The Patient as Consumer: Empowerment or Commodification?

Discussions surrounding patient engagement and empowerment often use the terms "patient" and "consumer" interchangeably. But do the two terms hold the same meaning, or is a "patient" a passive actor in the health care arena and a "consumer" an informed, rational decision-maker? Has there been a shift in our usage of the two terms that aligns with the increasing commercialization of health care in the U.S. or has the patient/consumer dynamic always been a part of the buying and selling of health care in the American system? A quick scan of the literature produces discussions of the issue in the popular press by authors such as Paul Krugman and Leana Wen, and in social media forums such as TEDMED, but no direct analyses in the academic literature of the ethical, legal, and policy ramifications of this possible shift in terminology. This paper will analyze our usage of the terms and any recent changes in the dynamic as well as discuss the ethical, legal, and policy implications of this simple terminology for the physician-patient relationship.