"Provider"

[Psai]

---

Members don't see this ad.

I didn't miss the point. I understand what everyone is saying. I personally don't think it's a huge deal. I don't see this as a small malicious step towards mid-level providers taking over. We use EPIC, and it's very easy to tell if the provider is a doctor, NP, PA, midwife, etc because your credentials are automatically populated when you input your name.

Maybe I'm wrong, and my opinion can change as I get farther in training. I fully admit that. But right now, I don't care what an EMR will label me as. I see physicians as healthcare providers and I don't feel "above" that word.

In 4 years or so when you can't get a job because a midlevel will accept slightly less pay than you in the same provider position, be sure to come back and post your story here. It's not about the word itself. It's the implication that all "providers" are interchangeable and the same. This is being heavily promoted by np groups who go even farther to saying that they are "just as good or even better" than doctors at being doctors. The dean of the nursing school here actually said that in the graduation speech. If you're fine with working hard for years to be paid the same as someone who cruised through an online course and knows a fraction of what you do while working much less, be my guest.

 

[Ismet]

In 4 years or so when you can't get a job because a midlevel will accept slightly less pay than you in the same provider position, be sure to come back and post your story here. It's not about the word itself. It's the implication that all "providers" are interchangeable and the same. This is being heavily promoted by np groups who go even farther to saying that they are "just as good or even better" than doctors at being doctors. The dean of the nursing school here actually said that in the graduation speech. If you're fine with working hard for years to be paid the same as someone who cruised through an online course and knows a fraction of what you do while working much less, be my guest.

I don't agree that using the word "provider" makes everyone interchangeable and the same. Do I think mid-levels should push physicians out just because they're cheaper? Absolutely not. Do I think "provider" is a completely benign word that is used generally to refer to anyone who provides medical care? Yep.

 

[Psai]

I don't agree that using the word "provider" makes everyone interchangeable and the same. Do I think mid-levels should push physicians out just because they're cheaper? Absolutely not. Do I think "provider" is a completely benign word that is used generally to refer to anyone who provides medical care? Yep.

When it's used by administrators to handwave all the people in white coats into one category, the people who make the decisions about who will provide care in their facilities don't make any distinction between physicians and mid-levels. It's the idea that they are too lazy to separate people. Do you think that the nurses would take it lightly if you included all of the MAs and CNAs in "nursing"? Of course not, they would tell you about how proud they are to be nurses and that they earned the right to be a registered nurse. Have some professional pride in your education.

 

[Ismet]

When it's used by administrators to handwave all the people in white coats into one category, the people who make the decisions about who will provide care in their facilities don't make any distinction between physicians and mid-levels. It's the idea that they are too lazy to separate people. Do you think that the nurses would take it lightly if you included all of the MAs and CNAs in "nursing"? Of course not, they would tell you about how proud they are to be nurses and that they earned the right to be a registered nurse. Have some professional pride in your education.

I do have professional pride in my education, thank you. We have a difference of opinion. When I graduate in a few months, I will consider myself a healthcare provider, because I am providing care, as well as a physician.

 

[sliceofbread136]

You are not a provider in the legal or ethical sense of the word. I hope you don't say this to a patient because that is very unprofessional and will get you in trouble. Also, if an intern doesn't get a medical license, then I want all my license registration fees I sent a check for refunded.

I already said I tell patients I am a medical student multiple times.

And I may be mistaken but to my understanding you start intern year before taking step 3 ie before completing the process for obtaining a medical license

 

[axiomofchoice]

My institution recently color coded scrubs. Guess what: all "providers" got the same color. This includes MD/DO/NP/PA. In the eyes of the administration (the people controlling health care) they're all the same.

Its happening - we (Physicians) are the suckers here for getting 10x the education needed to get the provider scrubs.

Unless of course you're one of the few people in your city who can perform procedures that can't be taught online.

 

[axiomofchoice]

I already said I tell patients I am a medical student multiple times.

And I may be mistaken but to my understanding you start intern year before taking step 3 ie before completing the process for obtaining a medical license

You are mistaken. You need Step 3 for an independent license. You hold a medical training license (starts with MT) the day you step foot in the hospital as an intern.

 

[Psai]

My institution recently color coded scrubs. Guess what: all "providers" got the same color. This includes MD/DO/NP/PA. In the eyes of the administration (the people controlling health care) they're all the same.

Its happening - we (Physicians) are the suckers here for getting 10x the education needed to get the provider scrubs.

Unless of course you're one of the few people in your city who can perform procedures that can't be taught online.

Do the administrators have to wear color coded suits? I don't understand how this is acceptable

 

[username456789]

I don't agree that using the word "provider" makes everyone interchangeable and the same.

It doesn't matter what you think. It matters what everyone else thinks. Particularly those who make decisions.

Do I think "provider" is a completely benign word that is used generally to refer to anyone who provides medical care? Yep.

And it's this attitude that has allowed plenty of midlevel providers to continue to chip away at our piece of the healthcare pie (and not just financially). I really don't mean to pull the "you'll understand when you're in my shoes" card, but it's hard to convey the importance of maintaining an identity as a physician to someone who has yet to become one.

 

[username456789]

And I may be mistaken but to my understanding you start intern year before taking step 3 ie before completing the process for obtaining a medical license

You are indeed mistaken.

 

[racerwad]

I am not pretending anything, I am a provider as I provide medical care. I am using the actual definition of the term not your made up one, which has now shifted from requiring giving care without supervision to having a license (something an intern doesn't even have)

You do and feel as you want, I clearly see there is no getting you off the high horse. Have fun shouting to the world you are a med student. Also, my school gives long coats 😉

As others have pointed out, interns do have licenses - they are institutional training licenses, but licenses nonetheless.

My definition never changed. I think it's pretty clear that you're the one who doesn't know what you're talking about.

And you know what, I didn't mind telling folks I was a med student and I never had any trouble because of it. People were always willing to help me help my patient.

I already said I tell patients I am a medical student multiple times.

And I may be mistaken but to my understanding you start intern year before taking step 3 ie before completing the process for obtaining a medical license

You made it quite clear that you lie for convenience. Maybe you should work on not needing to rely on that tactic to get things done. There are plenty of other ways. Honestly, I hope you consider on doing things differently because intern year can be tough and there is no need to make it tougher on yourself.

 

[oncology2020]

I do have professional pride in my education, thank you. We have a difference of opinion. When I graduate in a few months, I will consider myself a healthcare provider, because I am providing care, as well as a physician.

Lets forget being lumped with midlevels for a second, at the very least the term "healthcare provider" cheapens our entire profession and what we do, patients should not be viewed as "clients" to a "service" we are "providing"..physicians because of our extensive training are so much more diverse in capacity which isn't being recognized by others if we are being lumped with allied health..at our core, we are investigators, scientists, clinicians, leaders, and humanitarians..none of those aspects are conveyed by the term "provider" besides a business transaction between a service provider and its client which completely goes against the ethos of medicine

 

[Ismet]

Lets forget being lumped with midlevels for a second, at the very least the term "healthcare provider" cheapens our entire profession and what we do, patients should not be viewed as "clients" to a "service" we are "providing"..physicians because of our extensive training are so much more diverse in capacity which isn't being recognized by others if we are being lumped with allied health..at our core, we are investigators, scientists, clinicians, leaders, and humanitarians..none of those aspects are conveyed by the term "provider" besides a business transaction between a service provider and its client which completely goes against the ethos of medicine

I'm not following how you're extrapolating the word "provider" to a simplified business transaction. Medicine is a service industry, we have that role in addition to all of those other roles you mentioned, and several of those roles are also shared by mid-level providers. Shouldn't the ethos of medicine be patient-centered care?

 

[Entadus]

I'm not following how you're extrapolating the word "provider" to a simplified business transaction. Medicine is a service industry, we have that role in addition to all of those other roles you mentioned, and several of those roles are also shared by mid-level providers. Shouldn't the ethos of medicine be patient-centered care?

IMO the ethos of medicine should be "primum non nocere". Not every service industry can say the same. A service industry gives (sells) people what they WANT. A physician treats his patients with their best (health) interest in mind.

 

[oncology2020]

I'm not following how you're extrapolating the word "provider" to a simplified business transaction. Medicine is a service industry, we have that role in addition to all of those other roles you mentioned, and several of those roles are also shared by mid-level providers. Shouldn't the ethos of medicine be patient-centered care?

Feel free to read the NEJM article on it

http://www.nejm.org/doi/full/10.1056/NEJMp1107278

 

[WingedOx]

Feel free to read the NEJM opinion piece on it

http://www.nejm.org/doi/full/10.1056/NEJMp1107278

FTFY,
Ugh... Jerome Groopman.

 

[Ismet]

IMO the ethos of medicine should be "primum non nocere". Not every service industry can say the same. A service industry gives (sells) people what they WANT. A physician treats his patients with their best (health) interest in mind.

See, I don't see those things as completely separate entities. If you're going to go with beneficence and non-maleficence, you also have to include patient autonomy and justice. A physician's role is to use his education and training to provide care that is in the patient's best interest, but the patient has a say in the matter too. And sometimes that say is not in their best interest. I'm willing to bet that most patients would like a physician who speaks WITH them rather than AT them, which is the crux of patient-centered care, including the patient in the decision making while providing them with your expertise in evidence-based medicine.

 

[Psai]

See, I don't see those things as completely separate entities. If you're going to go with beneficence and non-maleficence, you also have to include patient autonomy and justice. A physician's role is to use his education and training to provide care that is in the patient's best interest, but the patient has a say in the matter too. And sometimes that say is not in their best interest. I'm willing to bet that most patients would like a physician who speaks WITH them rather than AT them, which is the crux of patient-centered care, including the patient in the decision making while providing them with your expertise in evidence-based medicine.

Did you just take an introductory ethics class? Patients either don't know what's good for them or know but don't care. They come to the expert to listen to expert opinion and receive expert care. That's the whole reason why we train for so many difficult years and learn so many things. What the patient wants and what's best for them are usually polar opposites. It's your job to tell them to stop smoking, stop drinking, stop eating so much, wear a condom and take the medicine as scheduled. Evidence based medicine lol...today's hot off the press evidence is refuted in tomorrow's bleeding edge article. In the end, it's about your knowledge, training and experience from medical school and residency, with evidence based medicine as a guide when you aren't sure about the right course of action

 

[WingedOx]

Did you just take an introductory ethics class? Patients either don't know what's good for them or know but don't care. They come to the expert to listen to expert opinion and receive expert care. That's the whole reason why we train for so many difficult years and learn so many things. What the patient wants and what's best for them are usually polar opposites. It's your job to tell them to stop smoking, stop drinking, stop eating so much, wear a condom and take the medicine as scheduled. Evidence based medicine lol...today's hot off the press evidence is refuted in tomorrow's bleeding edge article. In the end, it's about your knowledge, training and experience from medical school and residency, with evidence based medicine as a guide when you aren't sure about the right course of action

even so, that doesn't change what Ismet is writing... patients still have the right to make those dumb decisions either way.

 

[Winged Scapula]

This won't end. NPs are cheaper. People making legislation don't know how to read a scientific study - so it doesn't matter what these studies show. This in not a matter of NPs becoming independent (which will almost certainly happen), or NP reimbursement rising to meet that of physicians. Ultimately, physician reimbursement will DROP to that of the midlevel. "Providers" will be scheduled interchangeably by the institutions that employ them. The american public will sit back and take it.

Not interested? - Become a surgeon.....

They're not always cheaper.

Awhile back one of the hospitals I have privileges at fired the NPs who were running the Observation Unit because they were slower and consulted the hospitalists a lot; the hospitalists successfully made the case that if they hired one more of them, it would cost less and they would get the work done faster, than the multiple NPs.

 

[username456789]

They're not always cheaper.

Awhile back one of the hospitals I have privileges at fired the NPs who were running the Observation Unit because they were slower and consulted the hospitalists a lot; the hospitalists successfully made the case that if they hired one more of them, it would cost less and they would get the work done faster, than the multiple NPs.

This is only an n=1 example, of course, but a high school friend of mine is an NP and has been for several years. Specifically, she is a neurology NP.

A few weeks ago we were talking, and she told me that her standard procedure for anyone with a chief complaint of "headaches" is to image their brain (CT or MRI). Her reasoning, verbatim: "I just don't want to miss anything bad."

facepalm.jgp

 

[Ismet]

Did you just take an introductory ethics class? Patients either don't know what's good for them or know but don't care. They come to the expert to listen to expert opinion and receive expert care. That's the whole reason why we train for so many difficult years and learn so many things. What the patient wants and what's best for them are usually polar opposites. It's your job to tell them to stop smoking, stop drinking, stop eating so much, wear a condom and take the medicine as scheduled. Evidence based medicine lol...today's hot off the press evidence is refuted in tomorrow's bleeding edge article. In the end, it's about your knowledge, training and experience from medical school and residency, with evidence based medicine as a guide when you aren't sure about the right course of action

Haven't taken ethics since undergrad, but if we're talking about ethos of medicine, there are 4 traditional pillars of ethics. If you're going to say first do no harm, that's great, but patients also have autonomy in healthcare.

Our medical education is evidence-based medicine. The care you give to patients is based on evidence that smoking is bad for you, evidence that obesity has detrimental effects on health, instead of just the physician's belief of what is right.

I take it you're not going into primary care. If you read what I wrote, I already said that it's the physician's job to provide patients with all the information and counseling necessary to come to a decision, but ultimately it is the patient's decision, whether it's good or bad for them.

 

[username456789]

I take it you're not going into primary care. If you read what I wrote, I already said that it's the physician's job to provide patients with all the information and counseling necessary to come to a decision, but ultimately it is the patient's decision, whether it's good or bad for them. Are you as much of a bully to your patients as you are on SDN?

Just wait until you get a paycut because the patient's decision is to continue eating Krispy Kremes and not taking their insulin/statin/antihypertensive.

I'm not saying it's not still your job to encourage them. Or that you should bully them.

I'm just saying that medicine is f*cked up when you actually start to practice it outside of the make-believe world of medical school.

We're all in for a bumpy ride.

 

[Ismet]

Just wait until you get a paycut because the patient's decision is to continue eating Krispy Kremes and not taking their insulin/statin/antihypertensive.

I'm not saying it's not still your job to encourage them. Or that you should bully them.

I'm just saying that medicine is f*cked up when you actually start to practice it outside of the make-believe world of medical school.

We're all in for a bumpy ride.

I know that. While I'm sure I only know a small fraction of what actually practicing medicine is like, I don't think my med school experience has been make believe. I've done a lot of primary care work and I've had these discussions with attendings. It's not a perfect world. Patients make stupid decisions that continue to negatively affect their health, and both patient and physician will see consequences.

 

[Psai]

I know that. While I'm sure I only know a small fraction of what actually practicing medicine is like, I don't think my med school experience has been make believe. I've done a lot of primary care work and I've had these discussions with attendings. It's not a perfect world. Patients make stupid decisions that continue to negatively affect their health, and both patient and physician will see consequences.

But at least they'll know that they're ignoring a real life doctor and not a fake wannabe who doesn't have a medical degree. Oh wait no they won't because we'll all be white coat wearing providers

This is only an n=1 example, of course, but a high school friend of mine is an NP and has been for several years. Specifically, she is a neurology NP.

A few weeks ago we were talking, and she told me that her standard procedure for anyone with a chief complaint of "headaches" is to image their brain (CT or MRI). Her reasoning, verbatim: "I just don't want to miss anything bad."

facepalm.jgp

As her career progresses, she will eventually start finding the bad things that her imaging caused. The number of tests you do is inversely correlated to the amount of medical knowledge you have

 

[Ismet]

But at least they'll know that they're ignoring a real life doctor and not a fake wannabe who doesn't have a medical degree. Oh wait no they won't because we'll all be white coat wearing providers

You must be a real pleasure to work with.

The vast majority of NPs and PAs I've worked with in a medical team or worked alongside in a clinic are extremely beneficial to the practice. Sure you will still have your bad apples, you'll find that everywhere and in every field, and maybe I have a biased view with experience in only one healthcare system with some excellent providers. But they are able to see surgical follow-ups, bread and butter medicine, etc that frees up the physician to see more complicated patients, perhaps even allows them to spend more than 15 minutes with each patient, and ultimately the practice gets to treat more people. Some of the surgical services here are run by PAs on the floor (along with a resident), taking care of paperwork, pre-op, post-op, etc, which frees up surgeons and residents to do surgery.

It's obvious we're not going to see eye to eye, so that's all I'm going to say about it. I just hope you don't bully and talk down to people in real life like you do on SDN.

 

[chipwhitley]

The whole "provider" thing is becoming a huge joke. With all these different degrees and certification programs popping up and the alphabet soup of letters showing up on people's white coats, most patients will have absolutely no no clue what any of these "providers" background or qualifications really are. As I've said before, I'd rather get my diagnosis from an app than a random "provider" of the future. At least it'll be cheaper.

 

[Entadus]

This is only an n=1 example, of course, but a high school friend of mine is an NP and has been for several years. Specifically, she is a neurology NP.

A few weeks ago we were talking, and she told me that her standard procedure for anyone with a chief complaint of "headaches" is to image their brain (CT or MRI). Her reasoning, verbatim: "I just don't want to miss anything bad."

facepalm.jgp

Neurology NP? Sounds like an oxymoron. I really wonder what kind of neuro courses and clinical experience are required for that "specialty". (Is it even possible for a nurse to have the necessary expertise to diagnose and treat neurological disease??)

Apparently you can train in neuro in 6 months! http://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/neuronursing/fellowship/


P.S. I'm not knocking the people. I'm making fun of the (lack of) training.

 

[chipwhitley]

Neurology NP? Sounds like an oxymoron. I really wonder what kind of neuro courses and clinical experience are required for that "specialty". (Is it even possible for a nurse to have the necessary expertise to diagnose and treat neurological disease??)

Apparently you can train in neuro in 6 months! http://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/neuronursing/fellowship/


P.S. I'm not knocking the people. I'm making fun of the (lack of) training.

It's pretty ridiculous that physicians sit around and let this happen, while at the same time complaining that our already rigorous training isn't rigorous enough. I loved how the ACGME CEO complained about the "assistant physician" thing stating that primary care was too complicated for a fresh grad MD to handle because "anything could walk in the door", but in the same state fast-track, online degree NPs can practice independently. I wonder how the NP grad is going to handle those rare diseases they haven't even learned about so much better than the MD.

 

[username456789]

Neurology NP? Sounds like an oxymoron. I really wonder what kind of neuro courses and clinical experience are required for that "specialty". (Is it even possible for a nurse to have the necessary expertise to diagnose and treat neurological disease??)

Apparently you can train in neuro in 6 months! http://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/neuronursing/fellowship/


P.S. I'm not knocking the people. I'm making fun of the (lack of) training.

This is the reality across most specialties. The training is minimal, and the ability to easily switch from one specialty to another in a matter of months is one of the big draws to the field.

 

[WingedOx]

Just wait until you get a paycut because the patient's decision is to continue eating Krispy Kremes and not taking their insulin/statin/antihypertensive.

I'm not saying it's not still your job to encourage them. Or that you should bully them.

I'm just saying that medicine is f*cked up when you actually start to practice it outside of the make-believe world of medical school.

We're all in for a bumpy ride.

Unfortunately when you back up and look at it from the people who are ultimately responsible for your salary (the insurances and public sources) you can see why this is. If you see a patient in your office and prescribe a med that the patient ultimately never fills or takes, that entire office visit was a huge waste of the payer's money. For better or worse we've become a results-based business because too much money has been going flushed down the toilet.

 

[chipwhitley]

Unfortunately when you back up and look at it from the people who are ultimately responsible for your salary (the insurances and public sources) you can see why this is. If you see a patient in your office and prescribe a med that the patient ultimately never fills or takes, that entire office visit was a huge waste of the payer's money. For better or worse we've become a results-based business because too much money has been going flushed down the toilet.

There's a problem with how we're getting paid. If I buy a TV from Best Buy I can't go back and get a refund a year later because I never had time to watch it and it became a waste of money.

 

[sliceofbread136]

As others have pointed out, interns do have licenses - they are institutional training licenses, but licenses nonetheless.

My definition never changed. I think it's pretty clear that you're the one who doesn't know what you're talking about.

And you know what, I didn't mind telling folks I was a med student and I never had any trouble because of it. People were always willing to help me help my patient.



You made it quite clear that you lie for convenience. Maybe you should work on not needing to rely on that tactic to get things done. There are plenty of other ways. Honestly, I hope you consider on doing things differently because intern year can be tough and there is no need to make it tougher on yourself.

I never lied, if I get asked specifically my title I give it. If I think mentioning I am a student will make it so my job won't get done I don't mention it. Your definition did change over the course of the thread, and doesn't fit with the actual definition of the word, which is what I used. I see no dishonesty with using the actual definition of a word, and I remain unconvinced by you. Maybe you are right and I am truly just a dishonest person who won't make it intern year, I guess we will just have to see.

However I feel like I am just repeating myself in this conversation and don't see the need to continue. Have a good day.

 

[chipwhitley]

I never lied, if I get asked specifically my title I give it. If I think mentioning I am a student will make it so my job won't get done I don't mention it. Your definition did change over the course of the thread, and doesn't fit with the actual definition of the word, which is what I used. I see no dishonesty with using the actual definition of a word, and I remain unconvinced by you. Maybe you are right and I am truly just a dishonest person who won't make it intern year, I guess we will just have to see.

However I feel like I am just repeating myself in this conversation and don't see the need to continue. Have a good day.

I'm on your side and I think the guy who's giving you a hard time would do the same thing if he needed to do it to get ahead, he's just on his high horse online.

 

[WingedOx]

There's a problem with how we're getting paid. If I buy a TV from Best Buy I can't go back and get a refund a year later because I never had time to watch it and it became a waste of money.

And if Samsung or RCA were in the business of making most of their money on you viewing content with the TV set itself a glorified loss-leader this might be a good analogy.

The problem though is if I'm your insurance payer, public or private, I need you to deliver positive results for me because the consequences of you failing to do so will be me losing money in the long-run. Should you have repeated failures to improve outcomes, then quite simply I'm going to stop paying you to fail. You can argue that it's the patient's "fault" that things aren't getting better but in the end I'm not in the business of assigning blame, I'm in the business of putting my money where I'm getting results.

 

[chipwhitley]

And if Samsung or RCA were in the business of making most of their money on you viewing content with the TV set itself a glorified loss-leader this might be a good analogy.

The problem though is if I'm your insurance payer, public or private, I need you to deliver positive results for me because the consequences of you failing to do so will be me losing money in the long-run. Should you have repeated failures to improve outcomes, then quite simply I'm going to stop paying you to fail. You can argue that it's the patient's "fault" that things aren't getting better but in the end I'm not in the business of assigning blame, I'm in the business of putting my money where I'm getting results.

Yeah, I understand that. It's just business. But then what happens is I decide to ditch the patients who are hurting my performance and so does everyone else. Those patients end up with very few doctors to take care of them and get even sicker, requiring even more expensive treatment and ED visits, which ends up costing more in the long run?

 

[WingedOx]

Yeah, I understand that. It's just business. But then what happens is I decide to ditch the patients who are hurting my performance and so does everyone else. Those patients end up with very few doctors to take care of them and get even sicker, requiring even more expensive treatment and ED visits, which ends up costing more in the long run?

yup. Though depending on where you practice dropping patients for non-adherence can only be so possible before you aren't left with a lot to choose from. Communities where you can build up a practice fully stocked with rich, fully adherent patients are going to be the exception rather than the norm (and the ones where this is the case, you'll have competition). It's an unintended consequence to be sure, but the alternative wasn't helping anyone either.

 

[Psai]

You must be a real pleasure to work with.

The vast majority of NPs and PAs I've worked with in a medical team or worked alongside in a clinic are extremely beneficial to the practice. Sure you will still have your bad apples, you'll find that everywhere and in every field, and maybe I have a biased view with experience in only one healthcare system with some excellent providers. But they are able to see surgical follow-ups, bread and butter medicine, etc that frees up the physician to see more complicated patients, perhaps even allows them to spend more than 15 minutes with each patient, and ultimately the practice gets to treat more people. Some of the surgical services here are run by PAs on the floor (along with a resident), taking care of paperwork, pre-op, post-op, etc, which frees up surgeons and residents to do surgery.

It's obvious we're not going to see eye to eye, so that's all I'm going to say about it. I just hope you don't bully and talk down to people in real life like you do on SDN.

I'm not sure how you survived third year if you think I'm trying to bully you.

 

[racerwad]

I'm on your side and I think the guy who's giving you a hard time would do the same thing if he needed to do it to get ahead, he's just on his high horse online.

Whenever I was doing this exact thing - calling for records, labs, etc - I always told them I was the X-year medical student. Never had a problem. Maybe I got ahead by doing a better job than you two?

 

[chipwhitley]

Whenever I was doing this exact thing - calling for records, labs, etc - I always told them I was the X-year medical student. Never had a problem. Maybe I got ahead by doing a better job than you two?

Or more likely you were just lucky enough to not encounter someone rude who didn't want to deal with med students?

 

[Over9000]

Removing the distinction between MD and mid-level so that they are all lumped under the "provider" term is a way for administration to devalue the high cost of physician services by equating it with lower trained, lower intellect individuals. As a result physicians will lose control of patient care.

You'll never see the CEO sharing the same title with the middle manager of the hospital library. There's a reason for that. Since the C-level seems to be the new leader of the healthcare "team" we should try to adopt their strategies to regain our position. They've certainly outsmarted us "smart" doctors.

I am saddened that many physicians and students who have posted here are not just ambivalent but welcome this inappropriate, insulting term.

 

[chipwhitley]

Removing the distinction between MD and mid-level so that they are all lumped under the "provider" term is a way for administration to devalue the high cost of physician services by equating it with lower trained, lower intellect individuals. As a result physicians will lose control of patient care.

You'll never see the CEO sharing the same title with the middle manager of the hospital library. There's a reason for that. Since the C-level seems to be the new leader of the healthcare "team" we should try to adopt their strategies to regain our position. They've certainly outsmarted us "smart" doctors.

I am saddened that many physicians and students who have posted here are not just ambivalent but welcome this inappropriate, insulting term.

You are one of the few people here that gets it.

 

[Over9000]

Here is a nice article regarding "The new language of medicine". It was published in NEJM in 2011. It's behind a paywall so be aware of that.

http://www.nejm.org/doi/full/10.1056/NEJMp1107278

 

[WingedOx]

Here is a nice article regarding "The new language of medicine". It was published in NEJM in 2011. It's behind a paywall so be aware of that.

http://www.nejm.org/doi/full/10.1056/NEJMp1107278

You do know that the same article was posted upthread, right?

/and I'll give the same response... "Jerome Groopman... ugh 👎"

 

[Doudline]

You'll never see the CEO sharing the same title with the middle manager of the hospital library. There's a reason for that. Since the C-level seems to be the new leader of the healthcare "team" we should try to adopt their strategies to regain our position. They've certainly outsmarted us "smart" doctors.

The reason being that literally only one person can have the title of CEO at any moment?
(Bar co-direction.)

 

[Over9000]

The reason being that literally only one person can have the title of CEO at any moment?
(Bar co-direction.)

You do understand that by taking the term doctor away from us that they're essentially eliminating medicine as a profession and relegating it to the status of well-trained worker-bee (but not leader) along the lines of engineers, teachers and nurses, right?

It has nothing to do with the singularness of one's position - that's a red herring. It has everything to do with devaluation of credentials and usurpation of control.

I also think that it is incredibly ironic that, how despite the general jokes and snips within medicine as a whole about dermatology and pathology not being medicine, that a dermatologist and pathologist are among the few folk on this thread that see this for what it is.

 

[Doudline]

You do understand that by taking the term doctor away from us that they're essentially eliminating medicine as a profession and relegating it to the status of well-trained worker-bee (but not leader) along the lines of engineers, teachers and nurses, right?

It has nothing to do with the singularness of one's position - that's a red herring. It has everything to do with devaluation of credentials and usurpation of control.

I also think that it is incredibly ironic that, how despite the general jokes and snips within medicine as a whole about dermatology and pathology not being medicine, that a dermatologist and pathologist are among the few folk on this thread that see this for what it is.

A red herring? What a mess. I'm not responsible for your nonsensical analogies.

As for your other point: the exclusivity of care granted to physicians has eroded. It's a fact that certain patients have mid levels as their sole source of health care. The care these nurses and PAs provide is not necessarily equivalent to that of physicians, but from an administrative perspective both providers are the same (or roughly so, and only in states that allow it).

The stance taken by hospital administration right now is apolitical - they are witnessing a change on the field and changing their administrative tools to adapt to this change. The results, from your perspective, may advantage the "other side", but it's a nonetheless apolitical move in nature.

What YOU -and others- are suggesting is for hospital administration to take a a political stance - to take your side. To, despite the reality of mid-levels providing physician-like care -again, competence is not the point here-, pretend that they don't, or to make it more difficult for them to practice. Yet what pushes administration the support you one day -money, power- might push administration to the other side the next. It's a dangerous game to play.


EDIT: I do believe that, in OP's case, the action was apolitical, although I'm not implying that "recognizing" mid-levels in general is apolitical.

 

[chipwhitley]

You do understand that by taking the term doctor away from us that they're essentially eliminating medicine as a profession and relegating it to the status of well-trained worker-bee (but not leader) along the lines of engineers, teachers and nurses, right?

It has nothing to do with the singularness of one's position - that's a red herring. It has everything to do with devaluation of credentials and usurpation of control.

I also think that it is incredibly ironic that, how despite the general jokes and snips within medicine as a whole about dermatology and pathology not being medicine, that a dermatologist and pathologist are among the few folk on this thread that see this for what it is.

From what I've seen, I believe that many, if not most, doctors nowadays are already in the same category as all those other professions you have mentioned since they are increasingly not autonomous and are replaceable cogs in a huge healthcare machine run by business people. Does that seem accurate to you?

 

[sliceofbread136]

Whenever I was doing this exact thing - calling for records, labs, etc - I always told them I was the X-year medical student. Never had a problem. Maybe I got ahead by doing a better job than you two?

Lol I doubt it. You seem like the DO sub 220 step score kind of guy with a chip on his shoulder.

 

[Carbocation1]

http://gomerblog.com/2014/09/surgeon-general/