"Go Ahead, Call Me a Provider"

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Go Ahead, Call Me a Provider

We have far bigger problems to solve in medicine

Chadi Nabhan, MD, MBA
DISCLOSURES
January 17, 2020

Hello. I am Chadi Nabhan, chief medical officer at Aptitude Health. I'm also a hematologist and medical oncologist and an adjunct professor in the College of Pharmacy at the University of South Carolina.

Recently I came across a feud on social media where physicians were upset about being called "providers." Some of them say, "I am not a provider; I am a doctor," as if the term "provider" is an insult or is degrading, a taboo of some kind. I kept reading these threads and I struggled to understand what the pushback was all about. How do you define provider versus physician? What distinguishes them and does it really matter?

So, who is a provider? A provider is someone who is providing something. If you are delivering a healthcare service to a patient, you are essentially providing that healthcare service; you are providing a consultative service to this patient and to this family. There are other providers as well. If you are a respiratory therapist or a physical therapist, you are providing a different type of healthcare service, and thus you are also a provider. If you are a nurse or nurse practitioner, you are a provider.

There seems to be a lot of angst about putting physicians into the same category as other providers. A physician has a higher degree, and I understand that—hey, I'm a physician too. But I think we have bigger fish to fry. We have more problems to resolve in healthcare than spending hours and days and editorials and commentaries—this video included—trying to defend one point or another. We are all providing healthcare services to patients. We are all providers of healthcare. Some are physicians, others are nurses, physical therapists, respiratory therapists, or medical assistants.

If physicians think they can provide adequate healthcare and good outcomes without the help of everyone else I just mentioned, they're foolish because it just doesn't happen that way. We rely on each other. Physicians rely on nurses. Nurses rely on physicians. We both rely on other providers. That's how patients benefit the most—when healthcare providers work together and don't worry about titles, or what I'm going to be called and what the other person is called.

"How dare you call me a provider rather than a doctor?" What does that matter when it comes to a patient? Haven't you seen one of your patients direct their questions to the nurse as opposed to you? They did this because they felt they could ask the nurse and the nurse answered the question. The nurse provided proper service.

I'll probably get a lot of backlash about this. But ultimately, what I care about most is patients. And to serve patients well, we need to realize that all of us are providers of healthcare services to our patients. We provide different services, but still we are providers. I hope we can focus on the bigger topics, on the more important issues that we need to work together to resolve, rather than spending our energy on asking people to never, ever call us providers. Please, call me a provider anytime.

Dr Chadi Nabhan practices hematology and medical oncology in Chicago, Illinois, and is executive vice president and chief medical officer of Aptitude Health.


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I'm guessing this bozo is able to have this take for a couple reasons. 1. He's Heme Onc and I doubt anyone will be going to a nurse anytime soon to diagnose and treat their cancer. 2. (And probably his biggest motivation) He's part of the C suite at some health conglomerate and there's an army of nurse supervisors he has to keep happy.

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In essence, this doc has a good point to make. Sure, we all have a role and for the complex internetwork to function properly we should all work together. But therein lies the rub: The family becomes dysfunctional when the members get greedy and fail to recognize their proper supportive role and limits.
What he fails to acknowledge is the reason that many docs bristle at being labelled a "provider". There is an economic motive and agenda behind the label. And that is the usurpation of the doc's necessary and legitimate role in healthcare by lesser trained and less competent nurses.
 
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In essence, this doc has a good point to make. Sure, we all have a role and for the complex internetwork to function properly we should all work together. But therein lies the rub: The family becomes dysfunctional when the members get greedy and fail to recognize their proper supportive role and limits.
What he fails to acknowledge is the reason that many docs bristle at being labelled a "provider". There is an economic motive and agenda behind the label. And that is the usurpation of the doc's necessary and legitimate role in healthcare by lesser trained and less competent nurses.

Providers are interchangeable. Doctors not so much. Absolutely an economic motive.
 
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This is the kind of discussion that should be accompanied by at least the mentioning of “tiered care” and/or “practice at the top of the license”.

But we can’t. Because healthcare should be equal for everyone.

There is another article on KevinMD, along the similar line. I just want to point out all these people who are encouraging mid-levels are all specialists. Even the GI doctors saying something like oh they can see patients, but will they say, sure they can scope too...... no sirre....
 
According to his LinkedIn page he's not even a practicing physician any more and as a rule if you aren't seeing patients I don't care what you have to say.

His name isn't listed on the USC College of Pharmacy Faculty website, which is odd to begin with as he lives in Illinois so why would he be on faculty in South Carolina?
 
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Can we start grouping cops, lawyers, paralegals, and judges together, and call them “legal service providers”???
 
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According to his LinkedIn page he's not even a practicing physician any more and as a rule if you aren't seeing patients I don't care what you have to say.

His name isn't listed on the USC College of Pharmacy Faculty website, which is odd to begin with as he lives in Illinois so why would he be on faculty in South Carolina?

He’s an “administrative services provider”. Start referring to your hospital CEO as “property management”, and see how they like it....
 
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="vector2, post: 21538590, member:

I'm guessing this bozo is able to have this take for a couple reasons. 1. He's Heme Onc and I doubt anyone will be going to a nurse anytime soon to diagnose and treat their cancer.
So you are kind of admitting that there are some fields (like heme onc) which are complex and can’t be adequately covered by a midlevel, as opposed to anesthesia.....
 
So you are kind of admitting that there are some fields (like heme onc) which are complex and can’t be adequately covered by a midlevel, as opposed to anesthesia.....
It sounds more like they're saying people won't want to go to an NP for their cancer, more of a PR problem than anything.
 
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So you are kind of admitting that there are some fields (like heme onc) which are complex and can’t be adequately covered by a midlevel, as opposed to anesthesia.....

The "layest" of laypersons knows that cancer is complex, scary, sometimes lethal, and many times requires a high degree of expertise to manage. Anesthesia is much the same but somehow we've done a great job of convincing everyone otherwise.
 
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The "layest" of laypersons knows that cancer is complex, scary, sometimes lethal, and many times requires a high degree of expertise to manage. Anesthesia is much the same but somehow we've done a great job of convincing everyone otherwise.
Your field is a victim of its own success. Anesthesia is, these days, astoundingly safe. So clearly any idiot can do it.
 
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According to his LinkedIn page he's not even a practicing physician any more and as a rule if you aren't seeing patients I don't care what you have to say.

His name isn't listed on the USC College of Pharmacy Faculty website, which is odd to begin with as he lives in Illinois so why would he be on faculty in South Carolina?

He's an adjunct professor. We don't list adjunct professors on our website, either, I'm pretty sure. It's a fairly meaningless title, just means that they are somehow loosely affiliated with the school. Odd that he would list that in his intro, though...
 
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