sometimes), is doctors who take responsibility for their power and treat their patients with care and respect, without missing the truth of their vulnerability.
In my practice, I understand how vulnerable it can feel to be a patient. I pride myself on inviting my patients to bring their whole selves to appointments, tears and all. I see patients for a range of different women’s health concerns, including perimenopause, painful periods, birth control, vaginitis, UTIs, and more. If you’re exhausted by a medical system that treats your body as machine and your symptoms as noise, reach out. This is healthcare for women who know we deserve better.