In medical school, we are taught about the patient. In the real world, patients are hard to find. Instead, there are healthcare consumers, customers who are looking for a particular service or product from us.
For the idealists, skip this article because you’ll probably post a comment you’ll regret later. For the more cynical, enjoy.
For a quick recap from medical school and parts of residency, the patient is the helpless invalid who has relinquished all control over their health to their healer.
There were so many of them back in medical school. I haven’t found many in my practice. Maybe all the DPCs have gobbled them up?
The Healthcare Consumer
The healthcare consumer, much unlike the patient, is the masked person sitting in your exam room with that slightly avoidant look of frustration because you were late to their appointment.
They would like to hurry things along because they have things to do. Their sinus infection doesn’t have all day and they can’t afford to be sick right now.
They aren’t sure if they want to go with the Z-pack today or a shot of something that’ll work quicker. In fact, never mind, they want both but what else is there? Surely, we must have invented something other than the Z-pack by now!
When in doubt, the healthcare consumer can be differentiated from the patient because the former posts negative online reviews and the latter wouldn’t even know where to find you online.
Caring for Patients
Look, you probably have a preference for one versus the other. Maybe you prefer to see the genuinely sick, the patient. Someone who likely won’t get better without your care, attention, and possibly intervention.
Know that there isn’t much money in taking care of patients. They won’t be coming in with made-up diagnoses and so you won’t have a cookie-cutter treatment for them that will delete their
ICD-11 ICD-10 code.
Patient care is mentally and emotionally taxing but does reward you with a feeling of accomplishment. A sense of connection and bonding results from it.
Servicing the Healthcare Consumer
But the modern healthcare consumer has the spare time and money to take on new ICD-10 codes and will gladly come to you to help manage them. They will even call your office to ask why a certain code was/wasn’t included and whether you could please address that and Instagram over a new copy to them.
The healthcare consumer customer won’t take much bullshit from you. You can holster your genuine empathy and your physical exam. I mean, ew, they don’t want to be touched by you. You are probably trying to grope them anyways or at the very least you have healthcare cooties.
Having healthcare consumer customers is much more lucrative, however. You can get quite a few in and out. Treat ’em & street ’em and they’ll 5-star you on Google Maps with a bunch of yellow emojis you can’t even recognize.
These customers beget more customers. So that’s good. Like your drug seekers, they must have some underground lair where they spread the word about you – or maybe that’s what social media is.
But it takes your humanity out of you to service this group. Not just your humanity, they’ll take your clinical morals from you as well. Antibiotic stewardship? Please!
The Patient Clinic
The clinic for a patient needs warm, quiet colors with subtle lighting. It needs to be quiet and staffed by gentle souls. This clinic needs nurses who ooze empathy – so much so you gotta mop it up.
Yes, your patients will be sick and likely not in the best of moods. But they are coping with their own emotions while navigating their health. It’s not about you and they have accepted their role in their health.
The patient clinic will be slow. Kind of boring, actually. If someone stepped in they would think it’s empty. Maybe they’ll see a doctor reading articles and looking shit up. Like, in a book or something.
The patient clinic won’t have any interruptions. Really, like none. Because the nurses know that your train of thought shouldn’t be interrupted unless someone is actively dying. They know you need to remain focused just as they need to remain focused on what they are doing.
The Healthcare Consumer Clinic
Ideally, you want this located in a building with more than 10 floors and a price tag of at least $1b. But, a cheaper one will suffice as long as it’s mostly covered in large glass windows.
Think sterile. Commercial thin pile carpets or linoleum or something else really cold. You want more parking than clinical treatment space. I don’t have the ratio but 6.1:1 is a good ballpark to work off of.
LED lights are ideal. Something blinding if you look at it directly or halo-inducing if you have cataracts. Fluorescent bulbs are okay too but they sometimes give a slight illusion of comfort which you want to avoid – dog forbid your patients actually enjoy coming to your clinic. Can you imagine?!
Everything should be easily wipe-down-able because germs are everyone and we’re all dying due to excess germs … or was it obesity and insulin resistance? I don’t remember. I haven’t opened Uptodate in a minute.
Speaking of that. You need Uptodate. Because the only clinical care that should be provided should be standard of care and clearly written out somewhere. What are you a hack? A baffoon? A quack?!
The goal here is quantity over quality. We’re talking numbers. You don’t want to be that loser at the party who only sees 80 patients in your urgent care! Pffft, please! Dr. Hooman and Dr. Singh saw that in the first 2 hours and they were rounding on 4 nursing homes each while seeing their patients.
You were taught a standard definition of health somewhere in medical school. Perhaps it wasn’t concrete but you’d definitely recognize it if you saw it. The opposite holds true as well.
With your patients, you won’t have to worry too much about the topic of health. It’s fairly clear that health is lacking and something needs to be restored … gently, kindly, and compassionately.
Health, on the other hand with the healthcare consumer, is either a moving target or a negligible topic. Generally, if their BMI is in the double digits and their systolic # under 159 we’re golden. Now, pass the statin, por favor.