It's time to stop calling physician 'provider'.

[Splenda88]

I was told ACGME will have a meeting next week about this issue.

Here is a great article about that term:

Professional Identity Misformation and Burnout: A Call for Graduate Medical Education to Reject “Provider”

The professionalism of faculty and resident physicians has been on full display during the COVID-19 pandemic. Media stories have notably praised heroic “doctors and nurses” rather than “providers and nurses,” acknowledging the dedication and training of the people saving lives while putting...

meridian.allenpress.com

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[Kardio]

It’s nice to see a paper like this published in the journal of a major MedEd institution

 

[Lawpy]

Finally some academic attendings who aren't useless sellouts!

That's a good paper

 

[Maimonides1]

I was told ACGME will have a meeting next week about this issue.

Here is a great article about that term:

Professional Identity Misformation and Burnout: A Call for Graduate Medical Education to Reject “Provider”

The professionalism of faculty and resident physicians has been on full display during the COVID-19 pandemic. Media stories have notably praised heroic “doctors and nurses” rather than “providers and nurses,” acknowledging the dedication and training of the people saving lives while putting...

meridian.allenpress.com

Finally someone are listening for what we have been calling for for years..
I hope it’s not too late to start a movement to reverse the tide.., before it’s to late for the boat is sinking..!!

 

[nowanmd]

i think we should be called physician associate associate physician lol

 

[Chads2]

This is actually one of my few points of snark while I’m at work.

“Are you the provider for Mr. Smith?”
“No, I’m his physician.”

“Are you following Room 12?”
“I’m her doctor, if that’s what you mean by following.”

 

[Ho0v-man]

No. I think it’s totally appropriate that physicians are providers and nurses with online pay-to-play participation trophy degrees are ADVANCED PRACTICE providers. It’s not a slap in the face at all.

 

[Chads2]

I was told ACGME will have a meeting next week about this issue.

Can you imagine? Resident Physician/ Attending Physician...

NP’s will start clamoring for “Attending Practitioner.”

 

[Ho0v-man]

Can you imagine? Resident Physician/ Attending Physician...

NP’s will start clamoring for “Attending Practitioner.”

Bruh, they’ll probably change their name to “Nurse Physician” pretty soon. So I can totally see them demanding to be called “Attending Physician” and we’re all being unprofessional if we don’t want to.

 

[Matthew9Thirtyfive]

Bruh, they’ll probably change their name to “Nurse Physician” pretty soon. So I can totally see them demanding to be called “Attending Physician” and we’re all being unprofessional if we don’t want to.

The NPs are listed as attending physicians in the EMR here. It’s the EMR build, not the hospital. They have big badges that say NP or Nurse Practitioner on them.

 

[slowthai]

Inb4

"Stop whining about this, it's just a word"

and

"What other word can we use to group them all together?"

As an aside, I'm surprised the ACGME is even pretending to give a crap about this

 

[Lawpy]

Inb4

"Stop whining about this, it's just a word"

and

"What other word can we use to group them all together?"

As an aside, I'm surprised the ACGME is even pretending to give a crap about this

"Medicine is a team sport and we are ALL providers"

 

[mmchick]

Inb4

"Stop whining about this, it's just a word"

and

"What other word can we use to group them all together?"

As an aside, I'm surprised the ACGME is even pretending to give a crap about this

I mean.. it is just a word. Seems a little ego fragile to worry so much about what someone calls you. You know you're a physician, your team knows, and the licensure/law knows. Aside from boosting one's ego who really cares. This is just as nitpicky as the whole PA movement to get themselves to feel better about themselves. Once a god complex always a god complex, regardless of what the official title is.

 

[Lawpy]

I mean.. it is just a word. Seems a little ego fragile to worry so much about what someone calls you. You know you're a physician, your team knows, and the licensure/law knows. Aside from boosting one's ego who really cares. This is just as nitpicky as the whole PA movement to get themselves to feel better about themselves. Once a god complex always a god complex, regardless of what the official title is.

It's not just a word. It's a deliberately derogatory term created by anti physician lobbying groups to degrade and insult physicians and falsely equate them with midlevels. The only ones with the ego issues are the midlevels

 

[slowthai]

I mean.. it is just a word. Seems a little ego fragile to worry so much about what someone calls you. You know you're a physician, your team knows, and the licensure/law knows. Aside from boosting one's ego who really cares. This is just as nitpicky as the whole PA movement to get themselves to feel better about themselves. Once a god complex always a god complex, regardless of what the official title is.

This is a common misconception. It has nothing to do with ego, like I couldn't care less. It's all about the agenda behind these words (and movements). It's about devaluing the training of physicians and equating them to midlevels in an attempt to make us interchangeable widgets for these money hungry administrators.

Like "we're all the same". No we're freaking not. A physician is irreplaceable if taking the best care of patients is the aim. It should go without saying, but the standard of care is determined by physicians, not anyone else. Not midlevels, not administrators, not insurance companies, and not the government.

Furthermore, it's being used to destroy the physician-patient relationship, turning it into some stupid provider-customer BS. It's all about money at the end of the day.

 

[deleted966164]

When I was working as a secretary in an ED, at the beginning I used to pick up the phone from a pharmacy asking for some dosage clarifications. After consulting the docs, I used to say "After talking to our provider, (...)." Yeah, I got scolded pretty badly (in a funny way). I was told "Joe, we are not 'providers,' we are 'physicians.' It's a sign of a bigger problem and you will understand it in medical school..."

This, and the "women in medicine" thing (topic for a separate forum). One of our docs used to have to go to patients' rooms and had to introduce herself as "Hi, I am DOCTOR T., I will be your ER DOCTOR today." Even with that, the patient would not address her but the only male nurse in the room...

 

[Kryptocoin]

CMGs love that term. It is a great equalizer. It commoditizes us and makes us replaceable. At least once per shift, I get patients that come to the ER saying their 'doctor' sent them here. When I look up their 'doctor' it's usually a PA/NP. When I correct the patients, they say 'oh' and shrug off. Don't seem to care.

It's pretty clear that patients don't seem to care who's treating them. They incorrectly assumed that they are getting similar treatments either by an MD/DO or a mid-level or anyone wearing a white coat. More awareness needs to be done to educate patients on the vast difference of educational level required to become a physician versus a mid-level.

 

[Matthew9Thirtyfive]

I mean.. it is just a word. Seems a little ego fragile to worry so much about what someone calls you. You know you're a physician, your team knows, and the licensure/law knows. Aside from boosting one's ego who really cares. This is just as nitpicky as the whole PA movement to get themselves to feel better about themselves. Once a god complex always a god complex, regardless of what the official title is.

Lots of things are just words. That doesn’t mean they don’t have meaning or power. Provider is a term used by midlevel groups and administrators for very specific reasons that destroys any sense of hierarchy. It hurts patients.

 

[Splenda88]

The NPs are listed as attending physicians in the EMR here. It’s the EMR build, not the hospital. They have big badges that say NP or Nurse Practitioner on them.

Really... That is crazy

 

[deleted966164]

Really... That is crazy

Nurse PHYSICIAN...

 

[mrbreakfast]

The very large NP-run services in my hospital have "attending" NPs; several NPs report to an "attending" NP, and those then report to the attending physician. So when one of those NPs states "well, I talked to my attending, and..." they may be referring to another NP, not a physician.

 

[Mad Jack]

I was told ACGME will have a meeting next week about this issue.

Here is a great article about that term:

Professional Identity Misformation and Burnout: A Call for Graduate Medical Education to Reject “Provider”

The professionalism of faculty and resident physicians has been on full display during the COVID-19 pandemic. Media stories have notably praised heroic “doctors and nurses” rather than “providers and nurses,” acknowledging the dedication and training of the people saving lives while putting...

meridian.allenpress.com

Silence, provider!

 

[ACSurgeon]

Surgeons we will stick to being... surgeons. I don’t provide a surgery. I perform one. If we must change our title, we can be performers 😎

 

[ACSurgeon]

Also, can we have one midlevel thread or do we need a new one every other day? Maybe we need a separate midlevel complaining subforum for all the threads to go there...

 

[deleted966164]

Surgeons we will stick to being... surgeons. I don’t provide a surgery. I perform one. If we must change our title, we can be performers 😎

Coming to you in 2021... "Performer." There will be "Providers and Performers"

 

[Lawpy]

Also, can we have one midlevel thread or do we need a new one every other day? Maybe we need a separate midlevel complaining subforum for all the threads to go there...

Already suggested a midlevel master thread but that didnt go anywhere

 

[Matthew9Thirtyfive]

Really... That is crazy

Yeah. It’s just the build. The NPs are very clear here about their role and titles.

 

[Spetzler-Martin]

Thank goodness I'm doing neurosurgery. Don't think midlevels will be doing complex spine deformity surgeries any time soon. But at the same I'll be getting butchered by 100 hour shifts, so I guess it's not exactly a win.

 

[Lawpy]

Thank goodness I'm doing neurosurgery. Don't think midlevels will be doing complex spine deformity surgeries any time soon. But at the same I'll be getting butchered by 100 hour shifts, so I guess it's not exactly a win.

Anything can happen in the future and with the rapid corporatization of medicine, i honestly won't be surprised if midlevels end up doing advanced surgeries in the future

 

[Matthew9Thirtyfive]

Anything can happen in the future and with the rapid corporatization of medicine, i honestly won't be surprised if midlevels end up doing advanced surgeries in the future

I would be surprised. The same people I hear say they don’t mind NPs or PAs doing their primary care or a CRNA do their anesthesia would never let anyone but a surgeon cut them.

 

[Lawpy]

I would be surprised. The same people I hear say they don’t mind NPs or PAs doing their primary care or a CRNA do their anesthesia would never let anyone but a surgeon cut them.

What do you make of this?

Meet the nurse who will soon perform surgery on patients alone

Unlike other nursing roles, a surgical care practitioner is involved with the patient every step of the way

www.theguardian.com

This was 4 years ago. Who knows what will happen in 5 years from now? It's too bold a prediction to make that midlevels will never encroach surgery when stuff like this is gradually happening already

 

[Lawpy]

Also it's pretty insane to defer simple things to midlevels since being stuck with only complex cases is a fast way to burnout.

 

[Spetzler-Martin]

What do you make of this?

Meet the nurse who will soon perform surgery on patients alone

Unlike other nursing roles, a surgical care practitioner is involved with the patient every step of the way

www.theguardian.com

This was 4 years ago. Who knows what will happen in 5 years from now? It's too bold a prediction to make that midlevels will never encroach surgery when stuff like this is gradually happening already

I guess it can happen. What puzzles me is how they'll ever acquire the extensive knowledge base that 7 years of surgical residency would give you. However, as you mentioned, if they learned some common routine surgeries like aneurysm clippings, they could easily encroach.

 

[sylvanthus]

Thank goodness I'm doing neurosurgery. Don't think midlevels will be doing complex spine deformity surgeries any time soon. But at the same I'll be getting butchered by 100 hour shifts, so I guess it's not exactly a win.

The push for midlevels will be indirectly screwing up the surgeon market soon enough. When on the one hand you could have two surgeons able to round on their own patients and spend time in the OR or one surgeon and a couple midlevels to round on patients with the surgeon staying in the OR, which way do you think hospitals are going? The midlevels arent directly replacing the surgeon, but there is one less job for a surgeon....

 

[Ho0v-man]

I guess it can happen. What puzzles me is how they'll ever acquire the extensive knowledge base that 7 years of surgical residency would give you. However, as you mentioned, if they learned some common routine surgeries like aneurysm clippings, they could easily encroach.

They don’t have the extensive knowledge base of medical school or the knowledge base achieved over the course of ANY type of residency training. The job being too complex for them to do it well has never been a limiting factor.

 

[Matthew9Thirtyfive]

They don’t have the extensive knowledge base of medical school or the knowledge base achieved over the course of ANY type of residency training. The job being too complex for them to do it well has never been a limiting factor.

Yep. The limiting factor will be whether the cost of the lawsuits that follow their complications outweigh the money made by the hospital who employs them.

 

[Lawpy]

Yep. The limiting factor will be whether the cost of the lawsuits that follow their complications outweigh the money made by the hospital who employs them.

Hospitals and PE will ensure this won't happen

 

[Lem0nz]

Also it's pretty insane to defer simple things to midlevels since being stuck with only complex cases is a fast way to burnout.

I'm not sure how real this is. I hate the simple cases and really only enjoy the complex ones that require innovative thinking and expertise beyond that of a PGY3 resident. I've met several surgeons who hate complex cases and only want to churn out the easiest, simplest things but they're the ones who have kind of already hit a dead end of their career and don't want to continue growing or learning. They're often just in it for the money and the simplest things typically generate the most money because they have the least amount of planning, follow up, complications, and perioperative work.

Might just be me that feels this way. Its nice to get the simple thing once and awhile but people who want the vast majority of their things to be simple and get upset/frustrated with the complex cases seem to be the ones who are already burnt out and just don't care that much.

 

[Matthew9Thirtyfive]

I'm not sure how real this is. I hate the simple cases and really only enjoy the complex ones that require innovative thinking and expertise beyond that of a PGY3 resident. I've met several surgeons who hate complex cases and only want to churn out the easiest, simplest things but they're the ones who have kind of already hit a dead end of their career and don't want to continue growing or learning. They're often just in it for the money and the simplest things typically generate the most money because they have the least amount of planning, follow up, complications, and perioperative work.

Might just be me that feels this way. Its nice to get the simple thing once and awhile but people who want the vast majority of their things to be simple and get upset/frustrated with the complex cases seem to be the ones who are already burnt out and just don't care that much.

I worked with plenty of surgeons who loved the simple cases, and it wasn’t because they were at a dead end or didn’t want to keep learning. That’s a pretty condescending attitude to have.

 

[Lem0nz]

The push for midlevels will be indirectly screwing up the surgeon market soon enough. When on the one hand you could have two surgeons able to round on their own patients and spend time in the OR or one surgeon and a couple midlevels to round on patients with the surgeon staying in the OR, which way do you think hospitals are going? The midlevels arent directly replacing the surgeon, but there is one less job for a surgeon....

This is a huge misconception. I'm sure this occurs *some places* but I've been to a LOT of institutions that rely heavily on midlevels on every service and this is not what happens. The midlevels don't round 'for' the surgeon. They may round first, and report, and take action at the surgeon's direction, but the surgeons all still see their inpatients every single day unless they're getting discharged that day. This is not really all that different from a practice with no midlevels or residents except that the surgeon might see the patient at like, 10 or 11am instead of 6am. I'm not sure that's of significant consequence.

They do see routine post-ops in the clinic, but again. If they're actually just recovering fine and have no issues I'm not sure this is of significant consequence. Any issues get elevated to the surgeon.

 

[Lem0nz]

I worked with plenty of surgeons who loved the simple cases, and it wasn’t because they were at a dead end or didn’t want to keep learning. That’s a pretty condescending attitude to have.

That's just my experience. I've met a great many surgeon who would rather do 12 ports a day than one hard colon and when you ask them why they will start talking about RVUs. I'm pretty turned off by it.

 

[Matthew9Thirtyfive]

That's just my experience. I've met a great many surgeon who would rather do 12 ports a day than one hard colon and when you ask them why they will start talking about RVUs. I'm pretty turned off by it.

Yeah I’m sure it happens. My experience has been that some of them just don’t want to do the big, complicated cases and enjoy the less complex stuff.

 

[Splenda88]

We, as a profession, are screwed. We have too many looking out ONLY for themselves.

 

[Matthew9Thirtyfive]

We, as a profession, are screwed. We have too many looking out ONLY for themselves.

I’m hoping the new gen of docs will be different.

 

[Redpancreas]

I’m hoping the new gen of docs will be different.

They’ll be worse. Gen Z(oomers) are hyperfocused on quick money and instant gratification.

 

[Lawpy]

I’m hoping the new gen of docs will be different.

I lost hope because the virtue signaling millennials and zoomers on social media have proven to be even bigger pro-midlevel sellouts.

I'm betting entirely on gen alphas and future generations to make the change

 

[Spetzler-Martin]

They’ll be worse. Gen Z(oomers) are hyperfocused on quick money and instant gratification.

If I wanted instant gratification, I wouldn't be in medical school nor potentially entering nsg. There's good and bad doctors of every generation. Also, from my understanding, medical schools are emphasizing high value care more than ever (at least my school is)

 

[Lawpy]

If I wanted instant gratification, I wouldn't be in medical school nor potentially entering nsg. There's good and bad doctors of every generation.

Yeah which is why i think the bad significantly overshadow the good and why betting millennials/zoomers will fix this mess is unrealistic. They'll likely make it much worse, until the gen alphas/future gens get completely fed up and rebel against the millennials/zoomers to fix the mess

 

[Matthew9Thirtyfive]

They’ll be worse. Gen Z(oomers) are hyperfocused on quick money and instant gratification.

I don’t think so. What I’m seeing is a huge majority of current students who are pissed off at what the boomer generation has done.

 

[Spetzler-Martin]

Yeah which is why i think the bad significantly overshadow the good and why betting millennials/zoomers will fix this mess is unrealistic. They'll likely make it much worse, until the gen alphas/future gens get completely fed up and rebel against the millennials/zoomers to fix the mess

Well Step 1 of the revolution is getting rid of Dr. Mike, the ring leader. Haha