Government and commercial insurance sectors were early adopters of the term “provider” in health care, with Medicare using it since 1965 to describe entities eligible to receive Medicare payment.
But physician leaders at Delaware-based Bayhealth have had enough, and they are putting a stop to using the term “provider” when referring to physicians.
“Some are unaware of it, but some physicians find it a very negative and derogatory term to address them,” said Thomas Vaughan, MD. “It is felt to have come from insurance companies and others who are trying to make medicine transactional, as opposed to a relationship between patients and physicians.”
Dr. Vaughan is chief wellness officer and founding chair of the physician wellness committee at Bayhealth, which is a member of the AMA Health System Program that provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
Bayhealth has also been recognized (PDF) by the AMA Joy in Medicine™ Health System Recognition Program.
“We discussed this in a couple of committee meetings and decided that it was an area that we could have an impact and maybe help decrease some burnout among physicians,” Dr. Vaughan said.
“Maybe it's a little thing,” he said of avoiding the word “provider” to describe physicians. “But our approach with burnout is to take on a lot of the little things because there is not one answer to the problems in today’s medical environment.”
Reducing physician burnout is a critical component of the AMA Recovery Plan for America’s Physicians.
Far too many American physicians experience burnout. That's why the AMA develops resources that prioritize well-being and highlight workflow changes so physicians can focus on what matters—patient care.
Many think the term “belittles” the education and training required to become a physician, Dr. Vaughan said.
The AMA House of Delegates agrees. It adopted policy that considers the generic term “provider" as “inadequate to describe the extensive education and qualifications of physicians licensed to practice medicine in all its branches.”
Similarly, the AMA also has policy urging “all physicians to insist on being identified as a physician, to sign only those professional or medical documents identifying them as physicians, and to not let the term physician be used by any other organization or person involved in health care.”
The policy also calls for ensuring that “all references to physicians by government, payers, and other health care entities involving contracts, advertising, agreements, published descriptions, and other communications at all times distinguish between physician … and nonphysicians, and to discontinue the use of the term ‘provider.’”
“Calling medical doctors ‘providers’ does more than inflict moral injury,” says a Bayhealth presentation Dr. Vaughan uses when speaking to health system staff. “It reduces morale, worth, purpose, and results in already overworked doctors finding less meaning in the work that they do. The word ‘provider’ comes between doctors and their patients, thus chipping away the joy in practice.”
“I have presented this at multiple meetings,” said Dr. Vaughan, who has been with Bayhealth for more than 30 years and served as radiology chair for about half of that time.
His presentation also includes a Mayo Clinic Proceedings editorial which notes, “Respect is a cornerstone of professionalism in medicine. The language we use is a critical medium through which respect is conveyed to colleagues and patients.”
The editorial points out that the AMA is not alone in opposing the use of the term. Also on board with avoiding it are the American College of Physicians, American Academy of Family Physicians, and the Journal of Graduate Medical Education, among others.
Meanwhile, physicians with the University of Wisconsin School of Medicine and Harvard Medical School explained in a 2021 JAMA®Viewpoint column that “the personalized, important nature of health care depends on trust and professionalism, with the expectation that clinicians will place the needs of those they serve ahead of their own and those of their organizations.”
“When used to designate those who care for patients, ‘provider’ has the potential to suggest that patients are mere consumers, serviced without commitment to professionalism,” the column says.
At Bayhealth, the word “provider” has been removed from medical staff bylaws and, if it is spotted as a substitute for “physician” in any of the health system’s publications or other materials, a call is placed to “gently explain” the new policy, Dr. Vaughan said.
The person using the term is often well-intentioned, so Dr. Vaughan said he approaches the call with sensitivity to avoid putting the other person on the defensive.
“When people see you doing things for them and that you're advocating for them—whatever it is—I think it's helpful for morale and helpful for everybody.” Dr. Vaughan. “It takes a lot of little things to change culture.”