"I like calling them 'patients,' and I don't like calling them 'consumers,' " he says. "It feels like we're selling cars, and we don't have a fiduciary duty. Like we're a vendor. And if we can trick them into buying a fancier car, we do. That's not the way we or other physicians think about what we do."
This new kerfuffle, he says, represents "the reflection that this healthcare universe, metaphorically, is like a bunch of plates and utensils on the table and someone just pulled the tablecloth out. And they're all flying in the air and it's not clear what will land upright and what will tumble to the ground and break. During stages like that, people essentially juggle for power in the realization that the status quo is not going to be the future."
"No one pays attention to words when attitudes toward the words, or power or politics or money that flow around those words, are unimportant," he says.
Paul Levy, former CEO of Beth Israel Deaconess Medical Center in Boston, weighed in last week on his blog, "Not Running a Hospital," (when he altered his blog profile. Instead of being an advocate for 'patient-centered care,' he now is an advocate for 'patient-driven care.'
He says it's to reflect the idea that "clinicians should do their best to collaborate with patients to understand their needs and desires and to jointly design plans of care that are as consistent as possible with those needs and desires."
Wachter took issue with that. "We have to be so careful we don't go so far in the other direction that in fixing one problem we're creating another. 'Patient-driven' feels like it's too far in the opposite direction, and diminishes and marginalizes the role of healthcare professionals, who spent a lot of time trying to gain a kind of expertise and experience that is there to benefit the patient. It makes it appear that they almost have no role."