To consume (v)
I have always thought negatively of the word consume. I blame the Oxford English Dictionary (OED), whose first two definitions are; destroy or expend and; spend wastefully. The OED knows both interpretations all too well – no edition of the world’s finest dictionary has ever made a profit in its 135 year history.
OED business manager memo to his 80 lexicographers:
Pls stop consuming (spending wastefully) my budget. U R consumed (destroyed & expended) by time-consuming word research. Simply look up all the words in a dictionary – duh!
The lexicographers, who have the lowest job transferability of any known profession, would be impeccably polite in their replies, concealing their vitriol behind scathing insertions of the word sic.
The negative connotations of consume don’t stop there. Even scrolling down to the ‘eat’ definition inspires visions of gluttony or its opposite extreme: that bland soup, consommé, watery enough to serve to homeopaths.
But the main reason I don’t like consumption (no, second main, behind coughing up blood in old movie scenes) is that it causes flashbacks of interminable hours spent in my least favourite places—huge shopping complexes. Every time I enter their air-conditioned jaws, my legs quail, presumably afflicted by that low consumer confidence they’re always referring to on the news.
Finally, consume can mean devour, as in ‘consumed in the fires of hell’, but here I go discussing shopping complexes again.
Health consumers (n)
The reason I highlight the word is that recently I have discovered a most positive connotation. Health consumers. Having previously dismissed them etymologically as people who devour their own health, I now recognise them as the very reason I entered my profession.
I have just attended my first Consumer Health Forum of Australia conference and, closer to home, have been on the Queensland Clinical Senate with Health Consumers Queensland. I find consumer reps pleasant, passionate and often the most sensible voice in the room.
I was half suspecting the CHF consumers might forever be advocating for ‘more, more, more’, thereby giving me flashbacks of my shopping complex complex.
But no: speaker after speaker emphasised the need for balance – for disinvestment in medical practices which are unhelpful or give minimal ‘bang for their buck’, instead shifting the resources to high-value areas, including primary care.
So many of my pet themes were there, I wondered if Mike Munro was about to jump out to tell me ‘This is your life’. The discriminatory nature of the GP co-payment; making conflicts of interest transparent (I wrote the recent RACGP transparency submission to the ACCC); systems for meaningful patient feedback (Patient Opinion is certainly worth a look); and the Choosing Wisely campaign.
I am representing the RACGP as we bring Choosing Wisely to Australia. You’ve probably seen their dancing video. My first wise choice will be to ban anyone from filming me dancing. Then we have to come up with five things GPs do often, but shouldn’t. All constructive comments are welcome below, thanks. (Dancing doesn’t count.)
Consumer (adj) affairs
When I trained in the ‘80s, no one ever suggested patients should be given a role in actually deciding anything about health systems. That was left to the experts.
The AIDS 2014 Melbourne conference reminded us that ‘HIV activists’ were the first to crowbar open the windows and let in some fresh air. We all breathe easier for it.
As I age, my passions increasingly align with those of health consumers, although some fellow doctors might harshly (and probably accurately) assume I am merely getting grumpier. When it comes to self-interested medical advice, over servicing or rapid-throughput medicine, chuck me that crowbar.
There’s a circle at the centre of every health system flow chart and you and I, doc, ain’t in it. It’s a consumer affair.