In his letter to the editor in the November 17, 2006, issue, Dr. Julian Bravo hit the nail on the head with his disapproval of our patients having been turned into "clients." Alas, however, events have long since overtaken us; we no longer have even "clients" (a term implying a sense of reliance, with reciprocal support and care from us—at least etymologically). Now patients are referred to as "consumers," and we in turn have become "providers," like spigots in a water pipeline.

The trend did not start 10 years ago, but more like 40 years ago. I don't see any signs of its changing direction, let alone reversing—at least not until global warming begins to flood us all.