"Provider"

[TheFatMan]

Not sure if anyone is on Twitter, but there is quite a bit of butthurt from a certain subgroup of docs about being called provider. Some believe it is derogatory and related to the term given to Jewish doctors by the Nazis (false). Others have compared it to the 'N word' (not kidding).

Today someone was claiming that it actually made the care they provide worse when they are called provider. I sarcastically (of course) opined that no patient has ever been harmed by a doc. I got a reply that said, "Clearly no pilot has crashed a plane??.... But to use that as an argument to let flight attendants fly the plane hmmm.." The analogy is clearly awful. 

Thoughts? Do you get upset when called an APP, AP, mid-level, etc? Do you think it interferes with the care you provide?

Many docs also letting them know that they are ridiculous and of course they don't care if they are called provider.

[sas5814]

APP doesn't bother me too much. Mid-level has been used as a derogatory term to make us seem "less". 

I interrupted a department meeting yesterday after the third time our chief called us mid-levels. It isn't in our rules and regulations nor our enabling statutes and shouldn't be used.

I also advocate for getting rid of APP and calling us PAs and NPs. While we are similar we aren't the same and lumping us in in such a casual way, again, seems to make us undeserving of our respective professional titles.

[LT_Oneal_PAC]

I don’t like mid-level, but I never get up in arms over it. I ask PA colleagues not to use it. That’s about it. Never kept me from doing my job.

[TheFatMan]

[LT_Oneal_PAC]

2 minutes ago, TheFatMan said:

Holy F#€k!%g $4!7. I’m expected to take care of rapists and child molesters in the ED, but you can’t get past being called a provider?

If I were her employer, I would fire her for making stupid comments like that. Honestly, its not even so much that I’m offended they would do such a thing, but this employee is insane and its just a matter of time until she turns that crazy eye to the employer. 
 

I also think that having MD in your Twitter handle gives you a 94% chance of being a douche canoe. Not always, but likelihood ratio is high.

[TheFatMan]

She deleted some worse tweets, but here is her defending herself comparing "provider" to the "n-word".

[TheFatMan]

18 minutes ago, LT_Oneal_PAC said:

Holy F#€k!%g $4!7. I’m expected to take care of rapists and child molesters in the ED, but you can’t get past being called a provider?

If I were her employer, I would fire her for making stupid comments like that. Honestly, its not even so much that I’m offended they would do such a thing, but this employee is insane and its just a matter of time until she turns that crazy eye to the employer. 
 

I also think that having MD in your Twitter handle gives you a 94% chance of being a douche canoe. Not always, but likelihood ratio is high.

She is an EM doc.

[Komorebi]

Physicians are a type of medical provider. To use the Flight attendant/pilot example referenced above, it would be like a pilot getting up in arms about going through the "flight crew" security because flight crew is too inclusive of other disciplines. To me, this is about someone who needs to have their ego stoked and has to be recognized for their credentials, and cannot stand the thought of being classified by a term that can is also used by people with less education than medical school. It's the epitome of classism. If they insist that being an MD requires they be called "doctor" than I wonder how they will feel when NPs start to insist that those with the DNP also be called doctor?

As an NP, I use the term medical or healthcare provider. I never use mid-level because I do not provide mid-level care. I am not reserved for lesser cases nor am I stopgap until someone can see a physician - I diagnose and manage my own clients who are thriving and happy. About 50% of my clients call me "doctor" anyway.

Edited April 15, 2021 by Komorebi

[LT_Oneal_PAC]

59 minutes ago, TheFatMan said:

She is an EM doc.

 

[Reality Check 2]

Doc Houston needs to get over herself.

Does she "provide" medical care and advice?

Then she is a Provider. A Medical Provider who has an MD. Which does NOT stand for Medical Deity.

Do I, as a PA, "provide" medical care and advice?

Why, yes, I do.

So, I am a Provider as well. A Medical Provider.

DO YOUR DAMN JOB.

See patients, do right by them, do no harm.

Get over your ego.

 

[CAAdmission]

5 hours ago, TheFatMan said:

 

 

It may well be that a moderator will need to censor this post and I will take no issue with that, but it must be said:

 

 

Edited April 15, 2021 by CJAadmission
Sanitized to PG-13

[sas5814]

My my my....... someone needs to deflate her ego balloon a bit.

I wonder how long people with this much anger can survive in today's medical landscape. The only thing that stays the same is change. Adapt or die.

The better question is what about this physician makes her so insecure? People who are confident in their abilities and their place in the food chain don't need to be this angry.

[ventana]

I am not an animal, I am a human......

yeah logic escapes me.....

[rev ronin]

I am not a medical provider, either. I am a medical professional, and because of that I exist to provide care. My responsibility is not to provide anything to anyone, my responsibility is to practice medicine for the benefit of my patients.

While this doc may have a chip on her shoulder and be making some over the top analogies, she's not fundamentally wrong in disliking 'provider' as a word.

[TheFatMan]

8 minutes ago, rev ronin said:

I am not a medical provider, either. I am a medical professional, and because of that I exist to provide care. My responsibility is not to provide anything to anyone, my responsibility is to practice medicine for the benefit of my patients.

While this doc may have a chip on her shoulder and be making some over the top analogies, she's not fundamentally wrong in disliking 'provider' as a word.

I agree. I don't think we should intentionally refer to anyone as something they don't want to be referred to as (i.e. midlevel or whatever else). I do think it is our job to provide care though, and for that I will never mind being called anyone's provider. Ironically the same people use the term mid-level very liberally with no concern about our thoughts on it.

I think the issue is the extent that she (and many others) have taken it. They believe corporate medicine basically invented the term to demean physicians in order to replace them with us (and they believe AAPA and AANP are in on it).

 

Thanks for everyone's thoughts. This one has me puzzled. All I can think of is low self-esteem and paranoia. 

[MediMike]

28 minutes ago, rev ronin said:

I am not a medical provider, either. I am a medical professional, and because of that I exist to provide care. My responsibility is not to provide anything to anyone, my responsibility is to practice medicine for the benefit of my patients.

While this doc may have a chip on her shoulder and be making some over the top analogies, she's not fundamentally wrong in disliking 'provider' as a word.

I provide care to my patients.

I provide analyses of diagnostic tests and exams.

I provide differential diagnoses which I narrow down to allow me to provide the appropriate treatments or therapies.

I provide a therapeutic presence at the bedside when the patient is scared or worried.

I provide leadership during an arrest and comfort to the family when my patient dies. 

I provide support for my staff after the event.

Anyone who says otherwise, well I guess I don't know what your day looks like.

[TheFatMan]

Update: We are a HUGE part of structural racism in medicine, apparently.

[Pac30]

They can call me whatever they want as long as my paycheck clears. 

[WakadanPA]

2 hours ago, TheFatMan said:

Update: We are a HUGE part of structural racism in medicine, apparently.

Why we (black folks) always gotta get thrown in the mix. Leave us out of this one lady! We get care from whomever can write that script for our HCTZ okay. Lordy

[rev ronin]

3 hours ago, TheFatMan said:

I agree. I don't think we should intentionally refer to anyone as something they don't want to be referred to as (i.e. midlevel or whatever else). I do think it is our job to provide care though, and for that I will never mind being called anyone's provider. Ironically the same people use the term mid-level very liberally with no concern about our thoughts on it.

I think the issue is the extent that she (and many others) have taken it. They believe corporate medicine basically invented the term to demean physicians in order to replace them with us (and they believe AAPA and AANP are in on it).

 

Thanks for everyone's thoughts. This one has me puzzled. All I can think of is low self-esteem and paranoia. 

I really don't think that's it at all.  I mean, you're taking a reasonable approach, but one which is completely off point, in that it's not about courtesy, it's about the definition of medicine itself as a profession.

It may seem archaic in the modern world, but a profession is far more than a job or field; iaccording to Wikipedia:

"A profession is an occupation founded upon specialized educational training, the purpose of which is to supply disinterested objective counsel and service to others, for a direct and definite compensation, wholly apart from expectation of other business gain." https://en.wikipedia.org/wiki/Profession  (I do recommend at least skimming the article)

So, if I go to Subway, I get to order a sandwich.  Say... a 12" turkey breast on white with only green peppers and tomatoes. The "sandwich artist" doesn't get to tell me "Sir, that's an odd combination, and I don't think I'll make it for you unless you modify your order a bit... say by adding Provolone."  That's not his or her job, regardless of his or her own preference: a menu of services is offered, and I get to do what I want for it, fee for service, and the corporate hierarchy is right to correct or fire the hypothetical sandwich artist who thinks his or her judgment trumps mine... because "sandwich artist" is not really a profession. 

Am I a sandwich artist? Do I have to do whatever the customer wants?

The Hippocratic Oath says "no"--that there are foundational professional ethical premises that we, as a profession, agree not to cross. Even if you replace that with the Georgetown mantra, you still are not able to act against the best interests of your patient and claim to be a member of the medical profession.

I don't do physicals for full-contact martial arts or boxing. I've turned away people who were roomed expecting me to do that for them.  Why? Because in my professional judgment to do so would be an act where the non-maleficence concern ("I am enabling my patient to hurt (and possibly maim) another human being and in turn be hurt (or maimed)") overrides any beneficence concern ("This patient could win fame, glory, and money in the ring").

If I'm a professional, I get to make that decision.  If I'm a provider, I do not.

[LT_Oneal_PAC]

4 hours ago, rev ronin said:

I am not a medical provider, either. I am a medical professional, and because of that I exist to provide care. My responsibility is not to provide anything to anyone, my responsibility is to practice medicine for the benefit of my patients.

While this doc may have a chip on her shoulder and be making some over the top analogies, she's not fundamentally wrong in disliking 'provider' as a word.

If someone doesn’t like provider, fine, we’ve stopped using words for poorer reasons, but this is just over the top sensitivity. 
 

I personally don’t mind the term because I always provide something in the form of care, even if it’s just providing reassurance. But if people don’t like it, I have no problem with it changing. I certainly wouldn’t fault a patient for using it.

[rev ronin]

5 minutes ago, LT_Oneal_PAC said:

If someone doesn’t like provider, fine, we’ve stopped using words for poorer reasons, but this is just over the top sensitivity.

Oh, no, we're completely agreed that this is over the top.  But just because someone has gone totally off the rails over something doesn't mean there wasn't a kernel of truth behind the tantrum.

I mean, if ANY specialty has cause to resent "provider," it's probably ED:

"What brings you to XYZ ER today?"

"My dog ate my percocet"

"OK.  And how is that a medical problem?"

"I need them replaced! What are you, some kind of heartless jerk?"

...

"What brings you to XYZ ER today?"

"I need a work note that says I was sick last week. My work won't let me come back without one"

"But I didn't see you sick last week, and neither did anyone else at this hospital."

"So what? I was sick, I needed a note, and I waited six hours to be seen."

....

At any rate, you get the point.  The ED physician is abused by a bunch of ungrateful "customers" who believe they have a right to something that the physician can provide, so I have some additional sympathy for that subset of physicians.

[LT_Oneal_PAC]

40 minutes ago, rev ronin said:

Oh, no, we're completely agreed that this is over the top.  But just because someone has gone totally off the rails over something doesn't mean there wasn't a kernel of truth behind the tantrum.

I mean, if ANY specialty has cause to resent "provider," it's probably ED:

"What brings you to XYZ ER today?"

"My dog ate my percocet"

"OK.  And how is that a medical problem?"

"I need them replaced! What are you, some kind of heartless jerk?"

...

"What brings you to XYZ ER today?"

"I need a work note that says I was sick last week. My work won't let me come back without one"

"But I didn't see you sick last week, and neither did anyone else at this hospital."

"So what? I was sick, I needed a note, and I waited six hours to be seen."

....

At any rate, you get the point.  The ED physician is abused by a bunch of ungrateful "customers" who believe they have a right to something that the physician can provide, so I have some additional sympathy for that subset of physicians.

Well, you’re not going to hear any argument from me on people feeling entitled to what they are requesting. It ain’t Burger King where you have it your way. You wouldn’t ask an engineer to design your roof joists and then tell him to do it your way, right?

[MediMike]

2 hours ago, rev ronin said:

I really don't think that's it at all.  I mean, you're taking a reasonable approach, but one which is completely off point, in that it's not about courtesy, it's about the definition of medicine itself as a profession.

It may seem archaic in the modern world, but a profession is far more than a job or field; iaccording to Wikipedia:

"A profession is an occupation founded upon specialized educational training, the purpose of which is to supply disinterested objective counsel and service to others, for a direct and definite compensation, wholly apart from expectation of other business gain." https://en.wikipedia.org/wiki/Profession  (I do recommend at least skimming the article)

So, if I go to Subway, I get to order a sandwich.  Say... a 12" turkey breast on white with only green peppers and tomatoes. The "sandwich artist" doesn't get to tell me "Sir, that's an odd combination, and I don't think I'll make it for you unless you modify your order a bit... say by adding Provolone."  That's not his or her job, regardless of his or her own preference: a menu of services is offered, and I get to do what I want for it, fee for service, and the corporate hierarchy is right to correct or fire the hypothetical sandwich artist who thinks his or her judgment trumps mine... because "sandwich artist" is not really a profession. 

Am I a sandwich artist? Do I have to do whatever the customer wants?

The Hippocratic Oath says "no"--that there are foundational professional ethical premises that we, as a profession, agree not to cross. Even if you replace that with the Georgetown mantra, you still are not able to act against the best interests of your patient and claim to be a member of the medical profession.

I don't do physicals for full-contact martial arts or boxing. I've turned away people who were roomed expecting me to do that for them.  Why? Because in my professional judgment to do so would be an act where the non-maleficence concern ("I am enabling my patient to hurt (and possibly maim) another human being and in turn be hurt (or maimed)") overrides any beneficence concern ("This patient could win fame, glory, and money in the ring").

If I'm a professional, I get to make that decision.  If I'm a provider, I do not.

You simply had to know that citing Wikipedia would hurt your argument.

"A health care provider is an individual health professional or a health facility organization licensed to provide health care diagnosis and treatment services including medication, surgery and medical devices."

https://en.wikipedia.org/wiki/Health_care_provider

Ergo, all health professionals are healthcare providers, while not all healthcare providers are health professionals.

Your implication that the utilization of the term "provider" insinuates the inability to provide autonomous judgement and decision making, this is clearly fallacious.  You yourself have made a personal (subjective) decision that sports that involve a risk of bodily harm as mentioned above go against your moral code and thereby withold a medical clearance. While I see this as far from an individual providing "objective disinterested counsel", you remain providing a medical service to your patients albeit not what they would have chosen, much the same as when @LT_Oneal_PACdeclines to provide pain medication or a work note, meeting the legal definition of healthcare provider.

[rev ronin]

23 minutes ago, MediMike said:

You yourself have made a personal (subjective) decision that sports that involve a risk of bodily harm as mentioned above go against the Hippocratic Oath and thereby withold a medical clearance.

Fixed that for you.