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

[Spetzler-Martin]

Can someone clarify what the Step 2 CS disaster is? I'm a slowpoke in terms of news.

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[Lawpy]

I bashed admins before many times but this is too good

 

[xffan624]

Can someone clarify what the Step 2 CS disaster is? I'm a slowpoke in terms of news.

A couple years ago, Harvard students started a campaign to eliminate Step 2 CS. One of their arguments besides the fact that it was too expensive was that it was useless because it had such a high pass rate (97-98%). So the USMLE responded by lowering the pass rate, thus resulting in more failures. They ignored the other parts of the argument.

 

[VA Hopeful Dr]

I think the best way to increase access to primary care in rural areas is to do what Florida has attempted. Give unmatched IMG/FMG a limited license so can only practice medicine in facilities designated by the state.

Or just pay rural more. A solid half of my residency class went rural at first. Between more money and insane loan repayment, its absolutely worth it for a few years at minimum.

Best I heard was one of my classmates who ended up "rural" SC (hour from Columbia, 30 minutes from Florence). 250k starting (and this was 8 years ago mind you) with 50k loan repayment per year for I believe 3 years (might have been 5).

 

[Redpancreas]

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)

The generation as a whole. You just happen to be one student interested in NSG and that supply won’t change. No one on SDN is going to self identify with the “zoomer” caricature but my gestalt is that Zoomers like to diss the Boomers yet they themselves are growing up in an age seeking quick money and instant gratification. This is the generation of TikTok, kids who think they can day trade for income instead of working a job, and for SDN millennials and zoomers who post tons of maximum salary for 40hr/week threads.

 

[NY_Med]

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

Or slapping some sense into him so he can use his platform for something productive.

 

[NY_Med]

@Matthew9Thirtyfive see my point?

In my group chat, we were actively talking about the problem of mid-level encroachment a few weeks ago. I wouldn't say that proves anything tbh haha.

 

[Splenda88]

Or just pay rural more. A solid half of my residency class went rural at first. Between more money and insane loan repayment, its absolutely worth it for a few years at minimum.

Best I heard was one of my classmates who ended up "rural" SC (hour from Columbia, 30 minutes from Florence). 250k starting (and this was 8 years ago mind you) with 50k loan repayment per year for I believe 3 years (might have been 5).

That certainly should be part of the solution, but from what I see in my graduating class, many won't go rural because of their family dynamic.

 

[VA Hopeful Dr]

That certainly should be part of the solution, but from what I see in my graduating class, many won't go rural because of their family dynamic.

IM is less useful in rural settings so that's not really the target audience, especially with the emphasis y'all put on being hospitalists these days.

 

[Splenda88]

IM is less useful in rural settings so that's not really the target audience, especially with the emphasis y'all put on being hospitalists these days.

Are you saying that we are pseudo PCP? Lol

 

[ACSurgeon]

Or just pay rural more. A solid half of my residency class went rural at first. Between more money and insane loan repayment, its absolutely worth it for a few years at minimum.

Best I heard was one of my classmates who ended up "rural" SC (hour from Columbia, 30 minutes from Florence). 250k starting (and this was 8 years ago mind you) with 50k loan repayment per year for I believe 3 years (might have been 5).

I have a friend in a decent size Midwest city (largest in the state) making over 300k as a pcp and got over 150k in loan repayment for a 5 year agreement. Income includes committees and bonuses based on RVUs, not base but still not a bad gig for not being in a rural setting.

 

[VA Hopeful Dr]

Are you saying that we are pseudo PCP? Lol

Rurally, yes. Full scope FM is much more valuable in super rural places than IM since 1 doctor can see all ages, hospital included, and do maternity care.

 

[Spetzler-Martin]

The generation as a whole. You just happen to be one student interested in NSG and that supply won’t change. No one on SDN is going to self identify with the “zoomer” caricature but my gestalt is that Zoomers like to diss the Boomers yet they themselves are growing up in an age seeking quick money and instant gratification. This is the generation of TikTok, kids who think they can day trade for income instead of working a job, and for SDN millennials and zoomers who post tons of maximum salary for 40hr/week threads.

Lol. Well I hate those Tik Tok kids too, so I guess I can't disagree. Saw a video of kids lip syncing to some song in 2018. Vowed to never touch that platform since.

 

[jambro]

We need a special program that recruits doctors to only work in designated underserved areas. Like when they apply they know they’re not working anywhere else; akin to contract that the military does where they decide where you go. Don’t think anything else is going to get these places healthcare

 

[Splenda88]

AAPA responds to medical groups' opposition of rebrand

The American Association of Physician Assistants responded to resistance over its intent to rebrand the PA title to

www.beckershospitalreview.com

 

[Matthew9Thirtyfive]

AAPA responds to medical groups' opposition of rebrand

The American Association of Physician Assistants responded to resistance over its intent to rebrand the PA title to

www.beckershospitalreview.com

Lolol

 

[Redpancreas]

Rurally, yes. Full scope FM is much more valuable in super rural places than IM since 1 doctor can see all ages, hospital included, and do maternity care.

As an IM guy I agree that overall basic primary care is best handled by the FM guys. It’s weird because IM is trying to get into that but it’s half-assed because our training doesn’t adequately cover OB/GYN which is an important aspect of primary care. That said the field of IM is pretty complex and IM training does offer value especially for adults with chronic disease.

 

[Lawpy]

I think i'm losing track of which midlevel thread and topics we're discussing here

 

[Matthew9Thirtyfive]

We need a special program that recruits doctors to only work in designated underserved areas. Like when they apply they know they’re not working anywhere else; akin to contract that the military does where they decide where you go. Don’t think anything else is going to get these places healthcare

The PHS actually decides where you go way more than the military. We get to put in preferences and at least in the Navy they take it into account. Doesn’t mean you won’t get sent to Guam or something, but they at least look at your preferences. The PHS says straight up before you even start med school that you’re going to this place for this many years lol. Wouldn’t be too hard to do something similar.

 

[jambro]

The PHS actually decides where you go way more than the military. We get to put in preferences and at least in the Navy they take it into account. Doesn’t mean you won’t get sent to Guam or something, but they at least look at your preferences. The PHS says straight up before you even start med school that you’re going to this place for this many years lol. Wouldn’t be too hard to do something similar.

Exactly what I mean. Why wouldn't this work; and if it would, why doesn't anybody try and do something about it???

 

[LadyDustyBlue]

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.

Where do you work that this is allowed? Is this at a military hospital? That sounds like the confusion on paper would lead to liability issues at some point. And I’m assuming that you’re mentioning this because it’s not something you’re happy about, but since it’s how it is where you work, you (edit: added on the sentence I didn’t finish) live with it.

I think i'm losing track of which midlevel thread and topics we're discussing here

Yes… this has certainly turned into like 2 or 3 different topics, but it might have been bound to happen.

The value we place on the title, “doctor” or “physician” is constantly being redefined in an economic way. So that can easily veer off into: “How can we make certain that current & incoming physicians feel valued & show them their work has value despite re-labeling other professions that don’t have the same level of training? Probably pay them more to live somewhere else & expose them to places that are underserved, so more people who likely will vote for their interests will see them as valuable.

Or …. xyz?”

Or we can gradually increase residency spots, is a natural alternative path the mind goes for people.

But to go back on topic, I definitely don’t want to be referred to as a “provider” because it sounds like I’m selling someone insurance… and I’ve had some experience seeing how the insurance industry works. I have a brother-in-law who’s an insurance agent. So I agree with the fact that coming up with a different word for a “doctor” or “physician” that isn’t based in the language of medicine or healing changes it’s connotation.

It’s like when different languages die out b/c a government shows them that English should be their primary language. Generations of families don’t end up educating their children enough about their culture or original dialect, that eventually the dialect dies with the last parents who speak it unless there is intervention.

So the same goes w/ how do we see the word “doctor” or “physician” and how do we portray that to the populations we serve? How do they portray the value of a doctor to their children? And how does that help or harm?

It may not seem like it now to some, but how we talk about ourselves & to each other ends up being the reality.

 

[Matthew9Thirtyfive]

Where do you work that this is allowed? Is this at a military hospital? That sounds like the confusion on paper would lead to liability issues at some point. And I’m assuming that you’re mentioning this because it’s not something you’re happy about, but since it’s how it is where you work, you (edit: added on the sentence I didn’t finish) live with it.

Military hospital with a new emr (new as in built over the last few years). I don’t have a choice since I’m a med student lol. It’s ridiculous. The only saving grace is that thus far I have not seen a single NP misrepresent themselves at this facility.

 

[SurfingDoctor]

Shout out to all the providers (future or current) up in here...

 

[Ms Procrastinator]

Lolol

When I saw "medical groups' opposition", I thought NPs had joined in too (I've seen a few role their eyes at the title change). Oh well.

 

[NY_Med]

More than 45 osteopathic physician organizations unite with AOA in support of physician-led, team-based care

Following release of the American Osteopathic Association’s May 28 statement on the Physician Assistant title change and non-physician clinician use of the title “Doctor,” more than 45 osteopathic physician organizations have added their voices in support of physician-led, team-based care. We...

osteopathic.org

 

[FutureSurgical]

An issue I have with expanding residency slots is how there will only be a huge increase in NPs and PAs alongside with the growing population of residency-trained physicians. It's been said before in other threads, but if you only add more blood to a bleeding wound without fixing the injury, you're only going to bleed more. I agree that Rad Onc and EM are great examples of what happens when you increase residency positions without doing anything else: you put more physicians out of work.

There has to be action in other areas as well. The only place I could really think of is fighting independent practice laws. The AANP isn't going to crack down on the degree mills (which include ivy league institutions that have a BSN-MSN/DNP program.) AAPA has shown its hand on what they're trying to do with "OTP" (aka FPA.)

 

[sunshinefl]

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.

Words have meaning.

I think the best way to increase access to primary care in rural areas is to do what Florida has attempted. Give unmatched IMG/FMG a limited license so can only practice medicine in facilities designated by the state.

Yes but on the other hand, as I’ve said in other threads before, that suppresses the wages in those situations which discourages people with residency training from doing those jobs. So they get inferior care. I am from Florida, going into IM residency, want to do primary care, worked in prison for 10 years, strongly considered returning as a physician, but I have full COA loans and I can’t accept the compensation.

It’s funny because the inmates even know about the racket, and hate that they get inferior, non residency trained physicians. Before I left, some told me don’t come back as a doctor because Florida prison doctors are known to be “the rejects” (their words, not mine). Which is extra funny to me because people in this thread are saying the public doesn’t know or care the difference in “providers”, but inmates who have no choice in their “provider” are well informed on it but stuck with them.

As an IM guy I agree that overall basic primary care is best handled by the FM guys. It’s weird because IM is trying to get into that but it’s half-assed because our training doesn’t adequately cover OB/GYN which is an important aspect of primary care. That said the field of IM is pretty complex and IM training does offer value especially for adults with chronic disease.

I want to do primary care (from IM) so I specifically sought out programs with primary care tracks and/or strong primary care training/curriculum/exposure. I don’t see my future role as equivalent to FM, but I don’t want it to be. I specifically picked IM vs FM to avoid the components of FM primary care I don’t like. And I do agree with whoever said FM is better for rural primary care because it is more comprehensive.

 

[NWTR]

Thanks for the article. Lots of great replies on this thread. Curious to see what verbage is going to replace the term ‘Provider’.

 

[deleted966164]

But… why can’t this be actually PROVIDER Associate?

On another note… where I work, there are lists of NPI numbers hang out for use for staff. There are multiple copies of them. They’re divided into “doctors” and “mid levels.” Out of all the copies, the one that hangs by the “we’re the forefront of medicine”-movement has “mid level” whited out and “advanced practice clinician” hand-written in. Lol. I cringe every time I see that…

 

[Matthew9Thirtyfive]

But… why can’t this be actually PROVIDER Associate?

On another note… where I work, there are lists of NPI numbers hang out for use for staff. There are multiple copies of them. They’re divided into “doctors” and “mid levels.” Out of all the copies, the one that hangs by the “we’re the forefront of medicine”-movement has “mid level” whited out and “advanced practice clinician” hand-written in. Lol. I cringe every time I see that…

Can you imagine being that insecure? I had a patient whose parents loved me and wanted me to be their pediatrician. I’m a med student. I said that several times and every time they saw me, they called me doctor. I visibly cringed and corrected them every single time. It just baffles me that these people who have even less training than I do are so eager to trick people into thinking they’re doctors.

 

[watchfulwaiting1957]

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.”

Well then someone would have to education the patients on the different between physician and osteopaths as I have heard the argument that DOs should not be called physicians and should only be called osteopaths and only MDs should be called physicians.

 

[Matthew9Thirtyfive]

Well then someone would have to education the patients on the different between physician and osteopaths as I have heard the argument that DOs should not be called physicians and should only be called osteopaths and only MDs should be called physicians.

I have literally never heard anyone say this.

 

[slowthai]

Well then someone would have to education the patients on the different between physician and naturopaths as I have heard the argument that NDs should not be called physicians and should only be called naturopaths and only MDs should be called physicians.

Fixed that for you

 

[watchfulwaiting1957]

I have literally never heard anyone say this.

Yeah i consider DOs to be osteopathic physicians. So they should still be called physician like a MD.

 

[Matthew9Thirtyfive]

Yeah i consider DOs to be osteopathic physicians. So they should still be called physician like a MD.

I don’t think any MDs would disagree with you.

 

[Chads2]

Well then someone would have to education the patients on the different between physician and osteopaths as I have heard the argument that DOs should not be called physicians and should only be called osteopaths and only MDs should be called physicians.

I’m a DO

 

[Splenda88]

This is getting too pervasive.

The Charlotte Ledger

Delivering smart and essential news to Charlotte, one email at a time. Click to read The Charlotte Ledger, a Substack publication with tens of thousands of subscribers.

charlotteledger.substack.com

 

[Ho0v-man]

This is getting too pervasive.

The Charlotte Ledger

Delivering smart and essential news to Charlotte, one email at a time. Click to read The Charlotte Ledger, a Substack publication with tens of thousands of subscribers.

charlotteledger.substack.com

Gotta get rid of those costly pediatricians I guess.

 

[Matthew9Thirtyfive]

This is getting too pervasive.

The Charlotte Ledger

Delivering smart and essential news to Charlotte, one email at a time. Click to read The Charlotte Ledger, a Substack publication with tens of thousands of subscribers.

charlotteledger.substack.com

“The Ledger asked if the hospital has lowered its charge for newborn care, since replacing neonatologists with neonatal nurse practitioners should result in significant cost savings. Whitfield did not respond to the question.”

Oh, she responded. By saying nothing, she answered loud and clear.

 

[deleted50541]

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.”

This language drives me and my partner nuts. We figure it won't be long before they want to change our white coats and badges accordingly.

"Hi, I'm Provider Mike. I'll be doing your surgery today."

It doesn't help when you hear the executive folks talking about the "consumer experience" and making it painfully clear we're a commodity.

 

[LadyDustyBlue]

This language drives me and my partner nuts. We figure it won't be long before they want to change our white coats and badges accordingly.

"Hi, I'm Provider Mike. I'll be doing your surgery today."

It doesn't help when you hear the executive folks talking about the "consumer experience" and making it painfully clear we're a commodity.

I’d feel embarrassed. It’s not like you’re working in retail, and yet it makes it seem that way which likely doesn’t translate well to some people you’re treating.

Even years ago, as a patient w/ the insurance I had at the time… I remember I was at a hospital approved by that insurance, that’s run like a business (where it was painfully obvious, being in line & just the atmosphere whilst “checking in”). After maybe 2 visits, I was eager to find care elsewhere because I felt like I was just being put into a factory, then never really followed-up with. Maybe they were just serving too many patients but I doubted they lacked the employees. This *is still* a large hospital, with different locations in my county.

It was tough to get an appt with a specialist for something for months for a short consult for a reference to a different specialist. It was clear the hospital had a lot money, but I could feel like the people who worked there were like robots at a hotel or something.

It’s odd, even now, to think about how I’m currently pre-med but I truly hope I don’t work at a hospital like that for most of my career. They were certainly called, “providers” though I know I wasn’t the only person who ever complained it was just a business & the quality of care wasn’t as good as other hospitals because of how it was ran.

 

[Ms Procrastinator]

This is getting too pervasive.

The Charlotte Ledger

Delivering smart and essential news to Charlotte, one email at a time. Click to read The Charlotte Ledger, a Substack publication with tens of thousands of subscribers.

charlotteledger.substack.com

If "Nurses are better than a doctor and more experienced than a pediatrician" Then we should get rid of medical school and pediatric residency. It only makes sense right?! Also if NPs are so much better than pediatricians then what's up with this statement?! "If nurses have questions or concerns, she said, they can call a neonatologist or ask one to come to the hospital." Are they better than pediatricians or not?!

“The Ledger asked if the hospital has lowered its charge for newborn care, since replacing neonatologists with neonatal nurse practitioners should result in significant cost savings. Whitfield did not respond to the question.”

Oh, she responded. By saying nothing, she answered loud and clear.

Lol. Those "savings" go directly to fattening their pockets.

 

[deleted966164]

 

[Ms Procrastinator]

View attachment 338799

 

[Lawpy]

View attachment 338801

Oof

 

[sunshinefl]

Oof

I’m not gonna give you react points for Ms P’s cleverness.

 

[Lawpy]

I’m not gonna give you react points for Ms P’s cleverness.

Sunshiny pls

 

[SurfingDoctor]

Gotta get rid of those costly pediatricians I guess.

Finally, someone said out loud what we were all thinking...

 

[Splenda88]

 

[Matthew9Thirtyfive]

View attachment 340102

I educated some people on the origin of the use of the word provider. None of them knew, and I know at least one of them won’t use it in the future for themselves or anyone else.