"Provider"

[rev ronin]

3 hours ago, LT_Oneal_PAC said:

You wouldn’t ask an engineer to design your roof joists and then tell him to do it your way, right?

And that is the crux of the professional vs. provider issue in my mind: a professional is obligated to do things right, within the scope of their profession, rather than to do what they are told.

[MediMike]

2 hours ago, rev ronin said:

Fixed that for you.

Thanks? Think it did fairly well on its own. Nowhere in the Hippocratic Oath does it say anything remotely close to "don't provide medical clearance for boxing".  That's your personal interpretation of the phrasing from whichever version of the pagan testament you choose to pick from.

Which is fine.

Because as a provider you get to make that decision. That's the nice thing about being a provider.

[sas5814]

10 hours ago, rev ronin said:

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

Interestingly when we started calling patients customers is when the current corporate swing in health care started. I had a mildly heated discussion with our CEO and I told him "I'm not a shoe salesman and they aren't my customer." Now medicine is corporate and corporations compete for customer dollars.... and most of us are employed by the corporation including physicians.

I have finally gotten to an age (and degree of fatigue) that really limits how many things I am willing to get fired up about. Medicine is now corporate. Patients are now customers. Every health care provider is now part of a bigger team and provides a service for a fee (and salary). I can stand outside and shake my fist at the corporate offices all day and those immutable truths will not change.

[rev ronin]

6 hours ago, MediMike said:

Thanks? Think it did fairly well on its own. Nowhere in the Hippocratic Oath does it say anything remotely close to "don't provide medical clearance for boxing".  That's your personal interpretation of the phrasing from whichever version of the pagan testament you choose to pick from.

Which is fine.

Because as a professional you get to make that decision. That's the nice thing about being a professional.

Fixed it again.

I mean, sure, you can argue that 'provider' and 'professional' denote, or even connote, the same level of independent judgment and obligation to comply with external ethics, standards, or principles, but it simply ain't so.  And if you want, we can agree to disagree on that.

The point of the Hippocratic Oath is that it provides some absolute prohibitions (abortion, euthanasia, sex with patients or their slaves, disclosing private info...) and from those absolute prohibitions and their supporting statements that are clearly more general, a body of professional (not provider, professional) ethics arose.  The fact that in the last 100 years there have been egregious violations of professional ethics (Tuskegee Syphilis experiments, eugenic sterilization of minorities, Third Reich medical experimentation, People's Republic of China forced organ harvesting from Uighurs and Falun Gong, to name a brief few) doesn't erase the 2500+ years of their existence. I absolutely agree that "I will abstain from all intentional wrong-doing and harm" requires elaboration, and specifically that interpreting 'harm' is inherently subjective.

[Reality Check 2]

The entire world has gone mad about labels.

We have reached a point of blatantly stupid minutia, in my opinion.

It started as jokes - I am not a "housewife", I am a domestic engineer.

THAT was funny.

Now, everyone has to have a label of importance that sounds fancy, entitled, new, shiny.

For some reason we can't just be what we are any longer - everyone has to have a word salad.

I am a Primary Care Provider, Internal Medicine PA, etc. 

Take care of patients, do right, do no harm. 

Let's stop the stupid festival of new names and titles that "don't exclude or disenfranchise". 

JUST DO YOUR JOB 

[CAAdmission]

I once had to sew up some gangbangers in an urban ER after some sort of altercation. Most of them referred to me as "mother f'er." Now I'm not sure what to think - is that better or worse than "provider?"

[DiggySRNA]

Ooof. 

Not much to add here, but after assessing a patient and no one from the medical team signed up for them, I say "sit tight, one of the students or providers will be in shortly"...I don't know whether the medical student, PA student, PA or Physician will be in - the ER is too vast to say "Doctor so and so will be in" unless I know for a fact it's the physician that will be of first contact for the patient. Saying provider reassures the patient someone WILL be in lol.

 

[Cideous]

I've worked with several ER docs like her.  They can't get past their own egos and everyone in the ER hates them.

Edited April 16, 2021 by Cideous

[TheFatMan]

1 minute ago, Diggy said:

Ooof. 

Not much to add here, but after assessing a patient and no one from the medical team signed up for them, I say "sit tight, one of the students or providers will be in shortly"...I don't know whether the medical student, PA student, PA or Physician will be in - the ER is too vast to say "Doctor so and so will be in" unless I know for a fact it's the physician that will be of first contact for the patient. Saying provider reassures the patient someone WILL be in lol.

 

From what I can tell, that is exactly how this $#!7 storm on Twitter started. I think it was someone from the ED calling upstairs and asking for the 'admitting provider.' Thus opened Pandora's box. 

[DiggySRNA]

4 minutes ago, TheFatMan said:

From what I can tell, that is exactly how this $#!7 storm on Twitter started. I think it was someone from the ED calling upstairs and asking for the 'admitting provider.' Thus opened Pandora's box. 

Thank god I work with some cool a*s people in the ER. Haven't met anyone like this physician yet.

[sas5814]

2 hours ago, CJAadmission said:

I once had to sew up some gangbangers in an urban ER after some sort of altercation. Most of them referred to me as "mother f'er." Now I'm not sure what to think - is that better or worse than "provider?"

Depends on the mother....

[ohiovolffemtp]

9 hours ago, CJAadmission said:

I once had to sew up some gangbangers in an urban ER after some sort of altercation. Most of them referred to me as "mother f'er." Now I'm not sure what to think - is that better or worse than "provider?"

I had a similar situation - GSW to buttocks.  Patient kept squirming.  I finally told him to hold still and that it would take awhile because it was a "bigg a$$ wound".

I usually introduce myself as first name, last name, "the night guy" because I'm the only "provider" of any kind in the hospital at night - either in the ED or in the IP unit.  However, if I'm about to do a lac repair, I introduce myself as "your seamstress".

[UGoLong]

Titles are interesting. In Europe, surgeons go back to calling themselves "Mr." instead of "Dr." as an honorific. And lots of texts talk about surgeons as "operators," as in "an experienced operator..."

Our profession is relatively young and hopefully things will one day sort themselves out a bit. Patients often call us "doctor" because that is their frame of reference for what we're doing. And soreheads like the doc in the initial post will do and say what they do and say. The most effective strategy probably involves people who work with them, rather than all us folks getting upset at a distance.

Life is too short to get too upset about any of it. Just try to work somewhere where you're respected.

[iconic]

Americans are obsessed with titles. Where I am from in Europe, nobody uses the title Dr anyway. Medical degree is really not a doctoral level (research) degree.

Edited April 17, 2021 by iconic

[EMEDPA]

I hate midlevel. I am fine with APP (Adv practice provider).

At my newest per diem job, all the PAs and NPs have IDs that say

John Smith

Advanced Practice Provider

 

No PA or NP. 

[UGoLong]

15 hours ago, iconic said:

Americans are obsessed with titles. Where I am from in Europe, nobody uses the title Dr anyway. Medical degree is really not a doctoral level (research) degree.

Maybe so, but I remember a public phonebook in Germany or Switzerland in the 70s that actually had everyone's degrees listed so I'm not sure Europeans were always so egalitarian!

[Cideous]

I don't give a crap what they call us on the job as long as they leave me alone to treat my patients.....just don't call me Shirley....

[CAAdmission]

34 minutes ago, Cideous said:

I don't give a crap what they call us on the job as long as they leave me alone to treat my patients...

That, and as long as my paycheck clears.

[TheFatMan]

When asked if she had an NPI number... 

 

[LT_Oneal_PAC]

5 hours ago, TheFatMan said:

When asked if she had an NPI number... 

 

My god, I can’t fathom the lack of awareness she has. 
 

 

[iconic]

What a complete nut job

[sas5814]

wow....its hard to believe she is a functioning human much less an ER doc. I don't know how anyone functions walking around all day making up things to be outraged about. It is some weird personality disorder or other pathology

 

[CAAdmission]

2 hours ago, sas5814 said:

 I don't know how anyone functions walking around all day making up things to be outraged about. 

I'd say these days that this affliction is more contagious than Covid. 

[Cideous]

Some of the biggest nut job docs I have ever known were ER docs.  I worked with one guy who asked me after a shift if I wanted to go out to a dinner function with him.  I was young and thought, wow sure!  That F'er took me to an Amway meeting.  He didn't tell me until after we were seated and this asshat comes out selling us on their pyramid schemes.   Then this same doc (I find out later) had written an anti-PA article and had it published in the Texas Medial Association's magazine.  I was furious and never spoke to him again.

[Reality Check 2]

Cideous -pretty sure we worked with the same doc.

I got Amway gift packs - so did the staff - from our guy.

The whole comparison to Nazi tattoo numbers blew me away with this lady.

Just NOT OK and not logical or even remotely connected.

I am thinking she might need a med eval.......................