Monday, November 23, 2015
So not a provider: part deux
I wrote a piece about the word “provider,” and how physicians have been a bit blindsided to what's fast becoming their new title. It started something of a social media wave. For anyone who hasn't read the article, it can be found here. It was good to see the article encouraging lots of healthy debate, and I was also grateful for the large volume of supportive messages. As we continue this important discussion, I wanted to specifically address 5 follow-up issues:
1. This is not about ego or turf wars
My own dislike with the word provider doesn't come from an egotistical perspective or some desire to inflate my own position. Neither do I feel this is the case for most physicians. Speaking personally, it was my childhood dream to become a doctor. I enjoy what I do, consider the physician-patient interaction sacred, and strive to perfect the art of medicine each day I'm on the medical floors. A good doctor is what I always hope to be. Seeing a different job description and name creep into the equation, one where I'm known as the “provider”, is just as disheartening to me as it would be to any professional who strives to be the best at what they do and takes pride in their work—be it a pilot, an attorney, or even an actor—who wakes up to find they are being called “transport provider”, “legal advice provider” or “entertainment provider” by the people that employ them. Rightly or wrongly, I do consider it a bit of an insult when I'm addressed primarily as a Provider to my patients. I'm quite relaxed and informal, don't insist on being called “Dr.”, and don't mind being called by my first name. But I do insist that my job description is that of being a physician. Period.
2. All health care professionals should get on
Many online comments came from other professionals, including NPs and PAs. As I said in my original piece, this is not about them or what they do. We must all get on at the frontlines of medicine, because our ultimate mission is always the same: to serve our patients. By the same token, why any Nurse Practitioner or Physician Assistant would like the term “provider” also eludes me!
3. This is not just another fight with administration or the government
Although it may seem like the push to use the word “provider” comes from faceless administrators, having talked to (and being friends with) many of them, I don't think administrators necessarily realize the problem with use of the word Provider and might be caught up themselves in a wave without knowing where it all started. Neither would any of them ask for a “provider” when their sick child or elderly parent needs help. There's no “big evil empire” out there wanting to define physicians. Our fate is in our own hands and all ships that have sailed can be brought back to port.
4. Don't forget the power of words
Physicians are on the whole not the most linguistic people (no offense intended), and should understand that words have immense power. Talk to any marketer, business-savvy person or even any attorney—and they will tell you all about this. There's a lot in a name, and physicians can be a bit naive about this compared with other professionals.
5. Our patients don't want to know us as providers
I'm yet to hear of any patient who likes hearing or using that word. If, in the end, we all agree that the patient comes first—let's listen to them on this too!
We face some huge challenges in healthcare. In the overall entirety of things, this may not seem like a major issue. But I personally think about and face these healthcare challenges from the perspective of being a physician who wants the best for my patients. So should every other colleague who values what they do and the honor bestowed upon them of being a physician. The U.S. Bureau of Labor Statistics estimates that there are around 700,000 practicing medical doctors in the United States. Other estimates, including retired and non-practicing physicians, are around 1 million. That's an awful lot of people. Maybe, just maybe, a sleeping giant can be awoken.
Suneel Dhand, MD, ACP Member, is a practicing physician in Massachusetts. He has published numerous articles in clinical medicine, covering a wide range of specialty areas including; pulmonology, cardiology, endocrinology, hematology, and infectious disease. He has also authored chapters in the prestigious "5-Minute Clinical Consult" medical textbook. His other clinical interests include quality improvement, hospital safety, hospital utilization, and the use of technology in health care. This post originally appeared at his blog.
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