The Problem with “Provider”

The Problem with “Provider”

By NIRAN AL-AGBA, MD

As originally published here, shared with permission from the author: https://thedeductible.com/2019/02/15/the-death-of-specialization/ fbclid=IwAR1IK02oTlEE6Zb5Ae8pc3zFKXMB_czQb0ihCSsNJUcSdVQDMoHGBiAdPrI

“If you control the language, you control the argument 
If you control the argument, you control information, 
If you control information, you control history,  
If you control history, you control the past. 
He who controls the past controls the future.”
— Big Brother, 1984. (George Orwell)

Allow me to submit to you: a physician should be called a “physician.” A nurse practitioner should be identified as “nurse practitioner.” Please call a physician assistant, “physician assistant.” These are accurate titles, reflective of their specialized education, training, and expertise. They are all venerated professions which share a mutual goal of improving patient’s lives, yet the vocations are fundamentally different.

“But if thought corrupts language, language can also corrupt thought.” 
   — George Orwell

A central message of 1984 is that language shapes thought by structuring ideals and limiting ideas. Imprecise syntax spreads by imitation and tradition, even among those people – like physicians–who should know better. Some young physicians do not realize that the word “provider” undermines their profession by devaluing their specialized education and training. 

My request:  Stop calling physicians “providers.” It is insulting, personally and professionally.

Language is a powerful tool.  It doesn’t just allow us to communicate; it is a way to change culture and control people. History has shown us that every oppressive regime to come into power, did so by shifting language and influencing thoughts in order to alter perception and then, form a new reality. There is a word for this weaponization of language.

Propaganda.

Behind today’s push to change the language of medicine, is the colossal “medical-industrial complex” –part government and part corporate medical machine — which stands to benefit fiscally by denying physicians their special expertise.  Disparaging physicians allows policymakers to surreptitiously advance the idea that a nationalized health system, administered and controlled by the government, is the fix-all solution to what ails the health of our people.  But first and foremost, physicians must be conscripted, and that is precisely what is happening. 

While mass generalization is expedient, convenient semantics is part of a larger societal trend best described as “the death of specialization.”  In reality, this deceptive linguistic creep obscures a 19,000-hour training difference that exists between a physician and nonphysician, a fact that should be of great material consequence to patients.  The control of healthcare is being relinquished through this ambiguous propaganda war as a first step, which will be followed by changed in medical culture that will corrupt the entire healthcare system. 

“War is peace, Freedom is slavery, and Ignorance is strength.”
   – George Orwell

Today, in healthcare, absolutely anyone can be anything.  Any patient can self-diagnose and treat their condition using the internet, Jenny McCarthy can be an expert on immunizations for children, and Nurse Practitioners and Physician Assistants are considered doctor “replacements.”  While non-physicians with graduate degrees –nurse practitioners, physician assistants and psychologists– are fighting for the title of “doctor,” physicians who have earned the designation through more than a decade of education are being shamed into avoiding its use.  Any physician daring to highlight their credentials is labelled as “egocentric”, “elitist” or “self-important.”  The perversity of this is utterly astounding. 

Though seemingly innocuous, “provider” has allowed substitution of lower paid personnel in place of physicians under the premise of lowering costs, despite the fact there is not a single shred of evidence to scientifically support this claim.  The mainstream, believing anyone can practice medicine, have turned a blind eye to the plight of physicians struggling against the odds to care for patients.  

“If liberty means anything at all it means the right to tell people what they do not want to hear.” -George Orwell

By insisting physicians accept the derogatory term “provider”, we are being forced to comply with the systematic demise of our profession, for the sake of political correctness. Countless physicians have shared their repugnance of this derogatory term, yet remain silent due to fear of losing employment, or worse, face character assassination. I write in support of marginalized physicians unable or unwilling to speak up.  

We must think about our word choices.  If we relinquish control of our language, we will lose our humanity.  The term “provider” applies to almost any type of clinician.  This growing unwillingness to highlight differences in training, education, and expertise constitutes an increasing danger to not only our profession, but also to patients, our healthcare system and society as a whole.  Patients deserve to know who is rendering their care.  

We are physicians, not providers.  It is insulting and I am asking for it to stop. 

Niran Al-Agba, MD is a physician, not a provider.  She is based in Washington State.

5 Comments
  • Patricia Casimir, MD
    Posted at 02:00h, 20 February Reply

    Well said!

  • Anand Dave
    Posted at 23:54h, 28 February Reply

    I am a Physician Assistant and I agree with your sentiment toward the nomenclature of “Provider.” The Physician should be the Physician. The PA should be the PA, and so on and so forth. A patient should know who they are seeing and I will assure you that PAs will not and never intend to be physician “replacements.” While I understand your position, some of your comments are misdirected. Hopefully as time goes on you’ll realize that PAs and Physicians work well together and I, as a PA, want that to continue as together we are the only “practitioners of medicine” that treat patients from head to toe. Most of us have learned together, trained together and fought battles together. The rift between PAs and Physicians, if there is one, is unnecessary.

    • PPP Admin
      Posted at 16:33h, 04 March Reply

      We agree that PA and Physicians make a great team! We are concerned about the AAPA pursuit of Optimal Team Practice, which is just a clever name for independent, unsupervised practice. Thank you for standing with us on the “provider” nomenclature, which should be retired immediately.

  • Melinda Gottschalk MPAS PA-C
    Posted at 02:29h, 01 March Reply

    People are lazy. They call all healthcare providers “providers”. They use APP to describe PAs and NPs when we are really nothing alike in training and philosophy.. Everybody gets lumped together for convenance. When administrators and legislators finally understand as professions we have all earned our own title , maybe it will change. Until then, all of us are equally insulted by the lumping, just depending on which pile you are placed determines how bent of shape you become.

    • PPP Admin
      Posted at 16:34h, 04 March Reply

      You are absolutely right that NPs and PAs have completely different training models, and we do appreciate that.

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