kevinmd.com published a version of this story on Sept 12, 2018
In November of 2015, Dr. Suneel Dhand and William J. Carbone penned, “Physicians are not providers: An Open Letter to the AMA (American Medical Association) and medical boards.” The authors ended their piece with the following plea: “The word “provider” is a non-specific and nondescript term that confers little meaning. We, therefore, call on the American Medical Association and all state medical boards to consider discouraging and terminating the use of the word “provider.”
In Dr. Dhand’s follow up piece, he waves a white flag, as he recounts a conversation with a young resident. In this conversation, Dr. Dhand introduced himself as a patient’s “attending physician.” The resident translated this back to him by asking if Dr. Dhand was the patient’s “main provider.” Dr. Dhand writes, “Alas, the term may have already filtered through to the future generation of doctors much earlier than expected.”
That future generation might be taking tips from a recent startup trend in the corporate world that aimed to get rid of titles within companies as a way to increase creativity (the idea was that eliminating hierarchy would lead to a more “open idea forum” within companies).
This concept largely failed and is slowly phasing out. In its place are companies allowing employees to develop titles that accurately reflect their training, tasks, and involvement within a team. Why? Because it’s a fact that employees are more engaged at work when their contributions are recognized.
Calling medical doctors “providers” does more than inflict eco-injury, It actually reduces morale, worth, purpose and results in already overworked doctors finding less meaning in the work that they do. A recent Pearl Meyer & Partners poll found that 92 percent of employers use job titles to define an employee’s role accurately, so why hasn’t this trend found its way into the medical world and where did it come from?
Where did this term originate from and why has it been widely adopted across the medical landscape? The federal definition of the word “provider” is precisely the issue with this word. By law, the term refers to “a doctor of medicine or osteopathy, podiatrist, dentist, chiropractor, clinical psychologist, optometrist, nurse practitioner, nurse-midwife or a clinical social worker who is authorized to practice by the State and performing within the scope of their practice as defined by State law, or a Christian Science practitioner.”
These are all very distinct and unique professions that range broadly from a mental health expert to a Christian Science practitioner. Some of these professions do not require any medical training at all, but the term tries (and fails) to be all-encompassing. So where did the term come from and why has it been widely adopted? The term was adopted by federal law in the early 1970s and largely left festering amidst a tangle of professions that may or may not include the abbreviation “MD” after a person’s name.
The term is insulting to other members of a medical team too. There’s nothing “mid-level” about a “mid-level provider” working long shifts and taking care of sick patients. The whole term (any way you put it) doesn’t work and needs to be changed. I know that this is not a new fight amongst medical staff, but it’s one that needs to be re-addressed and reworked. Why is anyone on a medical staff still being termed “provider” if we know that titles matter, are used to accurately reflect a person’s role within a company, and lead to better overall engagement in the workplace? It’s not only nonsensical, but it’s also detrimental.
If the word “provider” didn’t upset me enough before today, I am now more sure of my crusade… As a Jewish pediatric orthopaedist, I felt a full on gut punch when a woman physician shared the following with me: “In the 1937 issue of the Reichs Medizinal Kalender, a directory of doctors, the remaining Jewish doctors in Germany were stigb matized by a colon placed before their names [Figure 1]. Their medical licenses were finally revoked in 1938. They could no longer call themselves “Arzt” or “doctor.” They were degraded to the term “Behandler” or, freely translated, “provider.”” quoted from
Jewish Pediatricians in Nazi Germany: Victims of Persecution
Paul Saenger MD
Children’s Hospital at Montefior/Albert Einstein College of Medicine, Bronx, New York, USA
The term “provider” creates an abyss where there should be a relationship between a doctor/surgeon/physician/physician assistant/nurse practitioner/nurse/therapist/CLINICIAN and patient. The depersonalization and interchangeability are demoralizing and confusing to me. I hope we can put this work behind us in 2018.