It turns out that when Shakespeare asked, “What’s in a name?” he didn’t have medical providers in mind. In the last decade, the nondescript and confusing term “provider” has crept into the American medical lexicon thanks to the Centers for Medicare & Medicaid Services (CMS) which defined a provider as a Medicare participant that is contractually obligated to provide health care to Medicare beneficiaries. This was beginning of clubbing all health care practitioners into a single club purely for an administrative purpose.
Over the last decade and a half, this has led to significant discontent amongst many physicians and others. As recently as last month, Dr. A. H. Gorroll wrote in the Journal of American Medical Association the evolution of the word “provider” in contemporary health care lexicon. I concur with him about the inaccurate nomenclatures describing the rapidly evolving U.S. health care delivery model.
However, in my opinion, as well as the opinion of a significant proportion of practicing U.S. physicians, the problem with the generic term “provider” runs deeper. It has delved into the very psyche of the people who are trivialized and commoditized, namely the physicians themselves. In addition to primary care, this term — created by insurers, administrators, and bureaucrats — has now percolated beyond the traditional sphere of primary care into subspecialties like cardiology for example, as a euphemism for the frontline health care professionals consisting MDs/DOs, NPs, PAs, and RNs.
When asked on Sermo, a social network of over 300,000 verified physicians, about how physicians feel about being called a “provider,” it is clear that most physicians resent this. By the administrative logic of referring all health care workers who provide medical care as providers, the logical next step might perhaps be awarding of a universal “MP (medical provider) degree” to all who goes through a unified medical curriculum irrespective of the scope of medical training.
The word “provider” also leads us to consider a physician-patient encounter as essentially a business transaction, devoid of the cherished therapeutic relationship and arguably catering only to a consumer-driven market economy where patients are mere clients or customers.
In this new world of medicine spearheaded by dynamic business organizations and third-party payers, healing is becoming more often a hard science than a mere art; the contemporary medical doctor remains the professional most trained in this field. It is in this spirit, that physicians (and nurse practitioners and physician assistants) should demand appropriate respect and recognition for their training. Anything short of that, in my opinion, falls into the realm of political inappropriateness in the health care lexicon such as the words “colored,” “retarded,” “idiot,” etc. which are not used in medicine anymore.
It can be done. It is not a matter of unnecessary administrative complexity; rather it is a matter of identity. Safety is a fundamental patient right, and the informed patient has the right to know the identities of the professionals who will take care of him or her — at the onset — from the point of first medical contact.
Sumit Som is a cardiologist.
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