When I first read about the disdain for the use of the term provider rather than physician, I remember thinking “umm semantics guys, what’s really the big deal?” That was meek me. I kept reading (here and here), and my opinion has changed. So confident me has started speaking up on the matter.
The truth is, calling a physician a provider minimizes and neutralizes the years of work and training that has gone in to becoming a physician. It lumps physicians with other providers. And I love and respect my NP, PA, CNM, CRNA, PT, and OT friends. Healthcare is a team effort, and we need everyone as a part to be successful. We all work synergystically together. However, we are not all trained the same, and we do not provide the same care. The current debate about CRNA vs physician anesthesia coverage within the Veteran’s Administration is an example of why delineating our training as a part of our description (in that case- CRNA vs physician) is important. Patients, administrators, billers and coders, and schedulers hear the word provider repeatedly, and over time, differences between the different types of providers fade in their minds. Providers become all the same, and can all do the same things, right? When that false assumption is made, it results in patients not receiving the best care, because the correct provider isn’t caring for them.
Provider also refers to the industrialization (and dehumanization) of medicine. In the industry of medicine, providers and consumers interact. But that is not what physicians do, or at least not what we intended to do when we started out in med school. We don’t want to be a part of an industry. We want to help, to heal, to prevent. And patients are not consumers. They don’t want to purchase a product or buy a service. Not really. (Corporate Medicine may tell them they do, with quite the PR campaign). Patients want someone to hear them, listen, and work together to get to the root of their illness or walk with them on their medical journey. Provider generalizes healthcare and is a part of the language healthcare organizations use to provide the “same services” to patients while paying for a “cheaper” provider– thus saving the organization more money. (This speaks to my NP, PA, CNM, CRNA, PT, and OT friends- practice within your scope, but don’t fight to expand it just so you can be someone’s cash cow).
The other day I finally filled out my time sheet for my medical director’s hours (after much encouragement from admin). As I went to sign it, I realized I had been a part of minimizing myself again, without realizing it, again!
Right there, above my signature, was the word provider. I have been signing that for over a year! Now, however, my signature section looks different.
First I crossed out provider and wrote physician
Then I realized I could just correct their form… So I did.
I want admin to know exactly who they are asking to fill out their paperwork. I want them to know that their medical director is a physician, not a provider.
I am not your provider. I am not administration’s provider. Hospitals and healthcare conglomerates have “service lines” that provide customer service, or excellent care, or short wait times, or high ratings on health grades. And that’s important. As a patient I want someone to be kind to me on the phone when scheduling an appointment or requesting results. When hospitalized I want compassion from the WHOLE team, including the registration person who takes my insurance and credit card information. But I want my physician to be a good physician. I want them to care more about me and what’s wrong and how to help than about my opinion on their care and their Press Ganey score. So that is how I practice medicine. I don’t provide customer service or anything else silly that doesn’t have to do with taking good care of my patients. I listen to them, not because I want a good “grade” but because I care about them and helping them as I am trained, as a physician. I tell them the truth, hard truths, because I know them, I learned them over 11 years of training, as a physician. You can’t lump together as providers everyone a patient may encounter in an office or a hospital setting. We are different. We have different levels of training, different perspectives. So let’s call everyone as they are trained and stop minimizing what we physicians do!
Simple steps to make a difference…
- Change your own vernacular. Particularly if you have already adopted the provider term as a result of your institution. This is hard, and I find myself slipping still. If you need a word when you are referring to more than just physicians on your team, try clinician.
- Correct paperwork, emails, contracts, privileges, etc. with the correct designation of your role. A physician. Cross out provider. Better yet, make them change it! Be obnoxious.
- Care about your patients like you want to be cared for. Use your training and make a difference, Press-Ganey be d%&#ed! Keep doing the right thing like you learned in your training, as a physician!