Patient

For the state of being, seePatience.For other uses, seePatient (disambiguation).

Apatientis any recipient ofhealth careservices that are performed byhealthcare professionals.The patient is most oftenillorinjuredand in need oftreatmentby aphysician,nurse,optometrist,dentist,veterinarian,or otherhealth care provider.

Etymology

The wordpatientoriginally meant 'one who suffers'. This English noun comes from theLatinwordpatiens,thepresent participleof thedeponent verb,patior,meaning'I am suffering',and akin to theGreekverbπάσχειν(paskhein'to suffer') and its cognate nounπάθος(pathos).

This language has been construed as meaning that the role of patients is to passively accept and tolerate the suffering and treatments prescribed by the healthcare providers, without engaging inshared decision-makingabout their care.

Outpatients and inpatients

Patients at the Red Cross Hospital inTampere,Finlandduring the 1918Finnish Civil War

Receptionist inKenyaattending to an outpatient

Anoutpatient(orout-patient) is a patient who attends anoutpatient clinicwith no plan to stay beyond the duration of the visit. Even if the patient will not be formally admitted with a note as an outpatient, their attendance is still registered, and the provider will usually give a note explaining the reason for thevisit,tests,orprocedure/surgery,which should include the names and titles of the participating personnel, the patient's name anddate of birth,signature ofinformed consent,estimated pre-and post-service time forhistoryandexam(before and after), anyanesthesia,medicationsor futuretreatmentplans needed, and estimated time ofdischargeabsent any (further)complications.Treatment provided in this fashion is calledambulatory care.Sometimes surgery is performed without the need for a formal hospital admission or an overnight stay, and this is calledoutpatient surgeryor day surgery, which has many benefits including loweredhealthcare cost,reducing the amount of medication prescribed, and using the physician's or surgeon's time more efficiently. Outpatient surgery is suited best for more healthy patients undergoing minor or intermediate procedures (limitedurinary-tract,eye,orear, nose, and throatprocedures and procedures involving superficial skin and the extremities). More procedures are being performed in asurgeon's office, termedoffice-based surgery,rather than in a hospital-basedoperating room.

A mother spends days sitting with her son, a hospital patient in Mali

Aninpatient(orin-patient), on the other hand, is "admitted" to stay in a hospital overnight or for an indeterminate time, usually, several days or weeks, though in some extreme cases, such as withcomaorpersistent vegetative state,patients can stay in hospitals for years, sometimes untildeath.Treatment provided in this fashion is calledinpatient care.The admission to the hospital involves the production of anadmission note.The leaving of the hospital is officially termeddischarge,and involves a correspondingdischarge note,and sometimes an assessment process to consider ongoing needs. In theEnglish National Health Servicethis may take the form of "Discharge to Assess" - where the assessment takes place after the patient has gone home.

Misdiagnosis is the leading cause ofmedical errorin outpatient facilities. When the U.S.Institute of Medicine's groundbreaking 1999 report,To Err Is Human,found up to 98,000 hospital patients die from preventable medical errors in the U.S. each year,early efforts focused on inpatient safety.While patient safety efforts have focused on inpatient hospital settings for more than a decade, medical errors are even more likely to happen in adoctor's officeor outpatient clinic or center.

Day patient

Aday patient(orday-patient) is a patient who is using the full range of services of a hospital or clinic but is not expected to stay the night. The term was originally used bypsychiatric hospitalservices using of this patient type to care for people needing support to make the transition from in-patient to out-patient care. However, the term is now also heavily used for people attending hospitals for day surgery.

Alternative terminology

Because of concerns such asdignity,human rightsandpolitical correctness,the term "patient" is not always used to refer to a person receiving health care. Other terms that are sometimes used includehealth consumer,healthcare consumer,customerorclient.However, such terminology may be offensive to those receivingpublic health care,as it implies a business relationship.

Inveterinary medicine,theclientis the owner or guardian of the patient. These may be used by governmental agencies,insurance companies,patient groups, orhealth care facilities.Individuals who use or have usedpsychiatricservices may alternatively refer to themselves asconsumers, users, or survivors.

Innursing homesandassisted livingfacilities, the termresidentis generally used in lieu ofpatient.Similarly, those receivinghome health careare calledclients.

Patient-centered healthcare

See also:Patient participation

Thedoctor–patient relationshiphas sometimes been characterized as silencing the voice of patients.It is now widely agreed that putting patients at the centre of healthcareby trying to provide a consistent, informative and respectful service to patients will improve both outcomes and patient satisfaction.

When patients are not at the centre of healthcare, when institutional procedures and targets eclipse local concerns, then patient neglect is possible.Incidents, such as theStafford Hospital scandal,Winterbourne View hospital abuse scandaland theVeterans Health Administration controversy of 2014have shown the dangers of prioritizing cost control over the patient experience.Investigations into these and other scandals have recommended that healthcare systems put patient experience at the center, and especially that patients themselves are heard loud and clear within health services.

There are many reasons for why health services should listen more to patients. Patients spend more time in healthcare services than regulators or quality controllers, and can recognize problems such as service delays, poor hygiene, and poor conduct.Patients are particularly good at identifying soft problems, such as attitudes, communication, and 'caring neglect',that are difficult to capture with institutional monitoring.

One important way in which patients can be placed at the centre of healthcare is for health services to be more open about patient complaints.Each year many hundreds of thousands of patients complain about the care they have received, and these complaints contain valuable information for any health services which want to learn about and improve patient experience.

See also

• Casualty
• e-Patient
• Mature minor doctrine
• Nurse-client relationship
• Patient abuse
• Patient advocacy
• Patient empowerment
• Patients' Bill of Rights
• Radiological protection of patients
• Therapeutic inertia
• Virtual patient
• Patient UK

External links

• Jadad AR, Rizo CA, Enkin MW (June 2003)."I am a good patient, believe it or not".BMJ.326(7402):1293–5.doi:10.1136/bmj.326.7402.1293.PMC1126181.PMID12805157.
  a peer-reviewed article published in the British Medical Journal's (BMJ) first issue dedicated to patients in its 160-year history
• Sokol DK (21 February 2004)."How (not) to be a good patient".BMJ.328(7437): 471.doi:10.1136/bmj.328.7437.471.PMC344286.
  review article with views on the meaning of the words "good doctor" vs. "good patient"
• "Time Magazine's Dr. Scott Haig Proves that Patients Need to Be Googlers!" – Mary Shomons responseto the Time Magazine article"When the Patient is a Googler"