"When politicians speak of America's health care needs, they often miss an important point: the doctor-patient relationship has become frayed," Peter Salgo, a professor at the Columbia University College of Physicians and Surgeons, writes in a New York Times opinion piece. Salgo says that "business jargon [has become] commonplace" -- "'[p]atients' began to disappear" and were replaced by "consumers" and then eventually "customers." Salgo states that "customers" are treated "quite differently" than "patients" -- who, according to Salgo, are treated by physicians as if they were family members -- because they are "in your place of business to purchase health care" and when that transaction is done, "they aren't your customers any more." Salgo adds, "[T]he less time you spend with your customers, the better your bottom line will be." He says that doctors are restricted by HMOs to an "average seven minute 'encounter' with each customer," which has "reduced the doctor-patient relationship to a financial concept." Salgo writes, "The medical establishment has ... simply rolled over and gone along to get along. It has sacrificed patients' best interests on the altar of financial return." Salgo says that "the solution to the problem [is] in the hands of our patients." He says, "[Y]ou need to realize that you employ doctors," adding, "Evaluate what you expect from your doctor, then ask for it. If you are unhappy with your doctor, fire him." Salgo states, "If you insist on being treated with care and respect, you will be. And the system will improve as a result." He writes, "Restoring the doctor-patient relationship will not save anyone any money. But I submit that it doesn't have to. There are other ways to curtail health care costs," none of which "requires patients to sacrifice their self-respect." Salgo says, "We can and must reduce health care expenses. But we cannot do it at the expense of patients' well-being. The doctor-patient relationship is critical to the integrity of the health care system. It is not disposable. Turning doctors into shopkeepers who regard patients as customers is unacceptable" (Salgo, New York Times, 3/22).

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