When I started my internal medicine practice in 1996, the medical arena was vastly different than it is today. Back then, having an MD after my name actually meant something.
A letter from me to an insurance company would get a needed medication covered for a patient––a time before preauthorization existed. Dr. Google was not yet born. “Provider” exclusively belonged to the insurance industry.
My patients called me “doctor” and referred to me as their “physician.” Well, most of them. I still chuckle fondly when I recall the WWII vets at the Veterans Affairs Hospital calling me nurse, no matter how I introduced myself. That’s OK – –I knew who I was and didn’t need to prove it. I actually think they did, too, and just wanted to get my goat!
Fast forward to modern times: professional appropriation runs rampant. I cringe with many of my physician colleagues when I am wished “Happy Providers’ Day” instead of “Happy Doctors’ Day.” I was also stunned when someone recently addressed me as “Provider Susan” in an email — that was a new one. The word provider has become ubiquitous.
Would you want your pilot to be the same as your flight attendant? “Good morning, I’m airline worker Carl, and I’ll be flying your plane today.” Would you want your trial attorney to say, “I’m Sarah, your legal worker, and will be defending you today”? I am a physician, yet somehow it has become OK to refer to me as anything but physician.
In an era where burnout is akin to another pandemic, it is further demeaning and demoralizing for all in medicine to be lumped together as if we are the same.
This is just not sustainable. This is also not about ego. It is about patient safety and transparency.
Substitute words only serve to confuse the public and take away transparency by implying all training and experience are equivalent, which is simply untrue.
When I presented Resolution B-8 at the Washington State Medical Association House of Delegates 2021 annual meeting, it was with a sense of urgency that patients and the general public deserve to know who is caring for them. Not so easily done, unfortunately.
I haven’t worn a white coat in decades. Nowadays, a white coat means nothing — the beauty counter makeover folks wear them. Everyone wears scrubs. ID badges are now issued with “medical staff” instead of actual titles. Badges are also notorious for flipping over and not actually being visible to patients. All too frequently, patients get seen by a “provider” never actually knowing their credentials.
How can we fix this? Patients and the public should be completely comfortable with asking who is taking care of them and what their credentials are. The staff should be trained not to ask, “Which provider are you calling for?” We need to refrain from grouping all physicians, non-physicians, and health care professionals together using one word. Words matter — at meetings, emails, nursing home forms, news, websites, and so on.
Let’s bring back respect for physicians and respect for non-physicians — respect our differences in training and medical experience. We are not all the same. Use our titles individually. With this will come transparency to patients and the public. And with transparency will come improved safety.
Every state has the opportunity to set a decades-overdue example for the rest of the country, not just by making another strong recommendation but by publicly educating everyone that using the term “provider” or any other replacement term is unacceptable.
Let’s reshape modern medicine. It is time.
Susan J. Baumgaertel is an internal medicine physician.
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