What's in a name?

We echo Peter Wing's sentiments regarding the use of the word "patient" rather than "client" for people seeking health care.1 The choice of words has perhaps more relevance in psychiatry than in other medical disciplines. Failure to call an ill person a patient may lead to suboptimal management of psychiatric disorders and may deprive the person of some state and insurance benefits. Indeed, the Mental Health Act continues to use the term patient.

Via a self-administered questionnaire, we surveyed the preferences of 402 consecutive people (median age 42 years) who sought outpatient mental health care between October 1997 and January 1998 from 5 psychiatrists in Langley, British Columbia. A similar questionnaire was also administered to 60 physicians (6 psychiatrists, 54 family physicians), 30 nurses, 16 social workers and 13 occupational therapists at Langley Memorial Hospital and Langley Mental Health Centre.

Seventy-two percent of the care seekers (289/402) preferred to be addressed as patients, with 27% preferring the term clients and 1% the term consumers. Older people preferred to be called patients. Ninety-five percent of the physicians preferred to address those for whom they care as patients. In contrast, 57% of the nurses and 15% of the occupational therapists preferred the term patient. None of the social workers wanted to use the term patient; they preferred the term client (75%) or consumer (25%).

There is a clear dichotomy between the preferences of physicians and non-physicians. However, the majority of people seeking mental health care prefer to be addressed as patients, which leads us to believe that there is no reason to deviate from the current medical vocabulary.