Not customers: doctors have patients, libraries have patrons, lawyers have clients and teachers have students

An unfortunate truth. At least they don’t wrap themselves in the Daily Mail, nobody in that situation makes it worse for themselves deliberately.

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If you wouldn’t do it to a fish, don’t do it to the homeless.

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I haven’t seen him again. In fact, I avoid him whenever possible though I imagine he would be less affronted by being called a news salesman than by my question.

When he came into the room at Harvard, he exuded what I call “money sweat,” a palpable unease about status and income that I could feel across the room. If you see him on a talk show, you will see he sweats a lot. At that particular moment, he had at least one perhaps two books on the bestseller lists and his MSNBC show plus another weekly show in syndication. The man was making at least a 6 or 7 figure income with a wife who also was pulling down 6 or 7 figures a year.

And yet I could feel his money insecurity from all the way across the room.

Yeesh, what a creep.

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It’s definitely a problem in higher ed. My college is hot for “guided pathways”: you funnel students into a program of study based on either their stated career goal, or their Holland code personality trait. The cafeteria model of students taking whatever classes they like is nearly gone.

I hate it, because it eliminates choice and discovery for our students. However… the students grok it. It’s all about getting that piece of paper so you can get that job. Learning? Critical thinking? Nah, just gotta graduate so I can do my thing. They don’t really “want” to be students, they want to be customers: I came here to earn an A, you’re going to give me an A, no I didn’t learn anything, no I won’t retain anything, but I jumped through the minimum number of hoops required to earn an A, which I deserve.

It’s very depressing.

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There’s plenty of evidence about how wrong things can go when you start mixing up social norms with financial incentives, usually ending with the commodification and devaluing of human decency. Ariely (below) has a good summary of a few bits of research where financial incentives were introduced and have had the opposite effect of that intended; rather than promote a desirable behavior (eg doing pro bono work; turning up to childcare on time), the financial incentives actually overrode the social norms and led to worse social outcomes.

Hooray for homo economicus. /s

Predictably Irrational - Wikipedia

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For years I choked at calling my patients “clients”. This change happened when hospitals began to be run by CEOs, rather than medical boards. Then I just gave up and went back to calling them “patients”. There is an inherent bunch of implied attributes around the term “patient” and their relationship to a clinician that “client” does not and cannot carry. The main one is trust.

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Sadly, the “customer” attitude is coming into play here, too. Businesses like to think that they are customers purchasing services, and the ability to pay for such things is the only consideration required. They really hate to be reminded that the actual term is “regulated party”.

OTOH, at least pharmaceutical companies are ostensibly regulated parties. All the supplement filks that the anti-pharma crowd reccomends? In many cases there’s no regulation or oversight whatsoever. The big-pharma drug that says it contains 25 mcg of active ingredient is very likely to contain 25 mcg. A supplement or alternative med? Maybe zero to a toxic dose of whatever is in there.

And people wonder why I stick to things like ibuprofen, instead of their herbal miracle cure.

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Australian in this case. But the “customers” thing to me sounds more like it came from the all pervasive international management consultant culture which denatures and homogenises organisations across the world.The same people who introduced “uplift” as a verb to my workplace, I reckon.

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giphy

Next: people who say “going forward into the future”.

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Whereas at my wife’s workplace they “surface” ideas. I wonder which organisation will win in the end?

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Letting lawyers have clients seems right, given that they tend to prioritize clients over morality and even law.

One pair left out of the list was that social media companies have products.

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Did they want a 100,000 year indenture contract?

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i’m all for getting off our consumerist vector, it is driving the destruction of the planet and maintaining global classism.

Isn’t the shifting terminology a reflection of the shift to a consumerist centric society and values rather than the cause of such change of behaviour?

(Makes far more sense that it is the former rather than the latter, the former requires a small change to culture in order to cause widespread shifts in language, the latter would require a conscious widespread shift in language prior to affecting a small shift to societal culture. that is basic causality.)

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I think as with most such things, it’s both.

The shift starts and the language changes to reflect that which in turn accelerates the shift which accelerates the language change which… etc, etc.

By the way, the article does not try to argue that the language shifted the values.

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Wait a second. I don’t want to totally derail this, but not being from the UK I have to ask: rough sleepers in public libraries is a thing in the UK? Not something someone heard of somewhere, but something which happens regularly?

I read headlines about the ‘rough sleeping’ crisis, and was wondering about it.

Sidenote: I wonder if security personnel trying to get rid of homeless people on behalf of their customers refer to the homeless. Probably not as customers…

I know I’ve definitely made that argument- usually in response to the idea that if doctors aren’t allowed to charge whatever the market will bear then we’ll have no doctors because they’d all quit. Any doctor who’s doing it solely for huge piles of cash is absolutely not a doctor I ever want looking after my health. I want the best treatment, not the most profitable one.

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I’m a doctor
And yes they absolutely do push this language
“They” being the executive
Who we generally ignore as much as feasible

Consumer satisfaction is inversely correlated with medical outcomes

A doctor is a teacher. That’s literally what it means. We can’t be replaced by Google because our patients don’t know the questions to ask.

Fact of the matter is, the bulk of my work is in chronic illness or psychiatric illness. And I am not a better person than my patients. I am as human and flawed as them and need my own doctors. But I am a smart guy who is trained to look at the patterns of behaviour people display and help them better themselves. And that requires hard lessons, difficult conversations. Often it requires saying “no” when they want you to collude with their dysfunction. Hell, you want good customer surveys? Give addicts the drugs they want and tell unhealthy people their lifestyle is FINE.

So yeah, they’re not customers because they’re not always right. And because I don’t work in america, they’re usually not paying me either. I’m okay with the term “client” because it has a history in psychology and recognises the individual as a person who learns and has their own strength to change - with guidance.

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It happens, sure. Where else can a homeless person go that is open to the public, free of charge, fairly well heated and (in the past at least) quiet enough to snooze through the day or at least read the papers in peace?

As long as they sit quietly and don’t bother people, most libraries won’t kick them out.

Same in the US, I understand.

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It happens seems to signify, at least to me, slightly less frequent occurrence than it’s a thing, respectively “British libraries have this”.

I’m a bit confused, TBH.