Provider vs. Physician

Please read NIRAN AL-AGBA, MD’s blog piece called If You Call Me a Provider, I Will Assume You are a Nazi.  

In it she traces back the origin of when doctors were first called “providers”:

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.

I recommend you read her whole piece. It was nicely done and reinforces YOUR belief that you should not be called a “provider”. We are physicians. We sacrificed our youth to get here. Others, with less education and less training, pretend to be “as good as” and they aren’t. Others, with less education and less training, are calling themselves doctors. Do not let anyone convince you that you are worth less. It’s time to fight back.

We are physicians. Let others be called providers.

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  21 comments for “Provider vs. Physician

  1. Steve O'
    February 10, 2019 at 10:17 pm

    A small idea to think about:

    The paradox of tolerance is a paradox that states that if a society is tolerant without limit, its ability to be tolerant is eventually seized or destroyed by the intolerant.
    Karl Popper first described it in 1945—expressing the seemingly paradoxical idea that, “In order to maintain a tolerant society, the society must be intolerant of intolerance.”

    Do we tolerate the use of muzzy verbiage to dilute ideas which, if they are to have utility, must be kept clear?
    One of the first thing that 20th century revolutionaries did was to seize the language in order to change it into Newspeak. If one owns the language, one owns the device of higher thought, it is said. This change weakens dialogue less than it does one’s frame of reference about the self.
    If I am insecure about something, then I crave objective symbols which imply recognition and achievement. Humility requires the refusal to claim bogus achievement and expertise; a habit which is essentially dead in the United States.
    I have no concern about re-telling the story of how Germany cast aside much of its medical skill and knowledge by denigrating the Jewish doctor. The meaning conveyed in the use of the word “Nazi” in modern American debate is almost nil. There is a point to be made in referring to the days in which the NSDAP Nazi Party cast its ugly shadow in Germany and Europe.
    The penance for misusing the word “NAZI” should not be shouting. It should be rather a requirement to read the works of VIktor Klemperer especially his notebook on how the Nazi’s used the German language to shape the thinking of the people. It is Lingua Tertii Imperii, and is mandatory reading for all Americans who wish to keep society free, in my opinion.

  2. Gary
    February 10, 2019 at 2:04 pm

    I think those in the medical profession should insist on the use of specific credentials when referring to doctor, physician’s assistant, and nurse practitioner. As a consumer, when I’m sick, I expect to see a doctor. Anything less, misleads the public and should be clarified before a visit. Using the word provider flattens those in the medical field not a kind of fast-food industry. It’s like calling a chef a cook.

  3. Sir Lance-a-lot
    February 10, 2019 at 11:15 am

    I agree with this piece wholeheartedly, but I would point out that a large reason for the use of the abhorrent appellation “provider” outside of the realm of medical billing is a simple matter of “customer relations” and avoidance of interpersonal awkwardness:

    If the “nurse” says, “The doctor will see you now,” that is straightforward and universally understood.
    If the “nurse” says, “The Physician Assistant will see you now,” the patient’s question is, “Why won’t the doctor see me?”
    If the “nurse” says, “The Nurse Practitioner will see you now,” the patient’s question is, “What’s a Nurse Practitioner?”
    If the “nurse” says, “The provider will see you now,” the patient’s question may be “What’s that?” but after a while, through sheer repetition, it begins to sound normal, and the unfortunate “nurse” (ie: medical assistant) is saved from having to answer the other above questions, or even to deal with the question of whether the patient is going to see a doctor or an “assistant” today, putting it off until the patient sees the whites of their eyes.

    The use of the “P-word” by administrators is a different story, and I feel it as a direct and cutting personal insult every time I receive some sort of message addressed to, or referring to me as, a “provider.”

    At least at my current job, the staff, including the PAs and NPs, are scrupulous about calling us “Doctor.” It’s a small thing, and one I’m not egotistical enough to insist on myself, but at least I get that morsel of respect.

    • JRDO
      February 10, 2019 at 12:07 pm

      “If You Call Me a Provider, I Will Assume You are a Nazi”. That is the title of the article.
      You agree with this wholeheartedly?

      So…a secretary from the radiology department calls my office and asks to speak to the provider who ordered an xray because of a coding issue.

      Because she used the term “provider” to describe me, I should now assume that she buys into the entire Nazi ideology?

      • Doug Farrago
        February 10, 2019 at 12:51 pm

        The title is extreme but the overall point she makes is important. I am looking at the big picture. You can argue the title with her.

        • JRDO
          February 10, 2019 at 2:15 pm

          We agree that it is insulting to call physicians “providers”.

          I find it ridiculous that we are going to get all pissed off about improper use of the term “provider” but we are ok about being very sloppy about the use of the word “nazi” which is infinitely more harrowing. Taking it up with the author is well and fine, but I believe it should be called out here as well instead of being tacitly approved.

      • Sir Lance-a-lot
        February 10, 2019 at 12:58 pm

        I agree with the ARTICLE.

        The headline is not the article, and, in general, throughout the publishing world, the headlines of opinion pieces and of news articles are written not by the authors, but by editors and similar types, in order to be provocative and to attract eyeballs (or clicks). This is a very basic fact of publishing that one really needs to understand before one criticizes any piece of published writing.

        But, now that you bring it up, how do we know that YOU’RE not a Nazi?!?
        Attend any Bund meetings lately, Fritz?

        • JRDO
          February 10, 2019 at 2:22 pm

          Ah, a little bit of debate and you resort to name calling.
          So now I’m a “Fritz” and like to attend “Bund meetings” because I object to the sloppy usage of the word “Nazi”.
          You must’ve gone to the DJT school of playground diplomacy.

          • Sir Lance-a-lot
            February 10, 2019 at 3:40 pm

            I’m obviously joking.

            The fact that the joke is eighty years old would be a giveaway to some.

            I bring up Nazis and their relationship with, and control over, the German medical profession all the time. Their central organizing theme, of physicians’ obligation to “der Volk,” rather than to the individual patient, was introduced gradually, and was ultimately used to justify first the euthanasia of the mentally infirm, and ultimately the murder of millions, all committed and/or organized by physicians in the belief that their actions were “healing” the “body” of “the People.” None of this occurred in Roman times or the Middle Ages, or in Darkest Africa or Vietnam, but within living memory, to modern, civilized people, in the Europe where many of our ancestors grew up, and where most of us are comfortable travelling, visiting friends, and spending time. The physicians who committed these crimes were trained in modern scientific medicine, post-Flexner (albeit in a different country), were supported by their government and their medical boards, were following philosophies explicitly espoused by their national Medical Association, and believed that they were doing their jobs as doctors.

            While I agree that one must be restrained in calling other people Nazis, or in comparing unremarkable acts and beliefs to Nazism, the fact is that our governing structures are flirting with, and slowly moving toward, the same philosophies that not only allowed, but encouraged, the extermination of millions of men, women, and children, and there is no meaningful movement to oppose them, and this constitutes an increasing danger to not only our careers and callings, but to our entire society.

  4. JRDO
    February 10, 2019 at 9:42 am

    I 100% agree that physicians should be called physicians, not providers. The term
    physician is one of respect that has been earned by undergoing significantly more arduous training and having greater responsibility/liability compared to other “providers”.

    Creating a false equivalency between our current U.S. government to Nazi Germany is disingenuous and dangerous.

    Nowadays, the term “provider” is hardly unique to the government. Non-governmental organizations (NGO) and government organizations (GO) in healthcare both use the term.

    The related issue as to why the non-physicians providers have gotten so popular has a free-market reason. They are cheaper. What’s the answer to preventing more erosion of physician’s ever diminishing role in caring for patients in the U.S.? It’s not the free-market is it?
    Patients, hospital administrators and health insurance companies will continue to choose a cheaper option if it’s available.

    • Pat
      February 10, 2019 at 10:56 am

      That “free market” is … not. So much of these economics were created by government interference in the industry, inviting obscene lies like the notion of non-profits, that end up soaking everyone. From government licensure to payments/auditing, to absurd mandates jacking up overhead, to unjustifiable price inflation- none of that is “free market.”

      Medicare can, for example, require a physician to pay for a translator out of his own pocket, or imprison those who commit grievous clerical errors with no proof of intent to defraud. There is no false equivalence in noting that a nation may embrace the totalitarian abuses of a previous.

      I will here the first nationwide “provider” strike, and laugh my ass off when the whole rotten mess implodes.

      • Par
        February 10, 2019 at 11:26 am

        “Cheer”. Damn autocorrect.

      • Pat
        February 10, 2019 at 11:26 am

        “Cheer”. Damn autocorrect.

      • JRDO
        February 10, 2019 at 11:33 am

        I know this is off topic, but I’m curious. Pat, are there any health & safety governmental organizations or programs at any level that you think are good? Vaccinations, NIH, CDC, Medicare/Medicaid, EPA, NHTSA, EPA, health education curriculum, licensing boards etc? Do you think they all should be dissolved?

        • Pat
          February 10, 2019 at 1:50 pm

          As I have often written here:
          1) Medicare should be phased out and abolished as a grossly inappropriate federal role, economic disaster, and cheap vote bribe.
          2) ALL social safety net/Medicaid activity should be at the state level. NO federal involvement
          3) I would grudgingly keep the CDC as a matter of national defense. And yes, I am very much pro-vax.
          4) The NIH??? That corrupt gov’t porkfest that started this MOC/recert extortion racket? I’d absolutely dump it.
          5) I’ve seen the EPA building in DC, and we don’t have enough environment to justify it. I’d give them at least a 50% cut, and look for more.
          6) And while jousting windmills, I’ve got serious doubt regarding the morality or efficiency of licensing boards that effectively make me a gov’t agent (see yesterday’s piece). I am 100% FOR individual disciplines certifying physicians, and let the customer inform himself. I am FOR hospitals hiring whoever they please without gov’t coercion.

          Yes, yes, I know all of that is radical and never going to happen. But I don’t like being told what to do in a daily basis, nor do I like telling anyone else what to do. Every damn thing in medicine now comes down to collective enactment through force, not of necessarily the best way, but of the way decided by those with the right pull.
          Even as physicians are victims of this growing machine, we are also contributors to our own strangulation, and it makes me sick.

          • Pat
            February 10, 2019 at 4:15 pm

            And apologies! The MOC scam came from the IOM, not NIH. Both of which I’d can 😁 as inappropriate federal functions.

          • JRDO
            February 10, 2019 at 5:29 pm

            You do understand that your views are not help by the majority of U.S. citizens including physicians? I think your views are considered very far right. In broad terms, in my opinion, the reason countries on the lists who rank higher than us have the success that they do is because they understand good government can be a tool to improve lives.
            https://www.usnews.com/news/best-countries/quality-of-life-rankings
            https://en.wikipedia.org/wiki/Where-to-be-born_Index

            Certainly government can be done poorly regardless of the economic model. In terms of quality of life, think of socialism done well by the Scandinavians vs socialism done poorly by Cuba, or think of capitalism done well in the U.S. vs capitalism done poorly in Mexico, or communism done poorly by the Soviets vs communism done better by China. The largest difference is the presence of corruption not the economic model. I’m no fan of Communism, but I think the quality of life is probably better in China than Mexico because Mexico is one of the most corrupt places in the world. It’s corruption that we need to be constantly vigilant against. Ideology that government is inherently bad misses the benefits that good (non-corrupt) government can do.

            It’s nice that Doug posted this article on a Sunday, I’d have much less time to communicate if it were a weekday.

    • Doug Farrago
      February 10, 2019 at 11:02 am

      She has a disclaimer about comparing Nazi Germany in her piece and deals with that issue well.

    • Steve O'
      February 10, 2019 at 10:31 pm

      It is worse to allow the dehumanization of society, than to use bad words.
      I see growing tolerance towards eugenics. It follows the concept that humans produce value by working. If they become aged or infirm, they then begin to drain capital from the society. At the zero point, would it be reasonable to end their burden on society? That is eugenics.

      • Pat
        February 11, 2019 at 11:31 am

        And yet sacrificing the autonomy of all patients and physicians, and ultimately an entire economy, for the open-ended support of retirees is regarded as compassionate. And suggesting that this is wrong a failure is akin to eugenics??

  5. Pat
    February 10, 2019 at 8:16 am

    And they got there in 1933 via increasing government control of health care. This ever resurgent egalitarianism is always more concerned about erasing earned hierarchy in deference to majority feelings. That’s where all this “part of the medical team” nonsense pushed by medicine mouthpieces comes from.

    Of course, anyone pushing for more government control of health care should be glad to be demoted to “provider.” That’s a small sacrifice to make for the common “good.”

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