UC Davis midlevels over students?

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VA Hopeful Dr said:
I've worked for 5 hospitals to this point and in every one of them Provider meant doctor, PA, and NP.

Never seen techs, nurses, RT, or anyone else called it.
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Pharmacists are calling themselves providers now in many places.

Edit: so are speech pathologists, CRNAs, etc.
 
Indebt4Life said:
So I learned that the term "provider" actually has a much darker origin.
I learned this from Physician for Patient Protection

excerpt --"Nazis used “provider” to devalue Jewish physicians, so there is a historical precedent of using the word to subordinate. (Isr Med Assoc J 2006;8[5]:324; http://bit.ly/2KHIDj6.) Please call us physicians"

ER Goddess: Words to Banish from Your Vocabulary Provider,... : Emergency Medicine News
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Wow, that took an unexpected turn.
 
VA Hopeful Dr said:
I've worked for 5 hospitals to this point and in every one of them Provider meant doctor, PA, and NP.

Never seen techs, nurses, RT, or anyone else called it.
Click to expand...
More often then not, those people call themselves providers and it just sticks. Or in some cases, they jump straight to “I’m Dr. xyz” when their badge doesn’t have either sets of letters
 
Goro said:
What terms are HMOs using?
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In written communication (letters, emails etc) with the public and patients, “Healthcare provider” is the general term used for physicians, NPs and PAs.

At least that’s how it is with the HMOs on this volcanic island chain.
 
cj_cregg said:
So maybe I'm out of the loop, and I would never call an individual physician, NP, pharmacist, etc. a "provider," or a group of physicians, NPs, pharmacists, etc. "providers" - I would call them by their proper titles. But I always interpreted "providers" and referring to a group of various types of healthcare professionals - we are all providing care in our various roles. So what is the proper term for that if not providers?

Not trying to be contentious lol, just genuinely wondering.
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"
What is provider status?
Pharmacists and pharmacists’ patient care services are not included in key sections of the Social Security Act (SSA), which determines eligibility for health care programs such as Medicare Part B. In the case of Medicare Part B, the omission of pharmacists as listed providers limits Medicare beneficiaries’ access to pharmacists’ services in the outpatient setting. Other health care professionals who are listed as providers in Part B of the SSA include physicians, physician’s assistants, certified nurse practitioners, qualified psychologists, clinical social workers, certified nurse midwives, and certified registered nurse anesthetists. In addition to providers, Part B provides the list of medical and other health services covered." - Provider status: What pharmacists need to know now
 
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VA Hopeful Dr said:
This is ridiculous.

Is provider sometimes used to blur the lines? No doubt.

Is it also used as a convenient way to say "people who provide medical care to patients"? Obviously.

Just yesterday we had a meeting for all physicians and midlevels about changes in our benefits. So the invitation was titled "Provider Benefit Meeting". I'm around 100% sure that HR isn't trying to promote the midlevel agenda. "Physician and Midlevel Benefit Meeting" is needlessly wordy.
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Almost always agree with you but I think you’re off base here. Wordspeak is powerful and it that is exactly what this is.
 
cj_cregg said:
Oooookay folks, the first 5 responses to my post were sufficient lol. Can I just start off by saying I'm not super thrilled with the implication that my understanding of the word "provider" is a result of me being duped by the mid-level boogeyman somehow? I'm not too dumb to understand stuff like this, thank you very much, nor do I think most med students or physicians are. It seems to me that we're ascribing motivations for using the terminology that isn't there for 90% of folks. The amount of times I've gotten snarky and even outright rude responses on this board for using "provider" in passing when I am very intentionally referring to multiple different categories of healthcare professionals is ridiculous. Pretty sure at one point someone said they hope I grow a pair and start referring to myself as a physician lol. I have 100% seen a few of you who are arguing about this being such a big deal use "provider" once or twice, and you are obviously not part of some secret plan to eliminate physicians and murder patients with sub-par care. In summary: please calm down lol.




Sorry, I should have been clearer - my understanding of "provider" would also include other healthcare professionals who are managing patients completely or semi-independently - pods, dentists, pharmacists, optometrists, PT/OT, counselors, etc. But as others have mentioned perhaps the definition varies based on hospital/region.



I would argue that "healthcare professionals" is broader than the group I'm trying to describe.
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In my opinion being classified as a "provider" as defined in what I posted (see above) is a privilege and bestows more authority. Because as a "provider" you can bill for your services under medicare.
 
cj_cregg said:
Oooookay folks, the first 5 responses to my post were sufficient lol. Can I just start off by saying I'm not super thrilled with the implication that my understanding of the word "provider" is a result of me being duped by the mid-level boogeyman somehow? I'm not too dumb to understand stuff like this, thank you very much, nor do I think most med students or physicians are. It seems to me that we're ascribing motivations for using the terminology that isn't there for 90% of folks. The amount of times I've gotten snarky and even outright rude responses on this board for using "provider" in passing when I am very intentionally referring to multiple different categories of healthcare professionals is ridiculous. Pretty sure at one point someone said they hope I grow a pair and start referring to myself as a physician lol. I have 100% seen a few of you who are arguing about this being such a big deal use "provider" once or twice, and you are obviously not part of some secret plan to eliminate physicians and murder patients with sub-par care. In summary: please calm down lol.
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You quoted me, so I responded to you. I'm calm lol.

I would argue that "healthcare professionals" is broader than the group I'm trying to describe.
Click to expand...

Yeah, I get that. But I also see the term provider being used to confuse distinctions and blur lines, so I am against it.
 
cj_cregg said:
Yeah, the "please calm down" was not directed at any specific person and also not 100% serious, I was just a little overwhelmed by the ~10 notifications I got from this thread lol. And I get where you're coming from, but I do think there's value in distinguishing between between healthcare professionals who are directly engaged in making decisions about management vs. those who are not, whether that person is supervised or not. But I do agree that there are right and wrong ways to use that definition - an NP saying "I'm one of the providers on your team" and leaving it at that is blurring the lines, vs "I'm a nurse practitioner, and I'm one of the providers working with Dr. X's team" where they're just defining exactly what their role is.
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You’re overwhelmed by forum notifications? I’m not one to drone on about millennials but sheesh.
 
Iz_FtB said:
Where are the physicians from the mid-level thread a few weeks back who had nothing but glowing experiences to share?

Not sure why the med student opinion is devalued when we will bear the brunt of this nonsense as our "mentors" sell us out.
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Lol, that's the thing, seasoned physicians today can be indifferent or even supportive of mid levels because by the time the pot starts boiling, they'll be in retirement territory. The sheep in that other thread hang onto the attending's every word like there is a gift waiting for them at the end of it all, and boy what a gift that will turn out to be...
 
Matthew9Thirtyfive said:
I'm not talking about HR. I'm talking about midlevels. I've worked with multiple midlevels who really wanted to be thought of as a doctor. They would introduce themselves as doctor to patients, use the term provider when referring to MD/DO/NP/PA to confuse patients, etc. It is a real thing.
Click to expand...
I know that, read the second line of the post you responded to.
 
Matthew9Thirtyfive said:
Pharmacists are calling themselves providers now in many places.

Edit: so are speech pathologists, CRNAs, etc.
Click to expand...
Funny, there's a thread in the pharmacy forum where they're discussing the fact that they don't have provider status.

CRNAs are the anesthesia midlevels so that's hardly surprising.

I know next to nothing about speech pathologists.
 
Matthew9Thirtyfive said:
You quoted me, so I responded to you. I'm calm lol.



Yeah, I get that. But I also see the term provider being used to confuse distinctions and blur lines, so I am against it.
Click to expand...
For me it depends on circumstance. If I'm lumped in with a big group of health care professionals that all provide/bill for services, the group can be called providers and I don't care.

If I'm being directly addressed and called a provider, that is a different story.
 
Giovanotto said:
Lol, that's the thing, seasoned physicians today can be indifferent or even supportive of mid levels because by the time the pot starts boiling, they'll be in retirement territory. The sheep in that other thread hang onto the attending's every word like there is a gift waiting for them at the end of it all, and boy what a gift that will turn out to be...
Click to expand...
This is an idiotic argument. I'm 35 years old, I've got at least another 25 years of work ahead of me. The pulm/CC guy in that previous thread is at most 40.

Most of you here aren't more than 5-7 years behind me.
 
Matthew9Thirtyfive said:
Okay. Except in context with the rest of the post, you then went on to talk about HR. Which is not what I was talking about, so I clarified.
Click to expand...
No, you said that on this topic it was never okay and I was disagreeing with you and showing a time when it was.
 
The term "provider" is absolutely meant to blur the lines and to elevate midlevels to the same level. Anyone who thinks otherwise has his/her head in the sand.
I have absolutely heard nurse practicioners refer to themselves as DOCTOR. Several. In front of physicians
 
VA Hopeful Dr said:
Funny, there's a thread in the pharmacy forum where they're discussing the fact that they don't have provider status.

CRNAs are the anesthesia midlevels so that's hardly surprising.

I know next to nothing about speech pathologists.
Click to expand...

Oh, there’s a thread on SDN? I guess that means that these don’t exist:

https://join.healthmart.com/business-and-operations/pharmacist-provider-view-future/

The State of Provider Status: An Update for Pharmacy Students



Pharmacists Provide Care

Whether they have it now or not, they want it and some of them are already using the term.

Edit: not trying to vilify pharmacists, just pointing out there are groups of them vying for provider status.
 
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VA Hopeful Dr said:
No, you said that on this topic it was never okay and I was disagreeing with you and showing a time when it was.
Click to expand...

I am pretty sure I made a post where I said that I think it would be acceptable in an administrative setting except for the problem that once you use it there, they will start using it clinically.

Speaking in generalities of course. I am friends with midlevels who don’t want independence, and I am friends with two NPs who went back to working as RNs because they felt way out of their league doing primary care independently as NPs. Obviously not all midlevels are like the aggressive ones who want to be doctors without the work.
 
VA Hopeful Dr said:
For me it depends on circumstance. If I'm lumped in with a big group of health care professionals that all provide/bill for services, the group can be called providers and I don't care.

If I'm being directly addressed and called a provider, that is a different story.
Click to expand...

That’s fair.
 
Matthew9Thirtyfive said:
Oh, there’s a thread on SDN? I guess that means that these don’t exist:

https://join.healthmart.com/business-and-operations/pharmacist-provider-view-future/

The State of Provider Status: An Update for Pharmacy Students



Pharmacists Provide Care

Whether they have it now or not, they want it and some of them are already using the term.

Edit: not trying to vilify pharmacists, just pointing out there are groups of them vying for provider status.
Click to expand...

They've been vying for it since I joined SDN almost 15 years ago.
 
Mr.S said:
The term "provider" is absolutely meant to blur the lines and to elevate midlevels to the same level. Anyone who thinks otherwise has his/her head in the sand.
I have absolutely heard nurse practicioners refer to themselves as DOCTOR. Several. In front of physicians
Click to expand...
And that is a problem.
 
VA Hopeful Dr said:
You mean things change over time? Stop. The. Presses.
Click to expand...

So first you post that they've been vying for it for 15 years and nothing's changed, and then when I pointed out that trying for a long time doesn't mean change won't happen, you respond with a snarky comment about how things obviously change? Smooth.
 
Matthew9Thirtyfive said:
So first you post that they've been vying for it for 15 years and nothing's changed, and then when I pointed out that trying for a long time doesn't mean change won't happen, you respond with a snarky comment about how things obviously change? Smooth.
Click to expand...
I'm very clearly mocking you because this thread has gone off the rails in a ridiculous way.

So riddle me this then: why are you worried about pharmacists getting provider status?
 
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This thread has totally taken a tangent. I will say this one more time and that's it.

The term provider is absolutely meant to blur the lines. Please refer to yourself as a physician or physician student. I am Dr. XYZ, your physician or a physician student. Etc etc.

And for those who are laughing and making fun of "conspiracy theories" that others have thrown out...I've got oceanfront property in Arizona that you might be interested in.

It is a HUGE conspiracy. Trace the money. It's all about the money. Turn on the TV...look at the wechooseNPs commercial, the Johnson and Johnson commercial about how amazing nurses are....these commercials are playing in primetime. Ask yourself where this money is coming from? How did the AANP get so much power? Robert Wood Johnson Foundation. That's how.

Now, read the recent HHS go to scope of practice. What do you think is happening on a FEDERAL level?
https://www.hhs.gov/sites/default/f...0mJsZ3auZncldL3K_P5uUU5R9SwA3dpbl7bqBtzCHc_2o

And you think this is just coincidence? LOL
 
VA Hopeful Dr said:
Just yesterday we had a meeting for all physicians and midlevels about changes in our benefits. So the invitation was titled "Provider Benefit Meeting". I'm around 100% sure that HR isn't trying to promote the midlevel agenda. "Physician and Midlevel Benefit Meeting" is needlessly wordy.
Click to expand...

If an extra 2 words is 'needlessly wordy' then I suppose we have different outlooks on this matter.
 
Indebt4Life said:
This thread has totally taken a tangent. I will say this one more time and that's it.

The term provider is absolutely meant to blur the lines. Please refer to yourself as a physician or physician student. I am Dr. XYZ, your physician or a physician student. Etc etc.

And for those who are laughing and making fun of "conspiracy theories" that others have thrown out...I've got oceanfront property in Arizona that you might be interested in.

It is a HUGE conspiracy. Trace the money. It's all about the money. Turn on the TV...look at the wechooseNPs commercial, the Johnson and Johnson commercial about how amazing nurses are....these commercials are playing in primetime. Ask yourself where this money is coming from? How did the AANP get so much power? Robert Wood Johnson Foundation. That's how.

Now, read the recent HHS go to scope of practice. What do you think is happening on a FEDERAL level?
https://www.hhs.gov/sites/default/f...0mJsZ3auZncldL3K_P5uUU5R9SwA3dpbl7bqBtzCHc_2o

And you think this is just coincidence? LOL
Click to expand...
Its not a coincidence, but not sure its a conspiracy.

Its been long known that midlevels, the NPs more than the PAs to my experience, have been using the "we're cheaper" to sell themselves. Its never been proven, but you know how it is if you repeat something often enough. That's the only reason the Feds care.

Interestingly, I don't think it will make much difference. Over time you don't see savings - they tend to order more testing and if they get independent practice you can bet they'll start asking for more money. We need only look at the CRNAs for evidence of the latter.
 
Okay. Whatever. I don’t think it’s a conspiracy because......????? Just my opinion or more like wish. Then tell me where is the money coming for prime time commercials coming from?
Why does the HHS report want to reduce competition but will allow a merger between CVS and Aetna? Isn't that hypocrisy?

I’m obviously speaking to a bright eyed bushy tail trainee or someone in denial

Until physicians join forces to combat this ridiculous “we are all the same” notion. The legislators will only hear one side

Medscape: Medscape Access

Read this ridiculous article. So you mean to say that just because a persons HBA1C was similar when managed by a physician, NP and PA...we are all the same. That’s quite an assumption.

Honest to God we need to put something just as ridiculous out there. But alas most of us are just sheep that go with the flock minding our own business and hoping there will always be greener pastures
 
VA Hopeful Dr said:
This is an idiotic argument. I'm 35 years old, I've got at least another 25 years of work ahead of me. The pulm/CC guy in that previous thread is at most 40.

Most of you here aren't more than 5-7 years behind me.
Click to expand...
Who has more to lose? Remind me, how much was tuition back then? Interest rates? Who will be able to speak up during a hypothetical scenario of increasing mid-level encroachment, physicians or students? Who's profiting off of mid-levels today, current physicians or students/residents? You can throw numbers out there all day, but the closer one is to paying off his debt and into retirement, the less this will impact them, and the more you can downplay the situation.

Bolded: short sighted point, this could impact future generations of physicians to come, not just "us" on sdn right now who are students; hence why this is a big deal. Anyway, I'm done with this thread, this problem is systemic, fueled by greed, and not unique to medicine in any way.
 
I fear the future of medicine.
Physicians have always been the pinnacle of medical knowledge.
Healthcare is getting more and more expensive while administrators are increasing their salaries. Their hunger is increasing and slowly but surely they are going after physicians.
They already dismantled pharmacy mainly due to greedy school administrators.

I suggest all of you ONLY see and recommend people to other physicians. My PCP will always be a MD or DO. Make this a point to tell your friends and families. Tell your friends that it only takes a few online classes to be a NP.

We must preserve the structure for the future of healthcare, patients and physicians.
 
Indebt4Life said:
Okay. Whatever. I don’t think it’s a conspiracy because......????? Just my opinion or more like wish. Then tell me where is the money coming for prime time commercials coming from?
Why does the HHS report want to reduce competition but will allow a merger between CVS and Aetna? Isn't that hypocrisy?

I’m obviously speaking to a bright eyed bushy tail trainee or someone in denial

Until physicians join forces to combat this ridiculous “we are all the same” notion. The legislators will only hear one side

Medscape: Medscape Access

Read this ridiculous article. So you mean to say that just because a persons HBA1C was similar when managed by a physician, NP and PA...we are all the same. That’s quite an assumption.

Honest to God we need to put something just as ridiculous out there. But alas most of us are just sheep that go with the flock minding our own business and hoping there will always be greener pastures
Click to expand...
You're getting a touch unhinged here.

Its not a conspiracy because its all out in the open. Simple as that.
 
Giovanotto said:
Who has more to lose? Remind me, how much was tuition back then? Interest rates? Who will be able to speak up during a hypothetical scenario of increasing mid-level encroachment, physicians or students? Who's profiting off of mid-levels today, current physicians or students/residents? You can throw numbers out there all day, but the closer one is to paying off his debt and into retirement, the less this will impact them, and the more you can downplay the situation.

Bolded: short sighted point, this could impact future generations of physicians to come, not just "us" on sdn right now who are students; hence why this is a big deal. Anyway, I'm done with this thread, this problem is systemic, fueled by greed, and not unique to medicine in any way.
Click to expand...
Interest rates for me were 6.something, I can't remember exactly.

Between tuition and COL, I was in for about 45k/year - state school for what that's worth. Based on a search just now, total costs/year for a student at my old school is going to be around 55-60k. So about 60k over the 4 years. Not nothing by any stretch, but not terrible either (and for what its worth I've complained about tuition increases quite a bit on here).

I make essentially no money from midlevels ($300/month for supervising one, I think), so I'm pretty sure its not greed motivating anything I do. I'm not THAT cheap of a *****.
 
puahate said:
I fear the future of medicine.
Physicians have always been the pinnacle of medical knowledge.
Healthcare is getting more and more expensive while administrators are increasing their salaries. Their hunger is increasing and slowly but surely they are going after physicians.
They already dismantled pharmacy mainly due to greedy school administrators.

I suggest all of you ONLY see and recommend people to other physicians. My PCP will always be a MD or DO. Make this a point to tell your friends and families. Tell your friends that it only takes a few online classes to be a NP.

We must preserve the structure for the future of healthcare, patients and physicians.
Click to expand...
We still are the pinnacle, don't let anyone else tell you differently.

You have hit the nail on the head - administrators and the corporatization of medicine has and will continue to be much more harmful than anything midlevels can do.
 
Matthew9Thirtyfive said:
The issue many have with the term provider is it has been used by midlevels to blur the difference between physicians and midlevels, creating a false equivalency. “We’re all providers” is exactly what they want people to say and patients to think.
Click to expand...
I’m not so sure “provider” was created by NPs or PAs to conspire to blur any lines. It’s much more likely that’s EHR and/or insurance systems rolled out the term as some lazy, all encompassing term to group together people who bill for services. In my experience as a student, the vast majority of folks using that term are our MD lecturers and PBL facilitators. It seems to have become part of the lexicon now.

I’ve said this in other threads and I’ll say it again here. There has been exactly zero instances where I have overheard a PA student or PA say that we are equivalent to physicians. And I have been around many students, my own faculty, our PA preceptors and guest lecturers, and PAs involved in our state chapter of the AAPA.

As for UC Davis- their PA program is not new. It’s been around for a long time. It’s a small class, I think 40 or less students admitted each year. Some of them are straight PA students, others are NP students who’ve chosen to also complete PA training (which ironically requires them to delay their NP graduation because they have to complete extra clinical rotations to meet our minimum requirements for graduation set by the accreditation standards). Their PA program has a extremely heavy focus on rural primary care. They actively recruit students who are likely to practice primary care in smaller Central Valley farming communities. Those not from California- these are areas like Madera. To that effect, they spend very little time rotating at UC Davis Medical Center and the program tried to have most students complete most of their clinical outside large hospital systems and inside small family practice office environments. I once heard their program director say he doesn’t want his students spending time in hospitals or academic medical center clinics. I applied here and ultimately decided to not go for all these are all reasons- wasn’t the type of training I was looking for.

I have no idea what the current situation is at Davis, but what I know about their PA program doesn’t at all jive with the assertions in this thread. There aren’t enough PA students to take up that many clerkship spots, and the majority of their rotations are done away from the Sacramento campus. I can’t speak for their NP program and what those students who aren’t doing the dual PA training are up to. But hopefully you aren’t lumping two different professions with two different training pathways and that have two different politics together.

I don’t say any of this to change any minds here- but it’s for those people who get here through a google search and start believing things that aren’t universally true.
 
VA Hopeful Dr said:
Its not a coincidence, but not sure its a conspiracy.

Its been long known that midlevels, the NPs more than the PAs to my experience, have been using the "we're cheaper" to sell themselves. Its never been proven, but you know how it is if you repeat something often enough. That's the only reason the Feds care.

Interestingly, I don't think it will make much difference. Over time you don't see savings - they tend to order more testing and if they get independent practice you can bet they'll start asking for more money. We need only look at the CRNAs for evidence of the latter.
Click to expand...
I am shocked this is coming from you...
 
Even my not so good DO school I go to gives us priority ours over the midlevel students. Not that we are fighting for rotation spots worth fighting for but


But then again this is California and the equality for everything bus is in full force even on things where there should be no equality like this.

Also California’s nursing lobby has tons of power (don’t think this does not effect it even if it is school specific and at the education level). I’m surprised midlevels don’t have FPA in Cali being as progressive as it is
 
cj_cregg said:
So maybe I'm out of the loop, and I would never call an individual physician, NP, pharmacist, etc. a "provider," or a group of physicians, NPs, pharmacists, etc. "providers" - I would call them by their proper titles. But I always interpreted "providers" and referring to a group of various types of healthcare professionals - we are all providing care in our various roles. So what is the proper term for that if not providers?

Not trying to be contentious lol, just genuinely wondering.
Click to expand...

Out of sheer laziness, when you're trying to contact the clinician taking care of a patient, it's easier to say "provider" vs. "NP, PA or doctor". Fewer syllables.

However, despite the volume of phone calls I have to make when relaying imaging findings, I've decided that I will never use the term "provider" again.

VA Hopeful Dr said:
Why use 3 words when 1 will do?
Click to expand...

But does it do?

It's semantics, and it depends on what side you're on.
 
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