Over the last decade the word “provider” has been used more and more when describing physicians and other clinicians. Language is an extremely important catalyst to changing cultures and the utilization of this word “provider” does have significant implications to a not-so-subtle change to our health care culture. Now I understand fully the need to move away from hierarchical thinking and actions in health care, especially in high reliability organizations, but I am also aware that this is having secondary, if not unintended, consequences.
The health care industry over the last decade or so has seen many more non-physicians providing care to patients, whether it’s advanced practice nurses, physician assistants, psychologists, chiropractors, or EMTs. Now some of this is very good because of shortages of doctors, and from pure economics, it also makes sense. Nevertheless, the unintended consequence of this language change is that physicians who take the longest to train and have the strongest background in pathophysiology and treatments are now becoming a commodity.
A commodity that then begin to think of themselves as employees instead of professionals. When they think like an employee, they begin to act like employees: losing the aspect of professionalism that differentiated them from others.
I’m not naïve enough to believe that being professionals doesn’t imply great quality. Too many doctors don’t use evidence-based practice, tend not to adapt science with any sense of eagerness or aren’t able and don’t keep up with the literature since it’s almost impossible with the explosion of information.
Having said this, the changes that society will feel is that the physicians will become just another provider, thus changing the relationships they have with patients and making their future interactions more “consumer-based” instead of patient-physician based. My solution would be to not use the word provider but rather use the word clinician when describing professionals who take care of patients. Even in high reliability organizations, there is a need to have admirals or captains of the ship.
If we continue to use “provider” to describe physicians and other clinicians who provide care to patients, I fear the impact will be a dilution in the quality of care the patients receive.
Phil Kibort, MD, is Children’s vice president of medical affairs and chief medical officer. Read his bio here.