Sir: We read with interest the article by Ritchie et al (Psychiatric Bulletin, December 2000, 24, 447-450) describing the preferences for the terms patient and client with respect to people attending a psychiatric clinic. Our prior study (Sharma et al, 2000), which involved a survey of 550 service providers and 427 service recipients at four sites in Canada - two provincial psychiatric hospitals, a private mental health centre and a psychiatric unit of a general hospital - showed similar results. The term patient was favoured by both service providers (68.4%) and service recipients (54.8%). The logistic regression results for service recipients' preference for the term patient showed that the variables of site, diagnosis and employment status contributed the most to prediction. More specifically, service recipients from the rural provincial psychiatric hospital had lower odds of preferring the term patient than did service recipients from the urban provincial psychiatric hospital. Service recipients with the diagnosis of mood disorders had higher odds of preferring the term patient than those with substance misuse disorders. Retired service recipients were more likely to prefer the term patient than those who were employed (Sharma et al, 2000).
The consensus among providers and recipients in current publications favours the use of the word patient. In our view the word patient carries a broader and perhaps deeper fiduciary commitment than does client.