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“This is an important time to rise up, come together, and understand that it is our time to remove the confusing veil put on us. We are not delirious. We are not psychotic. We are physicians. We are the ones who took an oath to benefit patients according to our most extraordinary ability and judgment to keep pure and holy both our lives and our art.

It is time to take back what belongs to us. It is ours. It is time to rise and start the revolution. Our title will not be taken away. You would never accept being called Laura when your name is Sarah. Our title has power. It is our healers’ birthright. Start the revolution. It starts with your title. Reclaim your power. Hi. My name is Diana Londono, and I am a physician — #notaprovider.

Diana Londoño is a urologist and can be reached on Twitter @DianaLondonoMD.

She shares her story and discusses her KevinMD article, “I’m a physician, not a provider.”

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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Rate and review the show at kevinmd.com/rate. Subscribe at kevinmd.com/follow. Today we welcome back on the show Diana Londoño. She is a urologist, and her latest KevinMD article is titled “I’m a physician, not a provider.” Diana, welcome back to the show.

Diana Londoño: Thank you so much, Kevin. I’m just so grateful, as always, to you and to your platform, and I know that even though you’re a little bit under the weather, you’re still here showing up. I really just want to spend a minute on gratitude for you, because I also just saw your interview with my colleague, Jillian Rigert, and I just want to say it really resonated. Not just the conversation you had with her, obviously, but how much we appreciate what you’ve done for so many of us, to allow us to express ourselves and to really heal. My journey of healing has hugely been in part because of you. So I really, really want to thank you, and I can just start with that, because I really am very appreciative. So thank you.

Kevin Pho: Well, Diana, thank you so much for your kind words, and it’s always a pleasure to elevate and share clinician voices and to really have you share your story. I know I’ve seen you on many interviews since KevinMD. Tell me how that has affected you: just sharing your story, letting the public read more about you, and being vulnerable in these interviews. How has that affected you?

Diana Londoño: Yeah, I think that sort of goes back to the first part. It’s just part of my healing: expressing and channeling, using some type of avenue or source to really channel these emotions. Whether I write for you or for any medium, or even speak, writing for me is mostly about something I’m going through at that time, and I need to sort of process it and channel it, and it helps me just release it and heal it. And hopefully it can resonate with somebody else. Hopefully it can help somebody else, energize them, give them hope, something for somebody else in terms of feeling like they’re not alone. We’re not in this alone. “Maybe I feel the same way.” Yes, of course, maybe you’re not ready to speak up about it. That’s OK. But we’re not alone in this, and we definitely need a community, a community of understanding, collaboration, and love.

And really, I mean, this is what you’ve built, obviously, but if somebody reads it and feels that, then that’s really the whole point of this. We all want one love, to be worthy, and to be understood. And that’s how it helps me, especially with writing, but speaking is just a different modality. There are many ways of expression: writing, speaking, and lately also movement. I’ve been doing a lot of moving on Instagram to express the same sort of emotions in a different way, in a little bit more fun and lighthearted way, because it’s a little ridiculous, but it’s just a different expression of creativity.

And creativity really gets you out of the things I talk about anyway, like burnout. People ask me all the time, “How do you get out of it?” or they say, “I can’t get out of it.” Well, you have to think about what you want. It’s something I’ve written about before, and even talked about in the podcast I did with you. What do you want? Where are you going? What fuels you? And it doesn’t have to be this word, “I’m not a provider.” It could be anything. It could be saving turtles in the Galapagos. It could be anything, but you’ve got to find something that fuels you, that gives you passion, that makes you wake up in the morning and do this, just like you woke up sick and you’re here. So what makes you wake up and do anything? You’ve got to find that, and that’s what got me out of burnout.

That’s what I really want to express and share with people: passion. What do you want? Where are you going? What am I good at? And then also, yes, do it with love and do it with gratitude, because that’s going to raise your vibration and your energy from a low, molasses energy of overwhelming guilt and all that negativity to a more positive place. So that’s sort of how you get out of it, that’s how I’ve gotten out of it, and that’s what I hope to share with others.

Kevin Pho: We’ll get into your article in a little bit, but one thing you just said really resonated: You share your story and you’re vulnerable in these podcasts and on my site because you want others not to feel like they’re alone. So give us an example of some of the feedback you’ve gotten from your appearances, either here or on other podcasts, when you were vulnerable. Tell us some of the feedback that you’ve had from other clinicians.

Diana Londoño: Yeah, I think it may not even be physicians. With people, even with a post or something, somebody will say, “Oh, yeah, I felt that too. I’m a mom, and that was a tough time.” I had a post up. I was doing an Instagram reel, and my daughter sort of photobombed it. She opened the door, and she was behind it the whole time. And I still went with it, because I just do it once. I don’t repeat it and do it five times; I do it once. It is what it is. But it was sort of like, “Well, yeah, that happens. I’m also a mom.” My kids also sometimes yell in the background of a podcast, and things happen, and it’s just what it is. We just give ourselves grace and love, and we keep going, and we’re not alone.

It’s not just a physician that it resonated with. It’s just somebody else who also felt like, “Yeah, I go through that. I struggle. I have three sons. This stuff is not easy.” But we can do it together, and that can happen in many ways. That was just something recent, and it’s kind of fun, and then people resonate, and then she starts sharing. I talked about how kids are our biggest teachers and kids have the best song choices, because I did a song about gummy bears, which is ridiculous, but it’s fun. And she shares all the songs her kids like, and it’s just community. We just build that community, that understanding, even if, again, you’re not a physician. It doesn’t matter. You’re a human that’s having an experience here, and we have a commonality, and that’s the magic of all of it.

Kevin Pho: All right, so let’s talk now about your KevinMD article. It got some traction, almost 700 shares. It’s titled “I’m a physician, not a provider,” and I know this has historically been an issue that’s been debated within the physician community. So talk to us more about your article, walk us through it, and share the story. Why did you decide to write it?

Diana Londoño: Yeah, I have sort of been fighting this fight for a long time where I work, and just throughout. Sometimes you just need to find an outlet for, again, the frustrations. If I’m frustrated, I’m not going to stay in that anger. I want to channel it. You have to start, yes, with anger, because you feel anger at an injustice, so that is a catalyst. But then you’ve got to move from that and sort of elevate it, and then transform it into expression, transform it into love, and then really, again, into community somehow. So that’s really where it started.

And it’s also very much rooted in love. This is not rooted in anger and separation. This is about loving ourselves and saying that we’re worthy, not from the ego standpoint of these temporary roles as physician, mother, whatever it is, but as healers. The beginning of the article talks about names. Names have a history, names are important, and words matter. Any word matters: “Cancer” and “benign” are different. They matter. So names are the same way, and they have a history.

We just have to learn the history. The word “doctor” comes from 2,000 years ago, from the Latin “docere.” It means to teach, to instruct, and that’s why physicians were, the doctors were called physicians, because we teach, we instruct, and we heal, hopefully. That’s what we’re doing, and this has been around for thousands of years. And this word “provider,” let’s just know the history again. It’s not something that’s been around for 2,000 years. It has really been around very recently, the last 50 years or so.

And the history of why it is also very dehumanizing is that it was used by the Nazis in the 1930s. Half of the pediatricians in Hitler’s Reich were Jewish, and they started to really dehumanize them in many ways. Of course, we know all the abuses of the time, but the Society of Pediatrics asked the physicians to resign in the 1930s. And then by 1938, the government just took away their licenses and started calling them, instead of doctors, basically practitioners or health care providers. So it was used in that psychological, dehumanizing way at that point. And just the fact that that occurred: I don’t want to be associated with anything that dehumanizes another human being. And that happened.

And then later, in the 1970s, it started to be used in hospitals, home health agencies, nursing homes, labs, all these different things, where they grouped us all into “We’re all providers.” And then that becomes really murky, because who is this provider that’s seeing you today? Is it a nurse that is taking care of you? Is it the doctor? A nurse practitioner? Who is it? And it’s not, again, about the ego, or “We’re better,” or “You’re different,” but I just need to know who is taking care of me, because that matters, and because that’s confusing.

And as a side note, as a physician and a surgeon and a woman, that role is already very blurred, because half the time they don’t know that we are the physician or the surgeon. “Who’s going to do my surgery?” We get asked that very commonly. “Who’s going to do it?” And I’m like, “I am the surgeon.” Not from the ego, but like, “I am the one that’s going to do the surgery. Nobody else is going to come in.”

So that has a lot of history, and we need to just understand it. And you don’t have to die on this hill, but I think we have to have some awareness and wake up and realize, “Hey, do you care that this is a slippery slope, and that pretty soon, when we wake up, this whole world will be very different for us as physicians?” That’s the question I want to ask, because people also ask me, “Well, how do you get everything done with all the things that you do?” Well, when you’re asleep. When my kids are asleep, I get a lot of stuff done. And the same thing happens to us as physicians. When we are just asleep and we’re not aware of what’s going on, then we wake up one day and we’re like, “Wow, how did all this happen? This is a terrible place.”

But at the same time, are we awake? Are we asleep? What are we doing? Are we doing anything? Are we just playing dead like a mouse? And I also understand that, because we’re in burnout. You’re going to play dead because it’s too much. But just think about it at least once and make up your mind what you want to do, because it’s not just a little word. It matters. Words matter.

Kevin Pho: When you’re working and someone addresses you as a provider, or they send out a bulk email from whatever medical institution or hospital you work at and address the medical staff as providers, what do you do next? Do you push back at all?

Diana Londoño: Oh, yeah, of course. All my email and all my EMR signatures say “Diana Londoño, not a provider.” All my profiles, LinkedIn, Facebook, and Twitter, say “not a provider.” They all say that because I got tired of explaining every time, and I still do, but I’m not going to get mad and try to change you, because you can’t change anybody. But I can change how I show up, and I show up as Diana Londoño, not a provider.

And I also went the extra step: I give out all these articles. I have all the articles I’m aware of about all this stuff I’m talking about, the history and people’s viewpoints on this, from Forbes and ACG and AMA. All of these are on my website, PhysicianCodeSupport.com, or my own DianaLondonoMD.com. They’re there for you to learn about it and understand what we’re talking about in a short segment. But I also share all these articles with people when they keep referring to me as a provider: “Hey, at least learn about it. Here’s the information. You decide, again, but learn it.” So I share it with the CMO, the CFO, and all levels of administration, so they are aware this is dehumanizing. And again, are we making changes? Not yet, but hopefully we will. So we’re going to keep doing something.

And I also made some badges now that say “not a provider,” and you can get those on the site. “I am not a provider.” It says “physician, not a provider.” That way, again, there’s no confusion about who is who. It’s on my badge. Actually, my badge says “doctor” and “not a provider.” It says all three. And I need a surgeon one as well, I think, because sometimes, again, that gets confusing. But being realistic, I try to do whatever I can.

No action is too small. Just educate with love. It’s not about being angry, but, “Hey, do you know what it really means?” Say that kindly, educate, and just make a statement: I am not a provider. I don’t provide electricity. Dentists are not teeth providers, and lawyers are not legal aid providers. That is just so ridiculous when we say it about other specialties. Pilots are not transportation providers. So why are we saying that about physicians? It’s just mind-boggling to me.

Kevin Pho: So we do have a lot of hospital administrators that listen to this podcast. If they wanted to address the medical staff collectively, what kind of terminology should they use?

Diana Londoño: I mean, I think, why are we being so cheap about different words? You could say “physicians, nurse practitioners, medical staff.” Just address it as it is. It’s two extra words to address whoever you’re clumping together. It’s not that much extra. And you are sending us a message, an important message. Again, words matter: “I won” and “I lost” are very different. So just add one extra word, “physicians,” “nurses,” whoever this email is sent to as a group, if there’s a group. Just say what it is. Again, we’re not providers.

If you’re sending it to the office: “Hi, physicians and nursing staff.” That’s who was in the office, the nursing staff and the physicians. That’s all you have to say. It’s very easy. Let’s not get complicated and say it’s too difficult to add an extra word to an email, and have it all over the EMR: “provider,” “provider on vacation.” I’m not a provider. I mean, again, it drives me a little bit bananas, but why is it everywhere? Why is it ubiquitous? And why is it OK? It’s not OK.

And again, it’s the slippery slope, just slowly eroding and confusing, and the article also talks about it. Let’s say you’re in the hospital and you’re seeing a patient, and you’re asking them, “What’s your name?” Are they alert and oriented times three? Name, place. Are they oriented to their name? And they don’t know who they are. Well, we don’t know who we are. We don’t even say we’re physicians anymore. We’re totally confused, and we’re not psychotic. We are not disoriented. We are physicians, and I think it’s time to take a stand in any way.

It is about bringing back humanity, and this is one step. A lot of people are advocates in many ways, and they do it from different standpoints, which are very important. But to me, my core value is about the humanity in medicine, and this is one way where I think it’s really important. There are many ways to talk about it, but this really is something that is important, not from the ego, but from love, from understanding history, from understanding how it’s been used by the Nazis, and also how it confuses the role of who’s taking care of you. That’s also an interesting part of it more recently, and I think that also has to be discussed.

Kevin Pho: Now, you’ve been advocating for calling physicians “physicians” and not “providers” for a while now. Tell us the range of responses that you’ve been getting.

Diana Londoño: Yeah, some people are like, “Really? With all the things to fight about, this is what you’re fighting about?” That’s one. Another one was like, “Ah, OK.” Another one’s like, “Yeah, I don’t see the dehumanizing part.” OK, but then they also say, “Well, but I’m also not a physician advocate,” which is a little bit sad, but again, you can have your own advocacy. That’s fine. Have advocacy for something. Again, it could be geese or chickens. It doesn’t matter.

But there’s a whole range. Some of it is apathy, and some of it is like, “I’m with you. I’m with you. Let’s go. Let’s start this. Let’s take medicine back. How can we help? How can we amplify?” So there’s a big range. I don’t think there’s one consistent reaction of “This is what I always get.” But on LinkedIn, where there are administrators and all kinds of people in medicine, not just physicians, it really actually resonates. The post about the article has generated almost 50,000 views, just a post about the article. And again, it’s not all physicians there, so it’s a lot of different people reading about this and understanding it.

At 500 or so words, it is my shortest article, actually. I usually struggle to get to less than 1,000, but this is my shortest and most powerful, and I actually cried when it was accepted, because it was so important to me and it really meant something. I am so grateful you’ve accepted so many, but with this one, I really did cry. I was really emotional. So it could be anything, but I think it is resonating with some people. As you said, it has gotten some traction. I’ve had some people reach out to me, in admin as well, in organizations, like, “Hey, yeah, let’s talk about this a little more.” And again, it’s about starting a conversation, starting a unity, getting together, coming together, collaborating. And really, it’s about loving each other in some capacity.

Kevin Pho: We’re talking to Diana Londoño. She’s a urologist, and her latest KevinMD article is titled “I’m a physician, not a provider.” Diana, any take-home messages that you want to leave with the KevinMD audience?

Diana Londoño: My messages are: Start your day with gratitude, or end it with gratitude. That’s going to change how you feel, and if you’re in burnout, and we’re going to talk about this a lot, it will transform you. It really will, and it’s not going to be in two days. It’s probably going to be in a couple of months. But start with gratitude. That’s going to change your life. And figure out what you want. Where are you going? What are you passionate about? Because when you’re in that state where you’re enthusiastic and passionate, you get creative, and creativity and passion are going to counteract all the stress and cortisol. And again, that’s probably going to get you out of burnout, as well as out of feeling depressed and overwhelmed and hopeless.

So practice that, and take care of yourself. You are valuable. This is really important: You matter, you’re valuable, you’re worth it. Self-care is about loving you so you can love others. So those are my important messages. You are the most important person. So thank you again, Kevin. I’m always so honored to be here. This is just a delight. Thank you.

Kevin Pho: Diana, thanks again for coming back on the show and sharing your time and insight.