By Elizabeth Ziemba, President, Medical Tourism Training, Inc.

“It was the best of times, it was the worst of times…“ And for today’s medical travelers and service providers, it may be the most confusing of times. The blurring of lines between the traditional notions of doctors as the decision makers and patients docilely accepting the physicians’ judgments are a thing of the past. The Internet age has turned that outmoded world on its head. The resulting confusion is reflected in the debate about what to call people seeking health and medical treatments. Are they consumers, patients, or clients? The answer is “It depends”.


The first two parts of this three part series offered actual situations of the worst care and the best care delivered by two physicians.* If you haven’t read these articles, now would be a good time to do so. They are available in the “Articles” section.


During the scenarios described in those articles, I was treated as a consumer, patient, and client. Each of these terms has a specific meaning and context that result in people wearing all three hats at different times as different messages are delivered and different aspects of the relationship are emphasized.

Hat #1 – I am a Consumer

Just like any person looking for a healthcare provider, when I was searching Google for a new dentist, I was clearly a “consumer”. According to the Oxford Dictionary, a consumer is “a person who purchases goods and services for personal use”. Within that definition, it may be implied that the person “is able to make a fully informed and independent decision about whether and what to purchase”. By selecting a dentist in a non- emergency situation where I am able to research his credentials, check whether he is licensed and Board Certified, and interacting with his staff, I am able to make an informed decision about whom to seek for treatment. Is it fully informed? Probably not but then again given my limited understanding of the inner workings of my computer, I don’t believe that buying decision was fully informed either.


Healthcare providers treat me like a consumer by creating appealing websites, engaging via social media, and other marketing techniques to attract my business. They want me to buy their services – the same way that Microsoft wants my dollars. I feel like a consumer and providers see me as one.


Once I walk into the door to actually purchase those healthcare services, everything changes.

Hat #2 – I am a Patient

Having selected healthcare providers – a dentist and an ophthalmologist – I expressly understand that those providers owe me a “duty of care” as defined within the US legal system. Patients around the world have the same or similar obligations owed to them according to the local medical standards of practice. “Duty of care” requires that healthcare providers deliver a certain standard of care and if they fail to do so, can suffer professional consequences including law suits. In this situation, it is clear who the “doctor” is and who the “patient” is as the doctor examines and repairs my teeth or examines my eyes and looks at test results.


Unlike my role as a consumer, as a patient I rely on my doctors to know what to do to keep me healthy or get me feeling better. There is no discussion about which medical device to use or how to use it. Control is relinquished to the expert to act in accordance with the required duty of care. This role is established as soon as the decision is made to engage the services of that provider or, in an emergency situation that decision is made for me. An individual is clearly a “patient” when a duty of care is mandatedby the laws governing the practice of medicine.


The role of patient ends when the service is delivered, the duty of care has ended, and I am discharged from care. At that point, I put on a third hat – that of “client”.

Hat #3 – I am a Client

In general, individuals can select providers in the same way that I have chosen my dentist, ophthalmologist, and family practitioner. I can choose to return to those providers or select someone else. Because of that choice, providers view me as a “client”, – someone with whom they wish to continue a long term relationship and they treat me as such. They send me reminders about scheduling an annual appointment. Newsletters are sent to inform me about new members of staff or tell me about the latest technology being offered. Incentives may be offered to bring me back. Because I have an existing relationship with that provider, I can be viewed as a “Client” until I do something to terminate that relationship. When I am no longer a client, I go back to being a consumer.


Providers often underestimate the “client” phase of the relationship – especially in the international medical travel sector. As a “Client”, a person is a powerful source for testimonials, referrals, and, of course, repeat business. Medical travelers often complain about the fact that the providers never followed up with them once they returned home. Those providers lose opportunities to build relationships with clients to grow their businesses and improve services.


In my personal case studies, the distinctions between patient and client became blurred as I was offered additional services not related to the reason I sought healthcare services. At the dentist’s office, I opted for the lovely, pampering hand paraffin treatment. While it did help me relax and most people need some help relaxing at the dentist’s office, the treatment was not directly related to the services I needed. It raised more revenue for the dental office and made me “feel special”. While at the ophthalmologist’s office, I was subjected to repeat cycles of a Botox advertisement on television that could be administered right after my eye examination. Perhaps Botox would make me feel younger or prettier, it certainly would not help me see better. Instead of Botox, the doctor’s office should have served up a better patient (and client) experience.

Which hat? All three.

Individuals and providers wear multiple hats at different stages of service delivery. Each stage offers opportunities to establish and build relationships that can last a lifetime or end abruptly. Awareness of the hat being worn at different times requires flexibility and mindfulness that challenges us as consumers, patients, and clients. That attentiveness can guide providers in their delivery of healthcare and marketing services.


“Here’s the rule for bargains. ‘Do other men, for they would do you.’ That’s the true business precept.”
– Charles Dickens, from Martin Chuzzlewit


*While the information reported in Parts1 and 2 of this series are based on my actual experience, the names of individuals are changed to protect their privacy.

Copyright © 2015 by Medical Tourism Training, Inc. Newport, Rhode Island, USA. Proprietary Information: All rights reserved. No part of thisdocument may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying and recording, or by information storage and retrieval system, without written permission from Medical Tourism Training.

The following two tabs change content below.
Elizabeth Ziemba

Elizabeth Ziemba

President at Medical Tourism Training
With a diverse background in public health, law and business, Elizabeth brings a unique set of skills and experience to Medical Tourism Training with services including assessment tools, online and onsite training, workshops, and consulting services for governments, providers, facilitators, associations and others involved in medical travel.