"Patient" versus "Client"

To the Editor: I was intrigued by the article by Sharma and associates (1) in the February 2000 issue about the terms used to describe service recipients. In my practice in central Pennsylvania, I work very closely with several consumer groups, including a local affiliate of the National Alliance for the Mentally Ill. My observation is that most service recipients prefer the term "consumer." My colleagues prefer the term "client" primarily and "patient" secondarily. Nonmedical staff overwhelmingly use "client."

Under the paradigm of managed care, the term "customer" is now in vogue in describing the various stakeholders, including the consumer. This term is also very popular in the lexicon of our continuous performance improvement activities at this hospital. So it really surprises me that in the Ontario study providers and service recipients rarely preferred the word "consumer."

I imagine that the use of terminology is widely diverse in the field and is largely contextually determined. Though it may be argued that any term we use has powerful implications for treatment, professionally I prefer "client" or "consumer," but I never lose sight of the person behind the term.

Mr. Kensinger is supervisor of performance improvement for behavioral health services at Altoona Hospital in Altoona, Pennsylvania.