A customer is an entity, individual, or group that initiates a decision to purchase an item or service.  It is an easy concept to grasp. We can all see ourselves going to the closest big box store to purchase the latest hi tech gadget. Generally, we have researched our choice, know how much it will cost, and are in control of the purchase.  The owners of the store understand that, by and large, the individual entering the store and paying the money is the customer and the storeowner will do almost anything to attract that business. 

            The customer concept in health care is not so direct.  First, the term patient denotes a ceding of control to the physician.  As a patient, we should be “patient” and wait for our appointment and do what the physician tells us.  Yet, as a customer we would research our potential purchase of service, take price into account, and evaluate the value we received as an indicator of whether we will return.  To be honest, this rarely occurs in the purchase of health services.  Payment through a third party, lack of transparency in pricing, and inaccessible quality information are but a few of the many reasons why the standard customer relationship does not exist in health care.

            Even defining whom the customer is can be a complex issue in health care.  The customer, more often than not, is not the person sitting on the exam table.  Determining who influenced the decision for that person to seek out your service can be complicated.  Due to a lack of accessible objective information on most providers, patients depend on diverse sources of information.  Family members, friends, mass media, third party payers, and other physicians play an influential role in the decision making process that is usually based on an evaluation of the provider’s subjective reputation in the community.     

            Future changes in health care policy are likely to enhance the concept of the patient as an empowered customer.  There are many who believe that treating patients more like customers will bring improvement in quality, safety, and lower the cost of health care.  Physicians who embrace the customer concept have already seen improvements in patient satisfaction as waiting times have decreased, while communication and physician access has increased.  The customer concept compels physicians to consider marketing techniques to grow their practices.  Identifying your customer base and effectively directing marketing resources is vital in achieving success. Specialists who overlook the power of their referrers to drive patient volume are at risk.  Primary care physicians who do not appreciate the influence of family members on medical decisions are at risk.  Any astute physician will identify who makes the decisions for a particular patient in order to determine the decision maker’s wants and needs.  Embracing the customer concept in your health care organization will result in a customer population that will be satisfied and a physician organization that will be successful.