Health care terminology has evolved significantly over the years, with the term “provider” becoming a standard reference for various health care professionals, including physicians, nurse practitioners, and physician assistants. While the term includes many health care professionals in current medical practice, it’s important to discuss why “provider” was initially used and should not be used interchangeably with “physician.”
A brief history of the term “provider”
The term “provider” in health care began in the 1960s. Medicare started using this term to describe qualifying clinicians or entities that could be reimbursed for health care-related charges. In the 1980s and 1990s, the term “provider” was used when introducing managed care systems. Managed care refers to methods intended to reduce health care costs while improving the quality of care. In this type of system, a distinction was made between “payers” (i.e., insurance companies or government programming) and “providers” (i.e., the clinician or entity delivering care). The term was used to commodify the care given by physicians and advanced practitioners, seemingly depersonalizing their roles to a transactional one rather than the deeper and more interpersonal relationship it truly is.
Understanding the role of physicians
Physicians undergo rigorous and extensive education, training, and certification processes to acquire the necessary skills and knowledge to diagnose, treat, and manage various medical conditions. Their training typically includes four years of medical school followed by three to seven years of residency training, depending on their specialty. Many also undergo additional years of fellowship training in a sub-specialty if they so choose. This level of education and training is unique to physicians and differentiates them from other health care professionals. Using the term “provider” to refer to physicians fails to acknowledge this unique training and physicians’ specific role in leading the health care team.
Risk of confusion
The term “provider” can create confusion for patients, as it does not clarify the qualifications or capabilities of the professional giving treatment. Patients may need help understanding the difference in training and expertise between different types of clinicians. This misunderstanding could impact their decision-making and their understanding of the care they are receiving. Suppose a clinician with less training/education recommends a treatment to a patient, and the patient cannot differentiate between that clinician being a physician, advanced practitioner, nurse, or technician. In that case, the patient may feel more pressed to make a particular decision depending on said clinician’s perceived training/education level. This term can also confuse other professionals, as “provider” can refer to individual practitioners or larger entities like hospital systems.
Different clinicians have different roles in the health care team. If all health care professionals are referred to as “providers,” this can be misleading and may give the impression that everybody who falls under the term “provider” has the same skill levels, education, and authority. For example, a physician has a different role and authority than a nurse, pharmacist, or advanced practitioner. Lumping all these separate – yet equally important – jobs under one term can blur the distinctions that make each team member individually necessary.
Preserving professional identity
A physician is a professional who practices medicine, which entails promoting, maintaining, or restoring human health through the study, diagnosis, prognosis, and treatment of disease, injury, and other physical and mental impairments. The title “physician” originates from the Greek “physikos” (relating to nature). The Latin term “physicus” – student of nature – was derived from this word. The French then created the term “fisicien,” meaning healer. The title of physician, bestowed on persons who graduate from medical school, differentiates them from other professionals with different responsibilities in the health care team. This professional identity is one that physicians earn through years of study and practice. Using the term “provider” dilutes physicians’ professional identity and role. Professional titles acknowledge the skills, expertise, and responsibilities individuals within that profession hold. By referring to physicians simply as “providers,” we risk undermining the recognition and respect associated with their title.
Implications for patient care
Physicians offer a unique depth and breadth of medical knowledge and clinical expertise that directly impacts the quality of patient care. Using a non-descript term like “provider” may inadvertently suggest that all health care professionals can provide the same level of care, which is not the case. This can also lead to a depersonalized relationship between the patient and the physician. Ensuring patients understand who cares for them is crucial for maintaining trust and providing high-quality health care. “Provider” also implies a more business-like transaction (i.e., internet provider, electricity provider), which may impact the perceived quality of care. It has been said that patients may feel more in charge of their health care when they can “shop” for doctors, but according to patient reports, this is inaccurate, especially in a primary care setting. Physicians are not salespeople providing a service but are partners charged with guiding each patient’s personalized care.
While “provider” is widespread and convenient, it should not be used as a substitute for “physician.” Maintaining the distinction between different health care professionals is crucial to accurately represent their training and expertise, avoid confusion, and ensure that the quality and credibility of patient-centered care are upheld. If a term is necessary to describe multiple types of people who deliver health care, perhaps the words “clinicians” or “health care professionals” would be better options, as they are not rooted in commerce and are not associated with delivering business goods. Recognizing the unique role of physicians does not diminish the contributions of other health care professionals but rather enhances the collaborative efforts of the health care team by acknowledging the unique skills and expertise each member brings. An accurate lexicon can benefit the entire health system and give each health care team member the distinction they deserve while also strengthening the patient-physician relationship.
I will not be a provider. I will be a physician.
Austin Miller is a medical student.