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May 1975

The Customer Approach to Patienthood: Attending to Patient Requests in a Walk-In Clinic

Author Affiliations

From the Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston.

Arch Gen Psychiatry. 1975;32(5):553-558. doi:10.1001/archpsyc.1975.01760230019001

This report conceptualizes the initial psychiatric interview as a process of negotiation between the clinician and patient. Patients are conceived of as appearing with one or more requests, many of which represent legitimate needs. It is the clinician's task to elicit the request, collect the relevant clinical data, and enter into a "negotiation" that should foster a relationship of mutual influence between patient and clinician.

We have attempted to show that this approach to patienthood not only improves patient care and patient satisfaction but also leads to improved staff morale. The "customer approach" has special relevance to those clinical settings (walk-in clinics and community mental health centers) in which clinicians see a broad range of patients with a broad definition of psychiatric problems and requests.