-
Practice your interview with the new SDN AI Interview Coach. Choose a school, answer by voice or typing, and receive a personalized feedback report. Available now to all SDN members. Try the AI Interview Coach.
- Status
D
deleted407021
"The term "provider" implies that the relationship between the patient and physician is a commercial transaction. The underlying premise of the "provider" based environment is that health care delivery is essentially a market-based enterprise based on a market ethic."
I think more than the simple use of the term "provider" contributes to this relationship, but it's certainly not helped by the use of such a vague blanket term.
Also this position paper is super old?
I think more than the simple use of the term "provider" contributes to this relationship, but it's certainly not helped by the use of such a vague blanket term.
Also this position paper is super old?
Provider: A term used by midlevels to claim (false) equivalency to physicians.
Advertisement - Members don't see this ad
Funny, doesn't say Provider anywhere on my diploma.
ill drink however much kool aid you want if I get to use the term "provider" instead of "physician or NP or PA or other qualified medical professional who can place orders"
I implore everyone in this thread to read about the origin of the word "provider" in medicine.
1938 Nazi Germany -
Jewish doctors were stripped of their medical licenses and instead of being referred to as doctors, they were demoted to the german word "behandler" translated to as "provider." Non-Jewish doctors married to Jews were forced to divorce their spouses or lose their medical licenses as well. In 1938 Jewish doctors in Germany were no longer allowed to treat everyone - they could only treat Jews.
1942 -
Dr. Lilli Jahn. Her non Jewish husband was forced to divorce her. She moved to another town and opened up shop. Her business card still read “Dr. med Lilli Jahn.” which was illegal at the time, since she was merely a "provider." The gestapo found out she was calling herself a doctor. They sent her to a labor camp, leaving her multiple kids alone without a father (since he was forced to divorce her). She was deported to Auschwitz in 1944 and was never heard from again.
https://pdfs.semanticscholar.org/9684/f277d886cac9f67784911df2c875186bf484.pdf
1938 Nazi Germany -
Jewish doctors were stripped of their medical licenses and instead of being referred to as doctors, they were demoted to the german word "behandler" translated to as "provider." Non-Jewish doctors married to Jews were forced to divorce their spouses or lose their medical licenses as well. In 1938 Jewish doctors in Germany were no longer allowed to treat everyone - they could only treat Jews.
1942 -
Dr. Lilli Jahn. Her non Jewish husband was forced to divorce her. She moved to another town and opened up shop. Her business card still read “Dr. med Lilli Jahn.” which was illegal at the time, since she was merely a "provider." The gestapo found out she was calling herself a doctor. They sent her to a labor camp, leaving her multiple kids alone without a father (since he was forced to divorce her). She was deported to Auschwitz in 1944 and was never heard from again.
https://pdfs.semanticscholar.org/9684/f277d886cac9f67784911df2c875186bf484.pdf
What does that have to do with anything? You cannot call someone a provider because in the past a country called physicians providers AND killed millions of Jews? What kind of logic is this.
It's derogatory to an extremely large group of people who were murdered in the Holocaust. Just like you shouldn't be using the n-word or any other derogatory terms towards groups of people - you must consider the historical significance. I assume you didn't read the article.
"provider" is a very intentional designation by the medical bureaucracy (insurance companies, the governement, even hospitals) to decrease the importance and power of physicians in the health care system. They want us to know "our place". We should all be apalled at this.
I didn't read more than a few sentences of the article, but "behandler" in German does not translate to "provider" with any sort of fidelity. I'm not sure what the author means by "freely translated as," but to claim that a common word in English is so historically charged because it's a translation of an epithet from another language in my mind requires an accurate translation. This seems like a politically expedient criticism of the rise of "provider" in American medicine.
I agree with the line of reasoning that it's detrimental (and frankly offensive) to our profession to intentionally call everyone "provider," but this is a stretch.
I agree with the line of reasoning that it's detrimental (and frankly offensive) to our profession to intentionally call everyone "provider," but this is a stretch.
No it's not
Really? I've provided peer-reviewed evidence that it is derogatory. The onus is now on you to prove it isn't
I'd just ignore him. He's always extremely pro MLP independent practice. Against anything that might hurt Non-Physician Providers feelings.
Advertisement - Members don't see this ad
No, you've provided peer reviewed evidence that Jewish doctors were called "behandlers" as a way to discriminate against them.
So first, behandler is more closely translated to practitioner or treater not provider (someone else already mentioned an issue with that articles translation).
Second, using a common word in the English language isn't derogatory to Jewish doctors who were persecuted by the Nazis. Context matters. Is calling us providers meant in negative ways? Yes, frequently. Is it meant to delegitimize us? No, it isn't.
Hardly. In fact I have testified at my statehouse before to the contrary, but don't let facts get in the way of your character assassination.
Why does there need to be one?
Well if I want to tell the patient to see their primary care provider who may or may not be a physician or for insurance companies/hospitals to indicate the need to have an order placed by a medical provider
Meh, what about internists who don't treat the whole family?
"Please talk to your primary care doc/NP/or PA".
I've heard some specialists say talk to your GP, but that's a pretty outdated term
It's an odd tirade on the semantics of a term that has its place in the medical system
Moving to TIH
Not as much as you'd think, the AAFP is very physician-centric. This is pretty standard for them.
Please keep comments professional and respectful. Disagree with the idea without attacking the user. Thanks.
If they need a physician then you tell them to go see a primary care physician. If they have an established diagnosis and simply need a simple follow up then tell them to see a primary care PA/NP that is supervised. Problem solved.
The AAFP is more open about it. They have had firm positions on midlevels for years while lots of others either haven't or have had them but don't publicize them heavily.
I think it helps that we aren't CMG funded to the same extent that the ACEP and ASA are.
That seems needlessly complicated.
Around here it's "follow up with your family doctor" and trust patients to know if that means their FP, internist, or mid-level.
Advertisement - Members don't see this ad
Did you even read what you wrote?Complicated?Can't be serious.
So first, we have to decide what level of post discharge care they require. That requires you know what takes a physician's level of care and what doesn't in a field not your own.
Second, you're assuming that having an established diagnosis that needs follow up doesn't need a physician.
Third, why are you even trying to stratify people on their post-discharge outpatient primary care needs?
You're adding a whole other level of decision making just to avoid saying provider. Do you not see how that's needlessly complicated?
Edit: if you really care that much, just tell people to see their primary care physician and let them sort it out. It's not hard.
Last edited:
You make good points. Who do you think is better to decide if they need a physician or not? The patient or a physician that is not primary care? My argument is that patients don't have the relevant knowledge to know which to see. I don't have the answers and you bring up good points about triaging. I just don't think that lumping NPs PAs and Physicians all under the same word is respectful to the training that physicians must go through to become physicians.
I don't love the term, but it doesn't even break my top 10 things that bug me on a daily basis. I really do think that most of the time it's a shorthand for "people who can write prescriptions", not ideal but a big ole meh most of the time.
Yeah there are a ton of other things that are headaches in medicine I am sure. I am just a young ole medical student so I understand my perspective on the issue is lacking in a practical sense. Maybe I am just paranoid but I see the logic for a large corporation to hire NP/PAs instead of physicians so that more revenue is generated for the hospital through increased orders of imaging and testing, and they get to pay them less. The first step towards replacing physicians is to confuse patients by using the word "provider" so that patients think the training is equal.
7
762513
As a NP I wouldn't mind if you mistook me for the janitor and used that as my title as long as my patients do well and I'm providing high quality, evidence based care. That being said, many non physician providers take offense to being called a midlevel, and I know many physicians specifically do not use the term around me, which I do appreciate, even if I'm not offended if they forget. The NP/PA's who dislike the term believe, as the article states "The term "provider" is one of bureaucratic origin and has no significance or relevance beyond that created by regulators and insurers." Which is exactly what the term midlevel is, as it was created by the DEA to signify a group of people who prescribe medications yet do not have a medical license. Med students love to throw it at people as a sideways insult, kind of like some physicians feel insulted by the word provider. Just food for thought that if you don't like being called a specific word, you probably shouldn't call other people words they also don't like being called, when there are other words that would work just as well. One of those kindergarten things.
Last edited by a moderator:
Patients still want to see a doctor nine times out of ten. Maybe that'll change, but I kinda doubt it. People either know or eventually realize that we're superior.
Right @Goro ?
One thing you should keep in mind, midlevels do not provide "high quality evidence based care"
Midlevels in a nutshell use the "monkey see, monkey do" approach. They don't know why they're doing what they're doing. They've just seen it done a couple of times so they do it. I'm pretty sure you can find a thread where doctors share all the incompetence they've witnessed being done by midlevels, but I'm not gonna go into that here.
Now that that's out of the way. Physicians do feel insulted by the term provider because we didn't bust our a$$e$ going through med school for us to be equated with someone who, on all objective measures, is not quite up to our standards intellectually. If you can't handle that then maybe you should've gone into med school so that, oh wait (please refer to text in bold)
7
762513
Yawn. Nicely offensive post. I'll just repeat myself since what I'm trying to say isn't really very controversial.
Just food for thought that if you don't like being called a specific word, you probably shouldn't call other people words they also don't like being called, when there are other words that would work just as well. One of those kindergarten things.
Last edited by a moderator:
You obviously don't understand hierarchy.
The difference between us and you is that when we call you midlevels, its your actual title. When you call us provider, you do it to blur the lines between who is and isn't a doctor. You feel offended by it because somewhere deep inside, you have a burning desire to be something more than what you are, just a midlevel.
ok... but you're still a midlevel. The physician is at the top. You're below, in the midlevel category.
7
762513
We're ALL providers here, except you, who's still a medical student. Have a nice Saturday.
I think that they may have to learn the hard way to stick with a doctor. Shots and sniffles? A midlevel will be OK then.
7
762513
Show me where midlevel is my title. It's not on my diploma, its not listed on my state license, it's not put after my name in the EHR, it's not on my business card, and my job doesn't refer to me as such.
So? I'll be a "provider" (lolol) in a couple of months. You're still a nurse and years and years away from being a doctor or real provider of healthcare.
Advertisement - Members don't see this ad
It's what doctors call anyone who pretends to be a doctor
What’s up with
Nurses can also share countless stories of the errors we witness at the hand of the physicians. Does that make every physician incompetent? I’m not sure what’s up with SDNers constantly bashing of midlevels.
Last edited:
You're below med students in the hierarchy of life. An NP is still a nurse, a PA is a doctor's assistant by title (literally). My role is finite, in fact just for another month or so. Your role is permanent.
Sure you can choose to be a prick to other providers, nursing, and ancillary stuff. The only thing you will accomplish is complicating your own job as no one likes to work with a prick
- Status
