230. Noel Gardner, conversation with the author, May 2008. Dr. Gardner has been involved in education of medical students for decades and noted that virtually all students reply with this answer when asked what their job is.
231. Health, United States, 2012: With Special Feature on Emergency Care, U.S. Department of Health & Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics. The first two statistics come from Table 88, p. 2 and the third from Table 99.
232. Many people would say that a “customer” is someone who writes the check (so to speak) to buy something. They would conclude that therefore the customer of health care is the government, which pays about half the tab in the United States, and employers, who pay another 25-40 percent, depending on how one counts. For the purpose of this book, customer is defined a bit differently. Health care can change or end people’s lives. People have to live in the bodies treated. They also have to take many of the actions required to prevent or treat medical problems. For these reasons, I suggest that they should be viewed as the primary customers of health care.
233. Donald M. Berwick, “What ‘Patient-Centered’ Should Mean: Confessions of an Extremist,” Health Affairs online, 19 May 2009.