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.”
Corporate influence
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?
Provider origins
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.
Post Script:
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.
Why don’t you include Physician Assistants in the definition of a provider when they are recognized by the law as such?
Physician’s assistants are clinicians and give excellent care to patients. I do not feel comfortable substituting the word “provider” for physician’s assistants any more than I feel comfortable substituting the term “provider” for doctor or physician or surgeon. We all work hard to care for our patients, and I hope that our patients can recognize which member of the team we all are!
It is equally interesting when a resident in surgery introducing himself to a patient as “Bob.” Bob has not credentials attached. Who is Bob and dies he have the training or rights to talk to me about my life threatening disease or a critical surgery I am going to have tomorrow. Patient want it to be Dr. Robert Smith there at the bedside for these “chats.” Bob the provider, the builder, or the housekeeper will not do.
There is no confurt in using a familiar name when an expert is needed. We forget that are friends are for support, our physicals are for expert advice, credentialed training and experienced care.
Alan, great points! Thank you!
What a great piece! I have been harping on this for years and I was worried we stopped caring about this. Organizations are scratching their heads wondering what happened to physician satisfaction and engagement. Well this is what happened. We became providers. Until we are recognized again for the sacrifices we have made and the burdens we all shoulder for our patients, physician burn out will continue to be a hot topic. Thanks again!
I have been brewing on this for years, too. I was ready for people to disagree with me, and I am so grateful to hear that others share my thoughts. So much work to do for us as doctors in 2018.
Overlooking the numerous typos I agree wholeheartedly. “Providers” and the use of familiar names makes us all “equal” to the extent that we’re everyone and no one at all. In the world of medicine we have to maintain professional and expertise distinctions and ranks. One must instill trust and confidence in our position with patients. “Bob the provider” won’t do.
Good reply. Thanks. I am a retired pediatrician with a good relationship with my Internist, aka doctor. I call him Doctor because it is an acknowledgement of his job and profession. That does not make doctors arrogant in itself. If an MD is arrogant, he will still be arrogant if called provider. I also want to know that the person caring for me is a professional who, hopefully is competent and educated appropriately.
I think this falls along the same lines as what happened to me recently. I was waiting for the nurse to bring the patient into the OR, she finally came and in front of the patient said ‘you met your anesthesiologist Alex already’. I think this is disrespectful and has nothing to do with ego
Or spelling
*Physician Assistant
There is no apostrophe S in the title.
thank you for this. I learned this after I wrote this piece. I am editing it now and apologize that this was written incorrectly.
I am wondering if you have a suggestion for the term “PCP”. It works nicely as “provider” apply to physician, NP, or PA. Now than many NPs and PAs are PCPs. What should they be called? With so many titles, it also gets cumbersome to make referrals, call in scripts, etc.. and sign on the “correct” line.
Interestingly, an old friend who is an Internal Medicine Physician told me recently that she hates the term “primary care” as well. It seems that the more I delve into this the more I uncover language that is painful for many.
Thank you for rating thus. I find it distespe tful when journals and other professio s get this wrong. Hats off to you!
I hate to point this out… but since you are obsessed with titles, it’s “Physician Assistant” not “Physician’s Assistant”. The possessive in that title went away many years ago.
I am GLAD you pointed that out. I thought I edited this a few weeks ago to remove my offensive apostrophe. RE-EDITING.
It’s physician assistant. Not physician’s assistant. Despite how the name sounds we are not assistants to a particular physician. We also practice medicine. Otherwise I agree with your article as the hospital I work at tries to call all of us caregivers. It’s demoralizing.
Thank you for this article. I am one of those who feels offense and slight when my job title was changed to “Provider” by The State. I chuckled at the post script, not because of the content but because I heard a speaker at an AAPS conference first enlighten me that the Nazi’s refused to refer to Jewish Physicians as such, and instead came up with a “provider” equivalent, but you beat me to it, and with better detail and support!
Thank you, Dr. Jef
Thank you so much, Doctor Weiss. I’ve been trying to make this same point for years to any of my colleagues who allow speakers or emailers to address us as “providers.” If physical therapists or doctors of nursing (is that a conflict of terms?) expect to be called doctors, is it too much to expect that those of us who have spent up to 10 to 12 years of post college training be addressed as doctors?
I think there needs to be a line drawn in the sand. Whenever we get an email or hear someone address us inaccurately, we need to speak out.
I have talked about this with our amazing team of physician’s assistants. They are the heart of our team, and our patient care is amplified and improved by them every day.
Jennifer, I appreciate that you feel your team of “physician’s assistants” are amazing, but whereas you have a problem with the term “provider” we (I’m a Physician Assistant) have a problem with everyone continuing to use the ‘s. If you could please take note that it is pretty offensive to a lot of Physician Assistants. We love patient care and being part of a team but we don’t belong to a physician as the apostrophe indicates. This has been an ongoing battle where we would like to change the name or spend more time educating people on the role of a Physician Assistant and stop implying that we are just “the doctor’s helper”. I personally think Physician Assistants would prefer to be called the “medical care provider” then people would know what we actually do.
You have just taught me something. Thank you so much. The Physician Assistants I work with have not corrected this error (maybe I use the abbreviation so much that I didn’t stop to think about what it stands for.) Point taken. The precise nature of this language is important, and I will remove the ‘s in the future. I encourage you to consider that the term “medical care provider” is not specific to the way you take care of your patients, and that this term does not help your patient differentiate the members of the team of people that take care of them. If you prefer to be called a “medical care provider” I of course defer to you and your profession.
This is one way Physicians are devalued in the health care system.
I know. so sad.
Excellent piece and describes a long overdue change. It is an insulting term and I am aghast whenever I hear it come out of a physician’s mouth. Thanks!!
thank you!
I am retired now, but at one time I corrected an administrative member of our clinic, stating that I did not go to “provider school” .I finished Medical school and want to be called doctor.
I too am retired, but 20 years ago I tried to get our Metropolitan Medical Society to push back against the term “provider.” In fact every contract that I signed had the word Provider crossed out and the word Physician written in.
In college I needed a couple of humanity credit hours so enrolled in a course called “Language” having no idea what it was about. It turned out to be a very insightful course that centered on exactly what this issue is about…”who names you controls your destiny.” Homogenizing healthcare professions is not an administrative accident. If you want the public to be “OK” with seeing a provider of any level of training, you must first train the public to accept the pool of talent as interchangeable. Step one is to
name everyone “Bob” so that you feel comfortable that you were able to see a “Bob” today. In an attempt to lower healthcare costs patients need to be made comfortable and satisfied with seeing Bob. If everyone is called Bob the patients will stop looking for the differences since, after all, everyone they see is a Bob. Remember Obama’s speech wherein he said that he would make healthcare more accessible by training more nurse practitioners? This is the primary reason. Additionally, I suspect that historically the term “Doctor” was held in high esteem and political arguments against doctors ran into headwinds due to the respect factors.
In the mean time this provider is going outside to provide some fertilizer to the grass in my lawn.
As a former registered nurse and an physician for 33 years, I detest the term provider. I am a physician who practices the art of healing using evidence based medicine.
Nurse practitioners and Physician Assistants also fall into the category of healers.
A person can be a provider of janitorial services, etc. That person did not spend a huge chunk of their early adulthood preparing to take the most sacred trust of our patients I to their hands.
I am not a paper pusher that only cares about numbers. Yes productivity and patient care must be balanced in order to pay the bills and eke out a decent living. Hiwvrr, we should strive to put the patient st the forefront and not as an afterthought.
thank you for this. I love the term “healer”.
Dr. Weiss, as an FNP-C I have had the privilege of working with many physicians who have honored my profession’s contributions to our patient’s health care. In the best practices we are a team, and the skills we bring to the examining table should be identified and respected.
I agree 100% that Doctors be identified as Doctors/Physicians.
That said, I was wildly uncomfortable being labeled a “Physician Extender,” lol. That’s going away, right?
My son, the Doctor, is in his second year of residency.
The number of terms that I have unlocked and discovered to be wildly uncomfortable and offensive grow as people take the time to join this conversation. I think that as I attempt to “lump” groups together I run into trouble. I don’t think I will move forward with any substitution for titles. I am honored that you have joined in by pointing out ways to improve. Your son must be proud of you.
Deliberate and calculated death of the “Guild” concept is where this began in the West. Your points are extremely well taken
this is fascinating, I need to read more about the “guild” concept!
Of course you are right about the term “Provider.” I’ve had my MD since 1975, and it’s been a losing fight against the bureaucrats and administrator in every area. I remember brief SOAP notes and spending just about ALL my time with my patients.
my dad was a doctor since the mid 1960s He was still alive when the term provider was beginning to make its debut, and he was so sad about it. I remember soap notes from medical school and sad that they went away!
Gosh I’ve been out of the loop for a long time as I’m no longer operating, office practice only. I didn’t know the SOAP notes were obsolete! I received my MD in 1993 and up until I stopped going to the OR in 2006 we were still using SOAP notes!
This article can really be condensed down to the issue of control.
Today a provider. Tomorrow an employee.
What appropriate new title to call a physician is really nothing more than a distraction “ a side show of the war” from the movie “Breaker Morant” – part of the strategy for insidious corporate and government control over physicians. This duopoly of political and corporate control is the pure definition of fascism.
Doctors have given away their profession. They won’t get it back simply by lamenting about it over the media.
Thank you for this. Help me focus my energy as a physician advocate… I am active in advocacy, lobbying working within my large medical group to advocate for physician culture. Please help me be more effective!
You are correct, at the heart if this is an epic battle that is waging regarding who controls the means of production in medicine. I firmly believe that the means of production in healthcare is the training, skill, and acumen of physicians. However, those in healthcare organizations want to see their organizations and administrative teams as the means of production of heakthcare, not physicians. This battle for control of the means of production has played out in the US society before, about 100 years ago, in a battle between labor and corporate owners. Much blood was spilled in that conflict and ultimately lead to the almost endless power of labor unions in the 20th century as a counterbalance to the mega corporation. Is the current struggle in medicine really that different?
what an interesting analogy. really powerful. thank you
You are 100% correct! I’m one of 5 doctors in our OBGYN department at a major hospital in NYC who is still a solo practicing physician in private practice. All other MDs in our HUGE dept are either in a large 8+ group, or working for the hospital. It’s ridiculous that doctors are like sheep being led to the slaughter… as a profession we are becoming blue-collar workers —- working for the “man” —- no control over how many hours one works, for how much money one works, nor the ability to practice both the science and art of medicine but forced to follow copious “algorithms” and “protocols.” With the now full-steam production of increasing numbers of physicians to prevent the so-called ensuing “physician shortage” doctors will be a dime-a-dozen and highly dispensable. At which point the healthcare corporations will be able to easily hire and fire doctors at will since there will be a “job shortage” not a “physician shortage” and doctors will be grateful just to have a job and they’ll be paid peanuts while at the same time society’s respect will rapidly spiral downhill.
You are exactly right: we physicians have given away our profession. There are many reasons for this from being too busy to put time and energy into infrastructure to being highly selected at the time of medical school admission as those who obey authority. We need to organize but, ironically, antitrust laws keep us from organizing for any financial reasons. But I believe we can form a union-like organization around the issue of quality patient care. The antitrust laws can’t touch us on that issue. And, as physicians lose control of clinical decision-making (think prior authorizations), our patients suffer. We need a strong physicians’ union to enable us to use collective bargaining for our rights to make medical decisions for our patients and create a medical delivery system that is supportive rather than so punitive.
I understand the annoyance at the use of the term ‘provider’. For all the manuals that are written, all the letters that are written, what would the writer suggest? Each time an insurance manual talks about getting a prescription, should the manual list all the people who can write the prescription? ‘TO get the medicine you need. ask your medical physician, osteopathic physician, advanced nurse practitioner, physician assisstant, psychologist or social worker or other professional who is licensed to write prescriptions in your state for a prescription.’ And each step in the process would need to list all people who could write prescriptions. Those of us who write these narratives talk about and think about what to say. Help us out.
Thank you for asking! I propose the word “clinician” in that scenario. When I write workflows and documents I err on the side of an inclusive list of people’s titles… but I understand that this is cumbersome! Another option is “your doctor or someone on the healthcare team”. I am so grateful to have this dialogue
I moved to the US in 2001 from Canada after practicing for 13 years. Working in a FQHC community clinic, I was struck by the use of the word “provider” and pushed successfully to have the clinics use the term “clinician” instead. There were so many small things I noticed that spoke to the factory-worker business model environment that I was quite aghast early on, yet the US docs seemed to not even notice. I guess they were like the frog in the water being boiled slowly. I was seen as a “trouble-maker” then, as they all wanted to “keep their jobs”, but by now they are all “burned-out” and starting to understand what I was talking about. Sad, really. Thank you so much for this conversation!!
I am so grateful for your words. Thank you for supporting this conversation
Hi Dr. MacDonald,
How was your 13 year experience as a physician in Canada?
Just wanted to point out, NPs can practice, own their own clinics, and prescribe autonomously in many states and are often not on a physician’s “team”.
Absolutely correct. NPs can also be doctors, either PhDs or DNPs, and as a DNP, I have seen a lot of pushback from some physicians and physician-based organizations about using the title of doctor when I introduce myself (I always explain to my patients that I am an NP with my doctorate in nursing practice).
In answer to your question, yes they should.
Licensed prescriber.
I would use the descriptive term, “Prescriber” in this context.
I agree with the comments from Dr Weiss
Thank you, Dr. Johnson!
They are trying and succeeding at downgrading our profession by using the term provider. When I worked for large healthcare systems the managers would refer to me and other physicians as providers and would implicate that I was no different than any other employee in the system. The same goes for the medium sized county hospital I work for now. They(CEO’s) turned our profession into a business. The patient is the customer now with most of the power(they call the clinic wanting MRI’s, x-rays, Abx, unnecessary referrals, pain meds, etc) and we are the providers ordering and giving them what they want. This is the model that has been created by the CEO’s. No wonder healthcare is broke. I believe it’s the patient(customer) that wants it this way. Just like any other business, the CEO looks at what the customer wants and gives it to them. The patient is now the most important part of the equation whereas the physician is the least important. If the physician leaves, no problem, just replace them with a PA/NP(less expensive) or call a recruiting firm and choose from a variety of applicants.
We need to work together as a physician community! thank you for sharing this.
You’re completely right! My husband saw it 15 years ago. He said “.. the insurance companies are turning doctors in blue collar workers but will pay you less and you’ll have fewer rights!”
If you are a “provider” do you have “clients” or “patients”?
I absolutely prefer the term “patients”, not “clients” or “customers” or “members”. I am curious if patients agree, and would like to do some work to better understand their preference because this is what matters, right?!
And the latest development is “Advanced Practice Providers”. This is now in medical staff bylaws committee meetings across the country and refers to Nurse Precticioners. I think it’s false advertising, intentional, to substitute nurses for doctors in hospitals. and to the patient “Advanced Practice “ sounds like *more* than MD/DO medical school training. They are being placed as hospitalists and even intensivists. See recent Medical Economics issue for what happens when an MD reports unsafe practices by these “APPs”. The doc gets fired.
the language is confusing and creates rifts between patients, doctors, nurses, therapists… I agree with you!
APP is a response to the disrespectful term “mid-level provider”. Nobody should be considers mid-level. If there is a mid-level provider, who is low-level?
Physicians are physicians, everyone else is a Medical care “Provider”
I don’t refer to my colleagues as Doctors, they are Family Medicine Physicians, Gastroenterologists, Internists, Surgeons, Nephrologists, Neurologists, Pediatricians, etc. No midlevel or PA can claim this achievement, and it specifies who I am talking about.
Hear hear! This is a world of political correctness on sick steroids. It’s insulting and I suppose a “micro-aggression” to highlight that some “providers” are Medical Doctors versus Nurses or Physician Assistants. The implication being a hierarchy of education, training, knowledge and expertise. What the Corporations really want to present to their “clients” is the “team” as a group of equal and interchangeable “clinicians” and “providers”. What’s the first step in controlling a person or a group? Change their name!
Did the AMA ever take a position on the term “provider”? If yes, then they should be vocal about it and get it changed in federal law. If no, then we need to change the AMA.
excellent point.
I still can’t find policy from the AMA, but here’s something from the AAFP: https://www.aafp.org/about/policies/all/provider-term-position.html
thank you thank you thank you for this.
I agree that as a physician I detest being referred to as a provider. It feels like I am an “asset” of the organization. Of course, that’s the point. To the administrators a doctor is a provider and an NP is a provider (and they are at times interchangeable). Providers are a class of employee.
However, what do we do now that there are many types of “healers”? We all provide a service and as a group what is the term? “Healers” is too affected. “Caregivers” is just semantics and doesn’t reflect education.
I’m afraid that in the world of large institutionalized corporate medicine the term provider is here to stay. We may need to accept that we are providers but then within that group carefully distinguish ourselves as doctors.
Perhaps it is like being a soldier. There are privates, and captains, and generals but to people not in the military they may all be seen as soldiers.
I think “clinician” is more respectful?
I guess PAs and NPs want to be upgraded as doctors, some even demanding the title, doctors on the other hand have been willing to be downgraded. So the term is an unique upgraded and down grade version of the MD/PA/NPs, benefits one group and outdoes the other.
How is this the case? Sounds like you have a chip on your shoulder. I have seen very few PAs who think they are doctors. The PA profession embraces physician oversight. I can’t say the same about NPs. Maybe it’s just me, but my experience (as a former RN, now PA) is that NPs seem to shun physician oversight, which is a problem. Don’t lump us together. As to the term “provider”, in the Army “Provider” is used generically (short for “Healthcare Provider”) to denote medical professionals who have the ability to diagnose, treat, and prescribe. I don’t view it as a dig on physicians or an upgrade to PAs. Frankly, in the Army the vast majority of the heavy lifting for primary care all over the world comes from PAs and often with very little physician oversight (often hard to do on a remote combat outpost in Afghanistan). That might not be optimal, but unless more doctors are willing to serve (and go to combat) that is what you get. I don’t care what you call me… my job/duty remains the same.
Brad,
1. Thank you for your service.
2. My intent is to point out that the word “provider” risks viewing all of us (doctors, physician assistants, nurse practitioners, nurses, therapists to name a few) as a commodity, not as people taking care of people.
We are providers and our patients are clients. How did this come about?
Why did we let it happen? The lawyers do not allow their legal assistants , many of whom are very knowledgeable to be called lawyers. and we clearly are reminded who is who. This is an attempt to level the playing field so everybody is created equal. It is a thinly veiled attempt to show the world we are not so special. Antbody can do our job, from the phamacist to the physicians assistants. Everybody can prescibe and does And it will not get better, The insurance companies and the govenment will see to that, and sadly our patients will also.
You are absolutely right. How many of us have had patients come into the office saying they consulted “dr Web MD” and commence to tell us what they think their diagnosis is and ask if we can just order or do a sono or just prescribe a certain antibiotic for them cause they already know what they have???? It’s obnoxious and disrespectful, but this is where we’ve arrived. QNumerous times a week I have to tell the patient, “let’s pretend I’m the person in this room who went to medical school and has the medical license; why don’t you NOT tell me your diagnosis but simply tell me your symptoms and I’ll come up with a diagnosis all on my own and we’ll see if we agree on the diagnosis (sarcastic tongue in cheek) ? It’s sad I have to remind patients that being a doctor isn’t as easy and as simple as it looks but this is a reflection of the rapidly downward spiraling respect for our training, knowledge, and contempt for our intellectually elevated place in society…. a means of leveling the playing field…. Sad.
As Pogo said,”We have met the enemy and he is us.” We have allowed a noble profession to be sullied.
Absolute chills. well said.
In the early 1980s I asked an HMO administrator the reason for referring to MDs and DOs as providers. Her answer was simple and degrading.
She said the HMO staff felt uneasy telling a doctor that the testing or procedure they were requesting was easy to refuse if the staff was communicating with was a PROVIDER. They felt uneasy telling a “DOCTOR” that permission was for the specified process was denied”
yes, simple and degrading
Gee, I never knew that I went to “Provider” school! The only ones I provide for is me and my family. Provider is a demeaning title that I believe was advocated by administration, healthcare corporations, insurance companies, and government and has created the perceived demotion or status of the physician. For similar reasons, why don’t we insist on the title of beancounter for those working in administration in the front office?
I agree. “Reducing” physicians to providers does a disservice to the patient. Having confidence in your doctor is part of the treatment plan. If the patient views us no differently than their neighbor “Bob” then she/he expects no more of us than an average Joe. It alo leads to much of the questioning we now encounter, asking us to justify our conclusions, choice of medication/therapies/testing and recommendations for followup care. The new wave of young physicians do not have luxury of perspective and usually see no harm in being collegial with patients. Quality = Being liked.
Hallelujah! It is wonderful to hear that Doctors in unison are speaking out against the put down word “ Providers”. Long overdue
I am so grateful to know that I am not alone
I’m unapologetic, incorrigible, old school. Graduating from medical school made me a doctor, and residency made me a physician specialist. My family considered me a good provider by putting food on the table and paying my kids’ tuition. What’s not to like about being a good provider?
Provider is a loose term which appears to be created to dictate physicians what to do and take away their bargaining power away
And on a lighter but still revealing note, we were M.D.s before auto-correct spell-checkers made us all cities in Maryland. Hey, I am not a provider and I am not a City in Maryland. –
I once get a letter from the feds which started out “Dear Entity”; That’s even worse than “provider”
that is absolutely so awful that I just laughed out loud
the reduction in physician role in medical care is a carefully orchestrated method of eliminating control of the purse strings of medicine and handing it over to administrators and entrepreneurs. compare physician salaries to ceos* and government supervisots. it is all about control and money, not patient care!!!
Until there is a substantial consequence to affect a change in an adverse action, the adverse action will continue, despite the flood of words and concern. This is an issue for us physians through the AMA collectively. But more importantly individually, by not accepting the designation. I am an an adult and would insulted if I’m referred to as “child,” even “very nice child.” How do we act when offended or degraded? Unfortunately we are what we accept. What is our individual/collecive consequence toward the cooperate downgrade? I do not accept the designation of “provider” and vocal in my non acceptance,
Innocently, “Provider” is a term used by non-clinicians for convenience: it’s far easier than referring to the group as, “MD/DO/NP/PA” and looks better in print, especially to patients. If one were more inclined it could be viewed as a medico-legal-industrial-complex conspiracy to equalize us for the purposes of lowering salaries and egos.
I agree that the only time I accept “provider” is when it indicates a space I have to complete on a form, ie. a pre-auth, that could be completed by various types of licensed health care professionals, or when I have to go through a phone tree (press 1 if you are calling from the provider’s office), just to not have to list all of the different types as discussed above. Otherwise, no.
Let’s sum this up in one word-Professionalism. Dr. Weiss and many of the other commenters are on board with this. As someone engaged in medical education this is one of my key point I try to emphasize from the first days of med school. Upon graduation you are not called “Provider Smith”. I feel that this degrading title is part of the “medical industrial complex” to cheapen out education and training and to justify replacing us with providers who lack our 4 years of school and 3+ years of post graduate training.
Thank goodness ! This so needed to be said out loud!!!Great Article thank you!
thank you
My husband and I are both docs, an FP and a pediatrician. We don’t answer to provider but that is what I am consistently called anyway. It is a corporate approach to downgrading what docs are, what we do, and what we know, and goes along with the growing lack of respect for physicians as a whole. Interestingly enough my patients really like calling me doctor and are very respectful even as I run a very friendly, personable practice. My parents of newborns certainly want to know that I am well trained and a doctor. Of course, the approach is that we can’t call them patients anymore….just consumers. Not just sad, appallingly ridiculous
I always refer to all physicians as Doctors and patients as patients.
It is a shame what we have let Government and Insurance companies do to us.
We need to unite like the Lawyers and Unions.
AMA is totally useless. Does not stand up or fight for Physicians ever.
Dr. Weiss, is absolutely correct. We are physicians,no providers, no clinicians, no practitioners and no prescribers. We have over 8 or 12 years of postgraduate education, research,etc to be bundle in the same group of others that doesn’t have the experience that we have. Let’s stop that P.C. that offend us and denigrate our profession. Let stop this nonsense!
“Who knew medicine could be so complex?” What concerns me is how difficult it is to convey this complexity to a layperson. Unlike some other comlex professions, like mathmatics or engineering, the lanquage of medicine is often common. And every person is familiar to some degree with it through mass media. Daily I struggle to convey the subtle complexity of medical issues to patients, coworkers, administrators, et al. Because they understand the words they often feel they understand the issues. It is difficult for a layperson to respect how complex even apparently simple decisions may be. Even more difficult to distinguish the expertise of various health care professionals. The common use of the word provider to lump all health professionals together simply compounds this issue and works against the ability of patients to take charge of their care. If they do not understand or value the training physicians receive vs. other members of the team how can they confidently advocate for themselves in a complex system where they will see all stripes of ‘providers’ and get a wide variety of advice. I too have a “Masters degree in Science” , then I went to medical school.
I agree with that it is a devaluation
What about the current ubiquitous use of first names only
For many years now there has been a concerted effort to remove any distinction from physicians. We are “team members”, Providers, and our patients are “clients”. There is movement to include Physicians Assistants and Nurse Practicioners/Midwives and even Registered Nurses in the same definitions and at the same level as a physician. The AMA has done nothing, as well as specialty colleges, to dissuade this lumping of physicians with anyone who approaches the care of patients no matter what their training and knowledge level is. Midwives and Nurse Practitioners are known to their patients as “Doctor so and so” without any semblance of correction or redirection. Doctors earn their place and their terms and their defining titles with CONSIDERABLY more learning and training than any of the others mentioned. The “dumbing” down of the medical profession to put it equal to all others is insulting and ridiculous. To direct the practice of Doctors by insurance companies, administrators, JCAHO and even specialty colleges with their previously forbidden “practice guidelines” is also an insult and degradation of our profession. And yet, once again, the largest physician organization, that has become corrupt with money making and insider power, the AMA, does nothing except encourage these changes. Physicians would be much better off sticking together and standing together to thwart all of these trends instead of “one upping” themselves over their colleagues.
denigration of extensive investment of time and sacrifice by physician
Brava. Galen spoke of the importance of precise language as necessary for accurate understanding of disease states. Precise language is one of the only weapons left to physicians but corporate medicine is dumbing down the flock to the lowest and most easily-controlled level. Imprecise language is the tool of the devil and wrong-doers.
This is the nicest thing I have read in a long time
Jennifer, excellent essay. I lost my career as a cardiac and trauma anesthesiologist to disability in 2010. Today, I help teach medical students and residents to properly protect themselves, financially but also from stress, burnout and depression. I teach one-on-one doctor-to-doctor these critical professional development tools for success in their careers and their lives.
Why I’m telling you this… I’m almost always referred to as “Dr.” now that I’m not “in medicine” and my brother and wife, both clinical physicians, get called providers. I wish a few very well placed and notably clinical doctors would add language to their custom contracts stating that they are never to be referred to as ‘provider’ and that every time they are by any employee or staff member a hefty fine must be paid for more staff training and etiquette to address physicians properly… that would be great, it would be “Doctor” all the time.
~Chris
Dear Doctor Yerington,
I am sorry that your career path change was dictated by disability. I am inspired by the way you shifted to teaching, caring for, and raising physicians. Thank you for sharing this.
I just want to say I have worked with some fantastic physicians. I would not have the knowledge base, skills, and judgement that I have developed without them. They have been kind and patient mentors. They learned they could trust me to call myself out on what I don’t know. They were always eager to help expand my skills. By expanding my skills they lighten their load to something more manageable. It is a win-win.i have worked emergency settings, inpatient settings, and outpatient settings. I prefer a rural setting. Currently, I see the doctor I work with weekly. He addresses the more complicated issues that I feel unprepared to handle independently while continuing to mentor my skills, knowledge, and judgement. I have a couple side jobs as a hospitalist NP and in the Emergency Department, which was my first love in health care. Every physician I have told about enrolling in DNP program has been nothing short of supportive. A few have even said they can’t wait to call me doctor.
After reading these comments I am more grateful than I was before to know them and to have had the opportunity to call them my colleagues.
Thank you< Laura, for sharing this. Jen
Do you mind if I quote a few of your posts as long as I provide credit and
sources back to your blog? My blog is in the very same niche as yours and my users would genuinely
benefit from a lot of the information you provide here.
Please let me know if this okay with you. Appreciate it!
You are of course welcome to quote with proper reference, and thank you. please link back to my source? thank you.
As an MD graduate of the 1970’s, when the term “provider” entered the lexicon of American Medicine; I find your article most enlightening and depressing. The ’70’s was the decade the vocation of Medicine in America came under attack by those hell bent on both destroying the House of Medicine”s prestige in the public”s view and gain a Golden Goose for the minions of capitalism. Sadly the parasites of this hit job on Medicine has succeeded beyond their wildest dreams. Labeling physicians as merely “providers” was the first step in this nefarious plan.
Thanks for your insight and historical references to the same Nazi planning of labeling Jewish physians. We have much to learn and stand against the powers that work to harm Humanistic Medicine…..for us as physicians and for our patients. May we reclaim Medicine as Healers.
Dr. Weiss, thank you for your comment. Inspirational words.
As a nurse practitioner, I too, hate the term provider. My organization insisted on using the term “mid-level” to refer to PA’s and NP’s, even using this term when talking to patients. I fought this with the organization, and our CMO actually was astounded that I took offense to that label, asking me, “Well, what do you want to be called then?” When I responded “Nurse Practitioner”, he told me that having to say “Nurse Practitioner” or “Physician Assisstant” was “too long”. Would he have told our interventional radiologist that his title was too long?
Nurse Practitioner has 5 syllables. I think we can all handle that!! I will happily call you by that…
I went to nursing school in my 30’s just to get to midwifery school. I never wanted to be a nurse. I became a certified nurse midwife and never practiced as an RN. I stopped delivering babies after 22 years and specialized in hormones along with GYN. My scope of practice has varied widely. In the early days I had to literally fight my way in some hospitals to be seen as a full-scope “provider”. Doctors were doctors and nurses were nurses but what is a midwife, an ARNP? Then came the term “mid-level”. Oh how a absolutely HATE that term! Makes me feel sick every time I hear it. I’m “mid” nothing! I’ve had a long and varied career and worked so very hard for each victory in being recognized for the incredibly long hours, tough legal environment, and animosity from above (Dr.) and below (RN). As long as the doctors can see us as a vital part of the team, so often not the case, I’m happy to be call a Nurse Practitioner. Although, as an aside, when I stopped doing deliveries I went from being a Midwife to a Nurse Practitioner. I felt like I had been demoted! It was hard to get used to. When an OB/GYN stops the OB part do they stop being a doctor? And where does all of this leave the all important patients we are working so hard to care for? My opinion is that medical designations should be what they are; doctor, midwife, nurse practitioner, physician assistant. As long as we all respect each other and agree each is a needed part of the team no one will have hurt feelings and the patients will respect everyone.
I fully agree, the mutual respect for the team of doctors, nurses, nurse practitioners, physician assistants, midwifes… AND patients is what this is all about
Oh, and Jeffery Gabel, DO. I would Never have allowed anyone, patient, medical assistant, nurse, etc to call me by the term “Doctor”. Not only is that a law suit waiting to happen but I never wanted to be a doctor. I wanted to be a nurse-midwife!
Plus, it wasn’t all that long ago that MD vs DO was a contested distinction.
And Lisa Meyer, ARNP, I completely disagree that our job is to lighten the load of the physician. That might be a side benefit but we have our own distinct method of practicing and we add that into the equation. One as important as the physician, but distinctly different. We are not mini doctors.
Physician Assistants Were started to assist the physician. As I am not a PA I really don’t know about that dynamic in today’s world of medicine.
I think the thing everyone needs to realize is that we cannot do our jobs without each other. One of the first things I used to say to new OB/GYN residents is “Be kind to your nurses. You can not do your job without them!” We are all needed, important and vital to providing the absolute best care we can to the patients who literally put their lives in our hands.
***Please correct that last comment. I wasn’t Lisa Meyer who stated we are there to lighten the physician load but Laura Hart***
And yet another article by someone who is offended.
Political correctness had gotten old.
Interesting that someone with the same last name as the author is so quick to throw in a reference to “Nazis”.
Aren’t you all just keeping the fires of discontent and resistance burning while harming the mental health of our entire nation?
Well, my various specialists have all asked me for the name of my “primary provider”
It’s not about being offended. It is about clear communication. Without this, we cannot take good care of our patients.