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July 28, 1993

The Era of the Patient

JAMA. 1993;270(4):451. doi:10.1001/jama.1993.03510040054019

To the Editor.  —The relationship between the terms "patient" and "consumer" in the article by Reiser1 is confusing. Whether consumers are something other than patients, whether "consumer" is just a synonym for "patient," or whether being a consumer is an aspect of being a patient never gets clarified. In the section entitled "The Modern Medical Ethics Movement and the Reemergence of the Patient," the first version seems to be true. He writes about "patients, consumers, courts" having been approached by physicians and the like. In the section "Shaping Health Care Practice Through Consumer Consultants," consumers appear as ex-patients who became experts in explaining their suffering to others. This might imply that the two expressions may be interchangeable. Then, in "Influencing Education Through Consumer Instructors," he writes, "consumers who have sustained illness..."—which makes patients a subgroup of consumers. Consumers also appear as research subjects later in the essay, making the