By NIRAN AL-AGBA, MD
As a physician, I am proud of the degree I earned. Upon graduation from medical school, my diploma conferred the title of physician and medical doctor, it did not say “provider.” The word “doctor” originates from the Latin “docere”, meaning to teach. I value highly my role as a teacher to patients, students, residents and colleagues. Physicians should accept nothing less than the title we worked hard to obtain through a great deal of personal and professional sacrifice. It was a small price to pay to join that sacred society of men and women who have devoted their lives to healing.
Calling me a “provider” is a professional insult, no different from that of discriminating based on my race, ethnicity, religion, or gender. The source of any argument can often be found by looking at the language used to frame it. Something about the word provider has always bothered me. So I decided to investigate and learn a little about the history of the word. As I researched this story, I made a very interesting discovery, which surprised me. It turns out the term “provider” was first utilized by The Third Reich, who embraced it to devalue Jewish physicians as medical professionals.
The historic root and use of the word “provider” deserves our attention and reflection because if we forget the tragic mistakes of history, we may be doomed to repeat them. While the more recent movement to disrespect the education and training of physicians was the brainchild of the federal government and corporatized medicine, this disdain for medical
expertise has occurred before–to Jewish physicians living in Germany in 1937, before World War II.
In 1933, the German Society of Pediatrics asked pediatricians who were Jewish to voluntarily resign or be removed from the membership roster. Sadly, an organization that should have been committed to the preservation of all humanity, wholeheartedly embraced Nazi policy, holding their first Aryan National Pediatric meeting in 1934.
In the 1937 issue of the Reichs Medizinal Kalender, a directory
of doctors, the remaining Jewish doctors in Germany were stigmatized by a colon placed before their names [Figure 1]. Their
medical licenses were finally revoked in 1938. They could no
longer call themselves “Arzt” or “doctor.” They were degraded to the term “Behandler” or, freely translated, “provider.” The Jewish
doctors had lost their government approbation. They could no
longer hang out their shingle and even their prescription pads
had to reflect the new law restricting their patients to other
Jews [1].These acts of systematic humiliation forbade the appointment
of Jewish doctors. Additionally, they could not own a typewriter,
enter theaters or restaurants, use public facilities or be on the
street at certain times.
In 1933, 15% of all physicians in Germany were identified as being Jewish. Many were pediatricians, in fact, out of 1253 pediatricians practicing within the borders of the German Reich, 47% were of Jewish descent. Among those pediatricians were many influential scientists who left a lasting impact on the pediatric field. Eduard Heinrich Henoch –famous for identifying a condition called Henoch-Schonlein Purpura – which can be very serious and even life-threatening for children. Abraham Jacobi was a pioneer in pediatrics, opening the very first clinic to exclusively treat children in the United States.
These acts, perpetrated by the Nazi regime, were intended for the purposes of systematic humiliation and denigration of those who had earned the title of doctor through education and training. Following these regulatory measures, a mass exodus of 750 pediatricians from Germany, Austria and Prague ensued. In all, about 50 pediatricians were deported to concentration camps in Eastern Europe, seven of whom survived by the war end. Those pediatricians who were deported took responsibility for the care of the children who were with them and a few brave pediatricians accompanied the children into the gas chambers.
Insulting any person on the basis of their race, ethnicity or gender is morally wrong. Using the word “provider” to describe a physician is and will always be insulting, personally and professionally; it is demeaning and devalues the education and degree conferred upon every physician. Why are physicians forced to suffer repeated use of this derogatory professional insult? And why have physicians as one professional body not risen up in anger at this injustice?
Because physicians are a conduit for insurance companies, hospitals, and even the government, to maintain the flow of money from patients in the healthcare marketplace. The word “provider” also encourages us to consider health care as a commodity and the physician-patient encounter as more business transaction than relationship, which must be grounded in trust and mutual respect. Physicians must not surrender professionalism to commercialism.
One only has to look at the emergence of electronic health record mandates, which facilitate billing for third-parties, and prior-authorizations, which restrict the clinical decision making by physicians to understand how fundamentally irrelevant our profession has become. Federal law has made it illegal to provide pro-bono care to Medicaid or Medicare patients. These and other “innovations” have insidiously dismantled health care delivery. I do not know when physicians accepted being called “providers,” but I do know that we must stop tolerating it. That time is now.
Niran Al-Agba, MD is a pediatrician based in Washington State.
Best read in years. Dr. Al-Agba hit the nail on the head with this. It is time for a real change and transparency.
Thank you. It is time for real change and transparency. Great thoughts. This is a step in the right direction.
Just brilliant and timely, thank you !
“Physicians must not surrender professionalism for commercialism.” Truth. I am a physician, not a provider. Thank you.
My pleasure Cheryl. I wish this article could be required reading for every hospital administrator and insurance executive in the country.
Agree! I want to share this but can’t copy the link.
Thank you for all you do!!! Physicians are not Providers!
Physicians are not providers. It is insulting and insurance companies need to stop using the term.
Yes. I completely agree. Thanks for reading and for your support.
A Doctor-Patient relationship is difficult to break; it involves a mutual effort to advance the health and well being of the sick party. The “managed-care” system requires a large cohort of patients to move to the lowest bidder, and cannot coexist with a system that recognizes the bond between the doctor and patient. The term “provider“ was conceived to imply the relationship was a one-way interaction, and merely a transaction.
It was also in the healthcare industry’s interest to expand the practice of medicine to the nursing profession, since it would cut cost. The concept of a provider fit nicely with this model.
The latest iteration of this progressive devaluation of the physician’s stature is the term “prescriber”, which is in the interest of pharmaceutical companies hoping to further expand the distribution network for their products.
The reality is that there were many in the upper echelon of the medical societies who were complicit in the devaluation of our professional worth.
They failed to represent the interest of physicians, in part because of the different economic perspective of academia versus private practice.
Unfortunately for us all, private practice physicians were rarely represented in the planning for healthcare policy. Medical societies, dominated by academics, had nothing but contempt for private practice physicians,and now private practice is on the verge of extinction.
The insights in the article are profound, but about three decades late.
Thanks for your thoughts and comments. You know three decades ago, I was 14 years old and while I was working as a receptionist at my fathers office, I was not yet a physician. He used to talk about how physicians missed the boat and you should have seen what he did with all those form letters addressed to Provider: he would slash the word in red and write all sorts of sentences with exclamation points.
Anyway, I wasn’t a physician 30 years ago and certainly was not in a place in my life to stand up — I am now and while I am quite late to the party, as you correctly suggest, I am young enough to have at least 40 more years of fight left in me to make a difference. Wish me luck 😉
Absolutely.
I, somewhat like your father, used to rewrite contracts with “Physician” instead of “Provider”. But alas, that battle was lost. The “30 years too late” quip was intended for those who did “miss the boat”, not you. I’m glad that there are people, like you, who understand that language has consequences, and the manipulation of language is a mechanism to change behavior and perception. The “doctor/provider” strategy was intended to pry apart the bond between doctor and patient, and was, unfortunately, successful.
“Calling me a ‘provider’ is a professional insult, no different from that of discriminating based on my race, ethnicity, religion, or gender.”
This has got to be one of the most foolish comments I’ve ever read. It’s not racist to call doctors “providers.” Neither is it racist to call someone Pam when she prefers Pamela. Your bourgeoisieness is showing. You’re not woke. Your words are dangerous and makes the mainstream scoff at people doing real anti racist work.
You, sir, are a fool.
Thanks for reading and sharing your thoughts. I was worried that many in the “mainstream” would attack as you have done, but I feel so strongly about this issue that it is worth it to face the music so to speak.
I understand your point of view and hear what you are saying. I really focused on the historical context of the reference article I found and tried to stay on point.
The mainstream wants to believe physicians are not marginalized. I am a physician sharing that I am feeling marginalized. That is real. As real as any other marginalized group. My words are not dangerous when they are the truth.
I am no more bourgeoisie than any other primary care physician — that is a stereotype, just as inaccurate as most stereotypes. Check your biases please. I am the poorest physician in my hometown and it doesn’t bother me in the least. I am proud to be part of this profession and I am fighting to preserve it.
Sorry. I meant Petite Bourgeoisie. You and I have privilege because of our education that’s not afforded to working class folks. Even if your parents didn’t pay for your school and you were indefinitely out of work that’s still our class. It’s up to us to use our privilege for good which it sounds like you are.
If you feel marginalized it’s probably less due to this fact and more due to patriarchal and anti-Muslim biases. Even if you’re not a Muslim, semitic names bring out the worst prejudices in America. I wonder if your father experienced much of this or if he missed out because he immigrated before the post-9/11 hysteria?
I have known quite a few medical assistants who can’t keep the differences between doctors, PAs, and NPs straight so they use the term “provider” for everyone. Not a single one of them was a neo-Nazi as far as I know. I don’t think that neo-Nazis care about what doctors are called. They’re too busy fighting with each other, e.g. Proud Boys vs. Patriot Prayer, or with Anti fascists to mislabel a doctor enough to make a difference.
If your preference is to be called “doctor,” that’s respectable. But calling everyone who does something you dislike “Nazi” just waters down the message of you and Anti fascists and is quintessential false equivalency. It’s an interesting story but calling someone “provider” is not mutually exclusive to “Nazis”. I understand your preference but the point could have been made better couched in less incendiary terms.
Justin, in answer to your Petite Bourgeoisie comments below…. My parents didn’t pay for my schooling as my father (as a solo pediatrician) could not afford it. I had been saving most of my life (literally since I was five) by working two jobs through high school and college and then borrowed the rest. This thing about my name does always come up however. FWIW, I am a 5th generation Irish Catholic, whose father was an atheist.
I do agree with you that my “point could have been made better couched in less incendiary terms.” But, it is perhaps a character flaw of mine that I sometimes get frustrated to the extent I let my fingers do the venting by typing away on the computer. If it helps you to know, I talk almost the same way I write — pretty fresh, honest, and unpolished.
As for the Provider debate, physicians have been writing about their distaste for it for more than 20 years to no avail, so I did take a stab at it….. Thanks again for your clarifying comments. Keep reading this site as I have plenty more to say that you might find rather interesting. 🙂
Seems your not aware of the distinction of the professional insult as subject and racial slur as a catcha-all. The story here seems to me to illuminate the exact reason someone may take offense to being called a provider where many may not. All those harsh years and student loans do mean something. I am gladly changing the verbiage in myriad reports I send out to a hundred clinicians to no longer state ‘provider’, instead ‘clinician’. Not so hard see… and those who may think in shallow terms such as ‘woke’ might not even know to get their undergarments in a bunch. But those who do know can appreciate the effort Great article!
I agree. By virtue of more arduous training and having a high burden of responsibility/liability than other healthcare providers, medical doctors should indeed be addressed with the respectful term of “physician” instead of being lumped into the “provider” category.
However I think that using a semantics discussion to create a false equivalence between Nazi Germany and the current U.S. to be both disingenuous and dangerous.
The reason for the rise of non-physicians in our healthcare system has nothing to do with government policy. The reason is that of a free-market economic forces. They are cheaper. Patients, healthcare administrators and insurance companies will continue to choose the cheaper non-physician provider option when available. The only organization with the clout to change that is…..the government.
First off, i did not create an equivalence between those two situations. What I did do is review the historical context of a word prior to a time when atrocities were committed upon our fellow human beings. That does not mean I am comparing those two events — this distinction is very important to me. However, the history illustrates how seemingly innocuous things can become so much more. We should value physicians and their education.
Actually, the government and large corporations ARE responsible for this word. Free market forces would have allowed for more separation of identities and encourage competition. Right now Medicare and Medicaid decisions are extrapolated to everything else, including referring to physicians as providers to lump them in to the alphabet soup that healthcare has become.
“First off, i did not create an equivalence between those two situations.”
Of course you did.
Today, doctors being called “providers” doesn’t mean that they are in danger of being gassed to death in concentration camps, does it?
Let’s be clear: You certainly have a right to be called a doctor, if you want. There’s no argument there from me. However, stop your ridiculous comparison and outrageous effort to expropriate the memory of the holocaust just, to a great extent, for the satisfaction of a doctor’s ego. Given the history you’ve presented, only Jewish doctors could justify this, not you (and I say this even though I am not Jewish).
On top of it all, you find it appropriate to accuse those of using the term, “provider” which has fallen into general use —whomever you want to blame— as “nazis”, yet you don’t even have the courage to own up to the fact —fact— that you are trying to create a false equivalence. That’s a bit rich, sir.
At a minimum, I’d say: Find another basis of argumentation or you’ll lose credibility for your point.
As well, seems to me you owe an apology to holocaust survivors. At least —whatever you’re called, provider or doctor— you still keep your livelihood, be paid and receive the same money, and you won’t friggin’ DIE because of it.
Christopher, so first of all many Jewish physicians were consulted before I wrote this piece and many of them had ancestors who were tortured or died at the concentration camps. I would NEVER have written this piece without their input, feedback and approval. It is FOR my fellow Jewish colleagues for which I have written this piece in the first place, no matter how you (as a non-Jewish person yourself) take it.
I absolutely did not draw a comparison between the use of the word and the Holocaust, in any way. Use of the word provider is systematic degradation, the kind of which we have seen before in history. Look at the atrocities that followed that basic systematic degradation. I am talking about how the use of words shapes the culture and a people. That is history and that is factual.
When people do not respect the sanctity of human life and refuse to acknowledge truth (as you have done) when a marginalized group is ask to be identified by their proper educational title, then there is a huge problem. Your comments are a perfect example of that blind disregard for you fellow human beings. It is far easier for you to say that this whole thing was published to satisfy a physicians “ego” than to admit you have bought into the “physician stereotype” hook, line and sinker.
Unfortunately, countless independent physicians across the nation, Jewish and non-Jewish alike, have know the courage it took to write this piece and publish it, and have sent their support, by sharing this piece, tweeting about it or writing down their thoughts over email, thanking me for standing up to bullies like you and others who prefer we remain silenced.
I am not afraid, nor will I back down. What is happening to physicians is WRONG. We are being marginalized and rendered irrelevant for no other reason than we refuse to accept mass generalizations about our profession and our expertise and that is harming our patients and ultimately will harm our society.
You speak of doctors, but I am curious as to your thoughts on the more generic use of the term “provider” to also identify nurses, physician assistants, paramedics, EMTs and other medical professionals who have also put in a lot of time, energy, money and a variety of sacrifices to get trained and “provide” care. Because not all medical professionals can “practice” like doctors do, and I think not clarifying or at the very least acknowledging that there are other medical professions that use the term “provider” may draw criticism that dilutes a very valid observation you had made.
Great question. I do not want ‘provider’ used on anyone period. I would identify others working in healthcare as nurses, physician assistants, paramedics, EMTs and many more. Each has a specific educational background and should be addressed appropriately as a professional. We ALL serve patients. I don’t like provide in addition because it makes it seem like I am doing everything and the patient is not part of the equation. The patient and I are a team, it is their body, their medical condition, and they should feel empowered by their physician or whomever serves their needs. I would be interested in asking how others in healthcare feel about being a generic provider? I don’t like it. I wonder how other professions feel?
I’m a PA-C. I’ve never really had an issue with the term “mid-level provider” (for PA, NP, etc.) or the catch-all “provider” (which we generally use as someone who can be a PCM and prescribe the gamut of medications). I think a catch-all term is necessary, but I agree that “provider” is not necessarily correct. “Clinician” has been thrown out as a replacement.
Wow, not sure where to start here. I have a bit of a dual perspective on this. As a global health physician, I realize that in most low-to-middle income countries the term health care provider is common, accepted, and acknowledges the fact that the healthcare workforce in these countries is much more diverse than in the U.S. with very low physician-to-patient ratios. Sometimes the word clinician or clinical officer is used to designate someone with more extensive training, and some countries (like Myanmar where I currently live) use the term GP to signify doctor/physician, as is seen in some Commonwealth countries. When I’m practicing in the U.S., no, I do not prefer the term ‘provider’. It’s representative of the corporatization of medicine in the U.S. and tries to supplant the patient-physician relationship with that of consumer-provider (I’d argue with the comment above that it’s not in fact a one-way street, but a very negative two-way street).
My dislike of the word ‘provider’, however, is driven by the above, explained somewhat in the last 2 paragraphs of the opinion piece. It is not driven by ego. The choice to go into medicine was mine, and with that I chose the good, the bad, and the ugly that accompanied that choice. Did I sacrifice? Sure, but I also reaped the huge benefits of landing in a honorable, respected, and largely recession-proof profession that pays well. I do not need my ego stroked. I fully agree with the commenter above who was as blown away by I was by the statement “Calling me a ‘provider’ is a professional insult, no different from that of discriminating based on my race, ethnicity, religion, or gender.” This plays into every stereotype of the physician with the God-complex, disconnected from her/his patients, and looking to be continually thanked for ‘sacrificing’ so much for the betterment of mankind. Please. Whatever the origin of the term ‘provider’ in medicine, that is no longer the intent of its use either globally or domestically, and to infer so diminishes the more real argument that we’re being commodified, and that the patient-physician bond is being broken to the disadvantage of both parties. I’m sorry that the author is feeling marginalized. This rebuttal is not meant to be a personal attack on how she/he feels, but to simply state that many of us wholeheartedly disagree that there is any similarity whatsoever in calling us ‘providers’ vs individual or systemic discrimination based on race/ethnicity/religion/gender.
I appreciate your rebuttal and I believe when a group shares they feel marginalized, that is not “having a God Complex.” This is stereotype plain and simple. Please don’t buy into it.
I have been insulted for my gender, height, Being an Irish Catholic and having Arabic heritage. Provider is subtle but degrading nevertheless.
As a global health physician, I believe you are more insulated from what front line medicine has become in the US. I might be wrong but those of us being insulted daily are fed up. Again thanks for your comments.
Dr. Al-Agba (I hope I got that correct), thank you for the article. I had never thought about the title of provider before but I believe in knowing your history. It is funny what little nuances people try to slide past us and we ignore as significant. Thanking you for bringing the past to present. I will definitely not be using that term any longer.
Amy thanks for your comments. For the record I just go by my first name (just don’t call me a provider please!) Yes, language can be used to insult or reframe and that is what has been done by insurers and government.
What is also worrisome is the movement among doctors to create a totalitarian state, remember those non-Jewish doctors in Nazi-Germany enthusiastically adopted the state order and did “great things for public health”. There is a serious movement sponsored by the Lancet to seize control of the food supply of the world, in order to prevent starvation, obesity , and global warming all at once. What could possibly go wrong. Those who disagree would have to be re-educated in camps, and have their obesity treated at the same time.
Seriously,
I am assuming there is sarcasm woven through this whole thing and I do see your point. I will just say this, despite the fact the word Nazi is in the title, words matter. As a reader pointed out below, other changes in language should be the patient listed first as in patient-doctor or patient-physician relationship. I prefer adherence to compliance and LOVE “shared” decision making. That is actually the cornerstone of my practice in that I provide information and guidance and patients make decisions for themselves. I also feel that my patients are brilliant, capable and without a doubt, teach me more than I could ever teach them….
I like the article but could you please let me know where exactly you learned this fact so I can highlight that when sharing it? “It turns out the term “provider” was first utilized by The Third Reich, who embraced it to devalue Jewish physicians as medical professionals.”
Sure and thanks for asking. It is actually an interesting paper. https://www.ncbi.nlm.nih.gov/pubmed/16805231.
There is no grand conspiracy. The use of the term provider comes from 2 main changes in healthcare. The first being that healthcare procedures that were exclusively done by physicians in the past can now be by people other than physicians. Think NPs and PAs doing wellness exams. Many practices supplement the dwindling ranks of physicians with NPs and PAs. It would be incorrect to say “physicians doing the exams in the hospital.”
The distinguishment of who is providing healthcare has been further blurred by everyone wearing scrubs. Female physicians lament being called nurse. How is one to distinguish or refer to any one or group of people wearing scrubs?
The issue is further obscured by those who use the term provider. This is a shortened form of the term “healthcare provider.” ANYONE who provides healthcare is (technically) a “healthcare provider.”
Should we list every possible designation that provides healthcare? Why should we call it healthcare then? Why not list every procedure? Maybe we should just ignore everyone else and just give physicians the credit.
HOW SHOULD WE DESCRIBE A COLLECTIVE GROUP OF PEOPLE OF VARIOUS PROFESSIONS WHO DELIVER HEALTHCARE SERVICES THEN?
Then there is the difference in the terms doctor and physician. Doctors are those who have a doctorate (post graduate) degree versus a physician, being one who is legally authorized to diagnose, treat, and dispense.
Some other healthcare misnomers include doctor-patient relationship versus the patient-physician relationship (the patient being the most important person in the relationship and first), AND adherence versus compliance (adherence recognizes patient autonomy and shared decision making, compliance is paternalistic).
Thanks for your comments and I agree with them to a certain extent. Physicians have been decrying the label “provider” for more than 2 decades yet no one seems to be paying attention. I believe the title does grab attention and there is no grand conspiracy, other than that of insurers and government to belittle physicians. I would prefer to be called Physician, professionally, though I go by my first name most of the time. I am so glad you brought up the misnomers because i think about these often also. The patient should always be listed first as in patient-doctor or patient-physician relationship. I prefer adherence to compliance and LOVE “shared” decision making. That is actually the cornerstone of my practice in that I provide information and guidance and patients make decisions for themselves. I also feel that my patients are brilliant, capable and without a doubt, teach me more than I could ever teach them….
Listen, while it’s certainly reasonable for a doctor —after arduous years of study and perhaps years of professional practice— to very rightly want to be addressed by his or her correct title, it can’t be denied that they are health care providers. The same is true of nurses, dentists, podiatrists, etc.
Therefore, it seems that what has happened is that the line to fill in on insurance forms which asks the name of your health care “provider” got out of hand, the English language being as democratic and anarchistic as it is. Or, it may well be true, as you say, that insurance companies want to format the profession to their liking. Whatever. I’m not arguing with your premises and I see your point.
That being said, it is way out of line —and, yes, outright insane and downright stupid— to compare your issue to that of Jewish doctors in nazi Germany. You’ve got to be kidding. You, or any other doctor in the U.S. today, absolute no right to try expropriate the history of the holocaust just because, in essence, your ego is hurt! So, let’s be clear: While the title, “provider” may not be to your liking —and, I’ll repeat, in my opinion, while your point is well taken— at least you are NOT risking your frigging LIFE because of it!! Are you out of your mind?
Therefore, if you don’t want your fair point to lose credibility, I suggest that you change your basis of argumentation and withdraw this one. Plus, the honorable thing to do would be to apologise to holocaust survivors you’ve insulted for trying to take on the mantle of their history for something which doesn’t deserve the moral weight it brings.
If you can do none of that, please keep your tongue, dowse your ego, and just live with it. You’ll still get the same money under the “wrong” name .. and you won’t be sent to a death camp.
So this article that I referenced was shown to me by my Jewish colleagues when they shared their frustration at being called providers. I support them and their perspective on this issue and therefore, I wrote about it. The mainstream public is struggling with our abhorrence of the term provider. And it can be denied that we are healthcare providers. We provide nothing, instead we serve patients and heal and comfort them.
By recounting the historical context of the word “provider” I expropriated nothing. And as far as physicians not risking their lives, please speak with our current abortion providers who wear bullet proof vests to work. Again this is a fact, one that does not involve the Third Reich. Furthermore, we do risk our lives EVERY SINGLE DAY and it sounds like you don’t even realize it or care. That is appalling to me.
When you call other people stupid, your credibility is automatically in question. I am not going to withdraw anything. I haven’t taken on any historic mantle, that is you reading and extrapolating to suit your conservative and closed minded narrative.
Based on your points, you have bought into the ‘Physician stereotype’ and cannot seem to imagine there are good physicians out there supporting those who feel marginalized. My suggestion is that you come down off your high horse and try to listen more to others who are struggling more than you.
On those same lines, as a Physician Assistant, I do not want to be called a mid-level provider because I do not provide mid-level care. I also do not want to be called a Physician‘S Assistant. I am not the Physician‘s property and I am not their assistant. We should respect everyone‘s professional title.
I do not like the term provider to refer to any professional. I call physician assistants, physician assistant. Agree mutual respect is absolutely imperative. Thank you for your comments.
As someone whos grandparents and father had to escape Germany because they were Jewish, I take huge insult of this reference. All of your rebuttals to the sane people commenting on this issue are you using big words to try and fuel more disparities of those and other readers. I find it gross and disgusting that you wrote an article such as this because you don’t like the word “provider”
This word is not even closely related to the terms throughout history, and used currently, to disparage a group or individual based on religion, race or sexual orientation. You being called a provider does NOT hold the same scathe as what American minorities, the LGBT community, the faithful religionists, or others who have had to deal with this issue not only at work, but in the privacy of their own homes.
Sending a child to school and being afraid of somebody wanting to cause them harm because of race, gender, faith, is not the same as a random patient calling you a “provider”. Are you afraid that your children will be beat up or ridiculed because they are a “providers kid”
You have an issue, yes-you don’t like to be called a provider, and want people to call you doctor or physician. Big deal. So, correct everybody’s language then. Write an article about your training and what you went through to be a doctor, and people should respect you. But honestly-do not dare single yourself out as some sort of prophet who is the same as people around the world and throughout history who have not only had to handle ridicule, but feared for their lives because of it. You are born a specific race, you are born a specific gender or orientation, and for a lot of people, certainly as children, you are born into a religion or belief system. You chose to be a physician.
Your article really should have compared you to a grocery store clerk who is being called a bagger, or a night watchmen who is being called a security guard, or a recruiter being called a headhunter. Being a physician is your chosen career-not who you are. There is absolutely no merit to you comparing yourself to people that have had to endure hatred, death threats or ridicule throughout their lives.
Your writing of this shows your basic lack of understanding of humanities by your inhumane article. Your responses to people that have taken offense to it show your sickening pride in who you are compared to everybody else. It is gross and mis-leading. More than slanderous and scrapes at the scab of improper treatment of people throughout time. You wrote it at a bad time, it is in bad taste and shows your true disrespect of others.
Your whole perspective is shameful. Be realistic next time. Do it right. Talk about your concern. But for God’s sake, keep it in context.
Again, this article was brought to my attention by Jewish physicians who supported writing and publishing this piece. Their ancestors, like yours, escaped or died at Nazi hands. They have thanked me for writing this. And my goal was to offend no one. Physicians feel marginalized and I write for those who cannot stand up for themselves.
Your comment “You being called a provider does NOT hold the same scathe as what American minorities, the LGBT community, the faithful religionists, or others who have had to deal with this issue not only at work, but in the privacy of their own homes” demonstrates you misunderstand the whole post. Being called a “provider” does hold the same scathe as insults on the basis of sexual orientation, creed or belonging to a minority group.
Your level of intolerance for others points of view is kind of disgusting. I think your comments are evidence of the fact physicians endure hatred and ridicule regularly. Your comments are missing compassion, empathy and any shred of understand the meaning of tolerance in support of fellow human beings.
I chose to be a physician. As did thousands of others and they deserve the respect of being called a physician and not a provider.
There is no world where you being called a provider holds the same harsh realities and insults as these other people that are listed.
Maybe Jewish physicians wanted you to write this post, however, they may also be looking out for number one.
Through all of these comments written on the subject you have yet to sit back to see other people’s point of view and the hurt you are causing with this. It is abhorrent that you keep saying you as a doctor feel the same sting as others in the wake of human emotion.
There has been no lack of consideration with anyone’s post for you as a doctor in fact nobody has disagreed with you needing to be called a physician instead of a provider. But there is absolutely no way that this experience is the same for you I recognize that you SHOULD be called a physician. But I don’t recognize that you have it harder than other people listed in these posts. Not one.
Dear Dr. Al-Agba,
You are so correct. Many of us have been struggling with the term “provider”. I have written about this and have received angry comments from the audience like you did. However, they were few and the majority of physicians whom I spoke to about this were as upset as you are and supported me. We do need to fight, we do need to stand up as a profession against this disparaging word that damages the authority of the physician-healer, damages physician-patient relationship (or the other way around- why does this even matter in this “head-neck” relationship?). We need to push medical societies, governments, anyone who is interested in having real medicine and not the “paradise of providers”. Providers are hired by healthcare system and are controlled by it. They loose the ability to advocate for well-being of their patients and are forced by the system to advocate for the “health and well-being” of the healthcare system.
And BTW, I am Jewish, born in the Soviet Union, seen many WWII heroes and holocaust survivors. I have probably more experience with antisemitism than many people born in the US. I do not find anything in the original post upsetting or incorrect or “incensitive” to the memory of the holocaust.
Thank you Michael for your comments and support. A physician whose parents survived the Holocaust called me today at my office and shared how much this post touched him deeply. He agreed with basically everything you said above and said how important it is that we, as a society, do not forget history. I will admit, I had not had much experience with antisemitism, but after the blowback from this post, I have learned a great deal about how insidious that movement is in this country. My next piece will be a follow up to this one about how language is used to shape society and limit the thinking of others. Some who are “outraged” by this post are excellent examples of trying to “shape” thoughts. Again, thank you for your support that the word “provider” needs to be eliminated from our lexicon.
So no, that is not the intent of the post. As far as what you put in quotations that I said, that is not true either. Anti-Semitism is wrong. I have explained above the intention and the history behind the use of this word. You disagree with my take on this subject. Thanks for your comments.
I appreciated this article. I am a retired Registered Nurse who had a very specific specialty that afforded me wonderful working relationships with many physicians. I always cringed, and corrected, my patients when they referred to me as “Doc”. The physicians I worked with worked hard for their degree and to maintain their practice as I did mine. We have different focuses in the care we provide, and to, intentionally or not, group all care under one title dismisses the care and efforts by the specific groups. CNAs work so hard, make your hospital stay so much better and safer. Let’s honor them by calling them by their title. Don’t call them RN. Please don’t call me “Doc”. My pharmacists is not a “provider” like my physician. It’s ok to have titles. It’s when people lose their correct view of themselves in relation to others that titles can become weapons.
This article omits the obvious fact that “health care provider” is a useful term to encompass both physicians and licensed nurse practitioners who independently provide medical care throughout this country. Use “physician” when you mean physician. Use “health care provider” or “provider” when you’re referring to either one or both. Or suggest a term that you like better—perhaps “practitioner”. I personally find the title and premise of this article offensive and ridiculous. I am Jewish and a physician. So you will assume I’m a Nazi if I use the term “provider” to describe people who provide medical care? I also see very little journalistic value in digging up history on the use of a term by Nazis in order to justify your distaste for that term and its commercial connotations, which by your account, precedes your discovery of this history. The fact that Nazis once incorporated a word into their vocabulary in their campaign of oppression and genocide is not an argument against using the word any more than the fact that they once ate eggs for breakfast means that those who eat eggs today have Nazi sympathies. It does not follow. While the history provided here is interesting and important, making spurious arguments about links with Nazi Germany does not help efforts to combat anti-Semitism, which appears to be on the rise. It just makes people less likely to listen next time.
The analogy may be a stretch, and insulting to many, but just try to substitute Provider back to Physician in any contract and see what will happen. There is no doubt that the term Provider intent is to marginalize the Physician.
Are you concerned that you are hinging your entire argument connecting the term “provider” to Nazi practices, on the translation of the German “Beholder” to American English “Provider?”
Stop referring to yourselves solely as the moniker “doctor” and instead refer to yourselves as physicians.
Dr. Al-Agba,
I enjoyed reading your article and your viewpoint is valid in that it forces discussion. Bravo!
I am a strong proponent in using proper title in our medical profession like M.D., Doctor, Physician, Surgeon. Opponents of Physician/Surgeons using their well earned title as Doctor argue it’s confusing, inefficient to say or driven by professional ego. On the contrary, the title of “Dr.” needs to be celebrated every day and acknowledged for more profound reasons.
1. It reminds the bearer of the noble title that their skill is more a responsibility to society and an obligation for sacrifice. In our corporate healthcare system the provider handles clients and members. In Medicine, The Doctor treats and counsels Patients. The Doctor’s skills are built on science and ethics spanning 1000 years. The title Dr. reminds each of us to rise to the occasion daily.
2. When you call yourself Doctor you reinforce your position as the most knowledgable and skilled. You will carry yourself with confidence to properly advocate for yourself, your profession, and your patients. These are the men and women who start their career already with 10 to 20 years of training. The title reminds the Medical Doctor that he/she is beholden to an ideal greater than any healthcare company or government entity.
3. Referring to our colleagues and ourselves as Dr., creates a professional fraternity among a diverse profession that includes various gender, religions, races, ethnicities, customs. It facilitates collegiality and communication that translates into better patient care and better medical care overall. In my family, all the men and women long since retired are referred to as ‘Doctor.’ When my medical students have a patient who is current or former medical doctor, they are told to refer to the patient as Dr. The respect is well earned.
Thank you again
OMG! It was so incredible reading through all the comments and responses. I do not think you were ever equating being called “provider” with people dying in concentration camps at the behest of the Nazis. I think the term provider in the United States has 2 purposes. Provider is used as an umbrella term for all the people in the medical profession. It is too awkward to say physicians, nurses, nurse practitioners, physician assistant, certified nurse assistant, pharmacist, podiatrist, physiatrist… I think the second use is more insidious-an attempt by the healthcare payors (government, insurers, business)- to flatten the field and reduce costs. America is promising healthcare to more people than it can afford to deliver to. One solution has been to increase the number of “prescribers” which is becoming more and more synonymous with “providers”.