Patientology (eBook)

Chapter 1:
What Is Patientology?

Patientology means the study of patients. Whenever -ology is attached to a word, it means the study of that topic. Most sciences use the suffix -ology in the names of their specialty fields; for example, cardiology is the study of the heart, anthropology is the study of anthrōpos or humans, and bacteriology is the study of bacteria. You get the picture. In the same way, Patientology refers to the specific study of patients.

Most people want to be pain free, to be as comfortable as possible while ill, to be cared for when they cannot care for themselves. In addition, they want intelligent, knowledgeable, expert care.

The health sciences—all of them—have focused on the diagnosis, prevention, treatment, cure, and care of illnesses and injuries. This is as it should be. Concomitantly, the health professions have developed the cult of efficiency. In their desire to provide the most effective and efficient services, they have forgotten that it was people, and not diseases, who receive this highly specialized, technical service. The patient, the owner of the disease, was lost in the rush to tend to the pathology.

Patient is the word used to label people (and animals) who are the recipients of some form of health-care services. Patients come in all shapes and sizes, ages, cultures, religions, races, genders, and health statuses. Patients can enter the health-care system voluntarily or involuntarily, and leave the system with or without medical advice or help. Patients can be long-term or short-term, legitimate or illegitimate, inpatient or outpatient. Patients can have all kinds of diseases, disabilities, and genetic issues needing a wide variety of health-care solutions. In addition, patients may seek out a variety of health-care providers.

Why Study Patients?

Why should we study patients? Without patients, there would be no health-care delivery system (HCDS). Yet the patient is frequently overlooked by the health system in its attempt to increase the efficiency of its service. In organizational charts of hospitals or community health centers, the patient is not acknowledged. Patients are assumed to exist.

There are as many definitions of patients as there are health professionals and social scientists. The primary concept of the patient, however, is that of the individual who needs and receives the services of the HCDS. Every individual is a potential or actual patient, at some time in his or her life needing preventive or healing services. Nevertheless, a person does not become a patient without entering the health-care system for services.

Patients are not alike. They differ demographically as well as in their pathologies, reactions to illnesses, health histories, beliefs about the causes and treatments of illnesses, and senses of responsibility for their own health care. Health professionals treat patients differently according to their pathology, length of time in the system, perception of the patient’s needs, perception of the patient’s degree of responsibility for causing the condition, and the patient’s place in the social system.

This book examines the concept of the patient from many of these aspects as well as the patient role and the patient as a victim. Part of this book parallels the ideas found in the book Victimology.

Studying how patients choose their providers and move through the health-care system (Chapman 1975), how they handle their diagnoses, how well they comply with recommended treatments, how they view the system and its personnel, and how they tolerate and live with their symptoms are all part of Patientology.

There are many studies of patients and their perspectives (McGovern 1973), including studies of the patients’ role in the hospital (Greenblatt 1957), their role in the education of health professionals, and the degree of their engagement with care. Patient-centered care (Hopkins 1972) and patient advocacy are as much a part of Patientology as the patient role and the sick role.

Patientology is a convenient descriptive title under which all these studies would fall. One day, perhaps, there might even be a Journal of Patientology!

There are many ways to study patients. If all these studies could be grouped under one umbrella, they would be easier to find, gaps in knowledge could be identified, and comparable studies could be more easily grouped. Researchers in the fields of medical sociology, medical anthropology, and medical economics (Bates 1968) have published many patient-centered articles that are unknown to one another. In general, health professionals do not read one another’s literature. Medicine (especially family medicine), nursing (Chirco 1963), chiropractic, dentistry, nutrition/dietetics, pharmacy, laboratories, and clinical pastoral care all publish patient-centered articles that are generally unnoticed by other disciplines. Yet the patient moves from one health discipline to the other daily. When there is little to no sharing of information across these disciplines, the patient is the one who suffers.

Patientology can and should crosscut all disciplines that offer some form of health care or health information. Folk medicine is as important to study as Christian Science (Hoffman 1958) or faith healing. Studies of patients can be qualitative or quantitative. Personal stories (Abramson 1956) can be as valuable as a clinical trial. There are numerous ways to study patients. So long as they use valid forms of data collection and follow ethical standards (Ramsey 1970), they should all offer valuable information.

What Can We Learn from the Study of Patients?

There is a variety of issues that warrant study. It is the patient who receives health-care services, but how does the patient feel about the process and the outcome? Do the patient’s feelings impact the decision to stay in the system? Will the patient comply with or fight the health provider? Does it depend on the patient’s culture or personality or the way he or she sees the provider or system? Is this even important to the health-care provider or system? With whom does the patient interact while receiving services? Is the patient treated as someone who can understand and cooperate, or is the patient treated as the recipient of commands? How is the patient expected to behave, and who teaches the patient appropriate behavior?

The patient is not just a single individual. The patient is also an espoused couple, a family, or an entire community. The patient can even be a nation. Since health care is not delivered to individuals alone, the same questions asked about the individual can be asked of larger groups.

When the patient is an entire community, to what extent does the political system influence health care? Governments, whether local or national, are expected to be concerned with the health and welfare of its citizens. Whether spraying for mosquito control, ensuring sanitation services such as garbage collection and removal of toilet waste, or providing clean water, local governments are intimately involved in preventing disease in their communities. To what extent are they patient oriented, monitoring their processes to ensure quality service? Who is held responsible if they fail?

While patients are the recipients of some form of health service, the service is not always provided by a designated health professional, especially in the case of preventive health services. Local, state, and national governments are also involved in preventive health services.

To what extent does the educational system influence the health of citizens? Are children taught basic hygiene in schools? Are food services and waste services in schools directed toward disease prevention? Are playgrounds safe places for children to play without being hurt? What about programs for the prevention of communicable diseases in schools? To what extent are the children and their families involved in the decision-making? Drug abuse is currently a major health issue; to what extent do health-education institutions try to counteract this trend?

Health education is not limited to schools and health-care facilities; the news and entertainment industries are also involved. What is their responsibility for providing accurate information? Drug abuse appears to be common among entertainers and athletes. These individuals are role models for children who try to emulate them. If their heroes do drugs, they are at increased risk of doing so as well.

The above examples fall under the public-health system. Because people are affected by the public-health system in one way or another, they are its patients. To what extent are the patients’ needs and wants considered in these situations? If drug abuse is a major health problem, what is the public-health system doing about it? What provisions for inpatient detoxification or rehabilitation centers are provided by the community? What about self-help groups such as Alcoholics Anonymous or Drug Addicts Anonymous?

Every five years, the federal government issues guidelines on what is considered a healthy diet for Americans. To what extent are these guidelines influenced by self-interested groups rather than valid research findings? Health agencies and citizens are ecouraged to comply with these guidelines, but what has been the impact of these guidelines on citizens over the years? Does a one-size-fits-all guideline meet everyone’s needs? How do people live and eat within these guidelines?

There seems to be a...