1. Hotta, Tracey A. RN, BScN, CPSN, CANS

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Are we caring for patients or clients? This question has been playing out in my mind, as provincial regulating bodies are scrutinizing many aesthetic practices. When I was in nursing school, we referred to those under our care as patients. I am not sure when this changed, but "client" seems to be the term of choice for many aesthetic providers.

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Would addressing those we treat as "patients" instead of "clients" change the perception of services provided by aesthetic providers? Would nonsurgical procedures requiring medical supervision be seen as medical treatments instead of aesthetic treatments? Would nurses providing these services be seen in a more professional light by those who do not see this as "true nursing"?


The term "patient" comes from the Latin word patior, which means to suffer, and is defined as one who suffers. The term "client" comes from the Latin word clinare, which means to lean. It is defined as "one who is the recipient of a professional service" (


According to Wikipedia (n.d.), a patient is the recipient of a health care service, whereas a client is a recipient of goods or services in return for monetary or other valuable considerations (


The terminology may or may not seem significant to some, but to others, it can mean a world of difference. Doctors don't seem to have the debate or have the need to refer to the person under their care as a "client" and seem to firmly believe that they provide care to their patients. Are nursing leaders succumbing to the ever-growing politically correct syndrome? (Clavreul, 2014). Is it our duty as aesthetic providers to offer awareness and validation for our profession by using the term "patient"?


This is not a new debate. A study by Wing in 1997 found that use of the term "client" was documented as early as 1970. He also shares results from his survey of 101 people attending an ambulatory back pain clinic; almost 75% of those surveyed stated a preference for "patient" rather than "client" (Wing, 1997).


The medical profession is based on the trusting collaborative relationship between a nurse, a physician, and the patient. Those undergoing an aesthetic treatment by a licensed medical professional, who has the knowledge, skill, and judgment to perform these procedures, should be referred to as patients. To be referred to as a client, it requires portraying the image of a business relationship. "Client" would be a more appropriate term for spa services being performed by unregulated technicians.


When a patient is seen for an aesthetics consultation, there are many other factors that are considered besides the cosmetic appearance. Many are seeking advice because of facial asymmetry, congenital deformities, traumatic injuries, and medical issues (i.e., headaches, hyperhidrosis, muscle twitching) that result in psychological impairment. As aesthetic providers, we must look at the physical picture, as well as any emotional issues, that may be influencing their decision to have a treatment. Aesthetic providers are educated to recognize psychological issues such as body dysmorphic disorder, depression, and obsessive-compulsive disorders, as these can be manifested in aesthetic patients. In the aesthetic practice, there is an exchange of payment for services, which could be appropriate to the term "client," but I consider aesthetic procedures to be a medical treatment and therefore to me "patient" would be more appropriate.


Nurses performing these procedures are using their basic nursing skills and utilizing the nursing process to assess, diagnose, plan, implement, and evaluate the procedure performed. They must be knowledgeable about proper aseptic technique and universal precautions to ensure that the patient is receiving the highest and safest standard of care, the basic nursing skills whether one works in a hospital, clinic, or the community setting.


In 2015, the public voted nurses as the most honest and ethical profession in America in an annual Gallup poll for the 13th year in a row. Eighty percent of Americans rated nurses' honesty and ethical standards as "very high" or "high," 15 percentage points above any other profession (American Nurses Association, 2015; The profession of nursing requires highly skilled, caring, and motivated professionals who are constantly seeking educational opportunities to maintain and upgrade their skill level. The aesthetic medical profession is forever changing and nurses, as patient advocates, must keep up with these changes.


This article is providing food for thought and my personal struggle to address "client" versus "patient" in my practice. In my opinion, providing aesthetic services are medical treatments performed by expertly trained practitioners. I leave it to you to make your own decisions regarding how we address those we are caring for-a "patient" or a "client." I welcome any comments you would like to share.


A sincere thank you to some of my colleagues whom provided me with their thoughts on this issue.


When a person enters my office I am seeing them in a state of wellness. When they are in a state of illness I would be seeing them in a more traditional setting like a medical clinic, lab, or hospital.


At my clinic, I see them with a smile on their face, whole and complete and they are on journey through life. I look at what I do as helping a person through their journey of life when they are at their best, celebrating all that life has to offer. That is why I use the word client as I am seeing them in a state of wellness.


In my opinion nursing is about looking after people during all times of their life. Not just illness but wellness too. And that is how I describe the type of nursing that I practice.


So in my opinion the reason why some say "client" is that they are looking after a person when they are well and are used to saying patient when a person might not be in that state. (Maura R, Ontario)


I struggle with this in my practice. Is it from the perspective of the service provider (professional), or the treatment? Would a self-employed nurse call her customers "clients" for a paid service, or "patients" because a medical director is involved? It sounds pretentious for a nurse to call a customer a patient, in a setting where other treatments not requiring a medical director may be offered. Perhaps in the professional context, they are always a patient, but in the context of a specific clinical/business setting (and there are so many variations), the labels become more flexible/fluid. (Robin P, Alberta)


I think procedures requiring consent should be on patients. We are providing nursing care under our scope of practice. They are called patients in a plastic surgeons office. Cosmetic dentistry uses the term patients as well. (Jeanine H, Ontario)


I say "patients" as these are medical treatments with informed consent involved, treatment, and then subsequent follow up with medical charting at each appointment. Also, I would add, as nurses, our level of education and having to follow guidelines by a professional college speaks more to the word "patient" vs "client." (Jolene D, British Columbia)


When I was in nursing school, the terminology had transitioned from patients to clients, which I thought was inappropriate. I felt that "clients" were someone who paid for services, such as those provided by lawyers, real estate agents, hairdressers, etc. However, now that I am providing medical services to paying customers, I still refer to them as patients.


It's not that my original thinking was misguided, I just believe that the medical care I am providing to people makes them more than a client, or "one who receives professional service," whether they are paying me or not. Previously as an RN and now as an NP I perform health histories and assessments, prescribe medication, provide treatments and follow-up care, and evaluate results for people. This is medical care according to the medical model and the nursing process. A person who receives medical care is the definition of a patient!


I think using the term "patients" will allow nurses to be perceived in a more medical professional light by the medical community, and the public. (Tanya Z, Ontario)


In all of the clinics we care for patients. This is because we have a strong belief that the services we provide are medical, done in an appropriate facility by highly skilled and trained medical practitioners. We also employ a team approach each patient is evaluated by at least two members of the team and maybe treated by many more depending on their condition.


As a sidebar I have colleagues whom still work in acute care in a hospital setting and refer to their patients as clients the reason I'm told is to empower them to be accountable for their recovery/lifestyle adaptations/advocacy. (Kathryn W, British Columbia)


I feel that we treat "clients" as these are not sick people and they pay for their services. To me the word "client" is described as a person using the services of a professional body or company ... the word patient signifies a person needing medical attention due to illness synonym a sick person. I don't feel that it diminishes what we do at all to call them clients. (Rachelle G, New Brunswick)


When I went through nursing school in Calgary ... through all years of school, and all areas of learning (hospital setting included) and in my many, many, many nursing journal entries, I was always encouraged to refer to the people that we "cared for" as clients. Although we were allowed to use the term "patient" interchangeably with "client" for journaling, the term "client" was often encouraged by preceptors, instructors, and peers. I suppose that it helped take away the negative connotation of being "sick" or a patient with a "medical condition" to encourage a more positive term for the individual. For me, the term "client" (no matter what health care setting ... aesthetics included) is preferred over "patient." Referring to individuals as clients offers a sense of being included in his or her own health care decisions and that they actually have a voice and can be heard and included in the health care decision-making process. To be referred to as a "client" represents more "choice" for the individual, as the term "patient" tends to refer more to an individual requiring treatment for a specific condition (much less personal). (Christy G, Alberta)




American Nurses Association. Welcoming in the "year of ethics." RNs named most honest for 13 years. The American Nurse. Retrieved January 1, 2017, from [Context Link]


Clavreul G. (2014). Patient? Client? Consumer? Labels and their effect on nursing care. Retrieved January 1, 2017, from [Context Link]


Wikipedia. (n.d.). Retrieved January 1, 2017, from[Context Link]


Wing P. C. (1997). Patient or client? If in doubt, ask. Canadian Medical Association Journal, 157(3), 287-289. [Context Link]