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J R Soc Med. 2007 January; 100(1): 6.
PMCID: PMC1761671


The language of health care
Karol Sikora, Professor

We can't lose our sense of humour just because Harry Cayton (JRSM October 2006) doesn't like it. All professions have amusing codes for their customers. He takes exception to the term ‘frequent flyer’ applied to those who use hospitals a lot. Many of my cancer patients are delighted to be gold members and refer to it with pride. But he's quite right about patronization and lack of customer focus. We could do well to take lessons from the travel industry. People don't get admitted and discharged from hotels—they check in and check out. They book services rather than get referred for them.

The NHS uses the language of passivity, not empowerment. The Choose and Book scheme is a poor man's version of buying a budget airline ticket. Most people haven't a clue what the options are. Real choice occurs when consumers have real cheque books. Competing outlets vie for their trade by providing user-friendly interfaces. Mobile phones are used equally well by all in society—rich or poor, black or white, young or old.

Harry wants patient-centred health care. So let's open the doors to a dynamic, competing marketplace and not a state monopoly. But his designation will have to go. Vodafone doesn't have a Director for Customers with the implication of line management over the people that are paying his salary. And the word patient goes back to the Greek pathos, meaning suffering. The cancer charities encourage us to talk about ‘people living with cancer’ or, even more PC ‘those whose lives have been touched by cancer’—but certainly not ‘cancer victims’, so loved by the media. This Journal should sponsor a competition to find Harry a more suitable designation.


Competing interests KS is a steering group member of Doctors for Reform.

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press