centres on caveat emptor - let the buyer beware.To my accountant or bank manager I am a client; such re- lationships are governed by well- defined legal ...
LETTERS * CORRESPONDANCE
We will consider for publication only letters submitted by mail or courier (not fax) in duplicate, printed in letter-quality type without proportional spacing and not exceeding 450 words. Letters must not duplicate material being submitted elsewhere or already published. We routinely correspond only with authors of accepted letters. Rejected letters are destroyed. Accepted letters are subject to editing and abridgement.
Seules peuvent etre reteniues pour publication les lettres reeues par la poste ou par messager (non pas par telecopieur) en double dont la longueur n'exce'de pas 450 mots. Elles doivent etre mecanographiees en qualite ..lettre>> sans espacement proportionnel. Les lettres ne doivent rien contenir qui ait ete presente ailleurs pour publication ou deja paru. En principe, la redaction correspond uniquement avec les auteurs des lettres retenues pour publication. Les lettres refusees sont ditruites. Les lettres retenues peuvent etre abregees ou faire lobjet de modifications d'ordre redactionnel.
Letter to my patient I support this letter (Can Med Assoc J 1994; 150: 123), by A. Albert Annen, MD. Faculty members at the University of Calgary medical school and probably other Canadian schools encourage medical students to use the politically correct language identified in Annen's letter. However, I agree with Annen that such usage distorts the sanctity of the doctor-patient relationship and makes it less honourable. People often try to define some thing or relationship better by giving it a longer name. Defining the patient as a "health care consumer" in the doctor-patient relationship is one example. Ironically, this politically correct term just seems to confuse people (it certainly confuses me). These names become such a mouthful that people abbreviate them into manageable lengths (e.g., HCC for health care consumer). Eventually e- For prescribing information see page 1163
one cannot remember what the abbreviation stands for! From the bottom of the vertical asymptote, sometimes called the learning curve, I say "Enough of this confusion!" It's difficult staying current with all the drug and "bug" names, let alone all the inoffensive terms for a patient. I applaud Annen for speaking out against the political-correctness movement, which has infected even the industry of the "state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity" (SoCP MaSWB MADI)! W. Ken Milne Medical student Class of 1995 University of Calgary Calgary, Alta.
Dr. Annen's letter exemplifies what is central to the doctor-patient relationship - those who seek our help should be regarded as patients, not clients. As a member of society I make a deal with the person from whom I buy a car, a home or a hamburger; I am a customer, and the relationship centres on caveat emptor - let the buyer beware. To my accountant or bank manager I am a client; such relationships are governed by welldefined legal, professional and ethical rules. However, my relationship with my doctor goes beyond this: it involves not only trust, honesty and competence but also human interaction, empathy and caring. There is a covenant. With my doctor I want to be a patient, not a client. The origin of "patient" is the Latin pati, to suffer. Surely the relief of suffering is what we physicians are all about. The backlash against "patient" seems to have originated from not
our patients but, rather, those who may have perceived that the term implies subservience of the patient. This is old stuff. Unless I am mistaken we are no longer turning out young physicians who feel that they alone know what is best for their patients, that patients should do as they are told and that doctors are somehow better than those they serve. If other professions wish to call the people they serve clients, so be it. With hope, doctors will continue to have patients. C. Anthony Johnson, MD, CM, CFPC Professor emeritus Queen's University Kingston, Ont.
Who should practise? Where? I n the article "Canadian selfsufficiency in physician resources" (Can Med Assoc J 1994; 150: 21-22), Robert F Maudsley, MD, presents a reasoned articulation of a position with which I am in complete agreement. It is counterproductive to reduce the size and strength of Canadian medical schools. International medical graduates (IMGs) continue to fill many clinical-medicine positions in Canada. We need to address physician supply across Canada at the level of recruitment into medical school rather than depend on IMGs who are less representative of our population and less adequately trained in Canadian medical practice than Canadian graduates. The strongest argument for allowing IMGs to practise in Canada is their recruitment to less desirable locations and specialties. Such resource needs should be met CAN MED ASSOC J 1994; 150 (7)
1055
