The simple act of calling a physician a “provider” is sparking debate within the medical community, with the American College of Physicians (ACP) issuing a position paper arguing the term undermines the profession’s ethics, and integrity. The discussion, gaining momentum on , centers on the potential harm caused by language that devalues the specialized training, clinical judgment, and ethical obligations inherent in the practice of medicine.
The Erosion of Professional Identity
The ACP’s stance, detailed in a paper released today, asserts that referring to physicians as “providers” diminishes their expertise and the crucial patient-physician relationship. “Words matter,” stated Jason M. Goldman, MD, MACP, president of the ACP. “The word ‘provider’ is derogatory and offensive. It demeans our entire profession and does not encompass everything that we do.” He emphasized that physicians offer more than just a service. they bring years of dedicated learning, intellectual rigor, and a commitment to ethical conduct to patient care.
This isn’t simply a matter of semantics. The ACP argues that the term “provider” frames healthcare as a transactional exchange, rather than a relationship built on trust and expertise. Physicians are not merely “providing” a service like a store or restaurant; they are applying specialized knowledge and ethical principles to diagnose, treat, and counsel patients. This distinction, the ACP contends, is vital for maintaining the integrity of the medical profession.
A Historical Perspective on the Term
The use of “provider” in healthcare has a surprisingly long history, originating with the passage of Medicare and Medicaid legislation in 1965. Initially, the term was used to identify entities eligible for reimbursement by these government programs. Over time, however, it broadened to encompass all healthcare professionals, including physicians. As noted in research published in JAMA, the term gained traction in the 1970s as insurance companies adopted it, further solidifying its place in the healthcare lexicon.
However, this widespread adoption has not been without criticism. Erlich and colleagues, writing in the Journal of Graduate Medical Education, described the term’s evolution as an attempt to “co-opt” language and reframe the physician-patient interaction as a market-based transaction. They argue that this shift has contributed to a sense of disempowerment among physicians and a focus on metrics rather than patient-centered care.
Ethical Implications and the Patient-Physician Bond
The ACP’s position paper, authored by Lois Snyder Sulmasy, JD, and Jan K. Carney, MD, MPH, delves into the ethical implications of using the term “provider.” The authors highlight the importance of distinguishing the physician-patient relationship from purely commercial interactions. They emphasize that physicians have a duty to act in their patients’ best interests, avoid harm, and respect their individual dignity – obligations that extend beyond simply delivering a service.
The historical roots of the words themselves underscore this distinction. “Physician” derives from the Latin word physick, meaning medical treatment, while “patient” comes from patiens, meaning one who suffers. This etymology, the ACP argues, reflects the inherent compassion and care that should characterize the medical encounter.
the use of “provider” can obscure the differences in training, expertise, and responsibilities among various healthcare professionals. It fails to acknowledge the unique skills and ethical obligations that come with being a physician.
A Call to Reclaim Professional Identity
The ACP’s stance is not new. Robert McLean, MD, took a pledge with ACP members in 2019 to refrain from using the term “provider.” Goldman anticipates strong support for the position paper within the medical community, viewing it as a call to reclaim professional identity and reaffirm the value of the physician-patient relationship.
However, he acknowledges potential resistance from administrative and corporate entities that have embraced the term for efficiency and control. “If they push back on this, it speaks to their desire…to continue to control health care and physicians and not improve the system,” Goldman stated. He believes that resisting the use of “provider” is a crucial step towards prioritizing patient care and restoring the integrity of the medical profession.
The ACP recommends using “physician” to specifically refer to medical doctors and employing terms like “clinician” or “healthcare professional” when referring to individuals with varied credentials. This simple linguistic shift, the ACP argues, can have a profound impact on how physicians perceive themselves, how patients perceive their doctors, and how healthcare is delivered.
The debate over terminology highlights a broader conversation about the corporatization of healthcare and the potential for administrative practices to undermine the core values of medicine. As the healthcare landscape continues to evolve, the ACP’s position serves as a reminder of the importance of language and its power to shape perceptions, influence behavior, and impact patient care.
