Our knowledge of orthopaedics. Your best health.

AN ORTHO-PINION

Jennifer M. Weiss, MD, FAAOS

Any views or recommendations shared in the Ortho-pinions blog are solely those of the authors and do not necessarily represent those of the American Academy of Orthopaedic Surgeons. 

This article is adapted from an article published by Permanente Medicine on December 16, 2019; it has been modified from its original format.

“Hello. I’m Doctor Weiss.”

That simple greeting to a patient and their guardians reveals not only my name, but my role in the child’s care. It lets them know that I am a physician — specifically, I’m a pediatric orthopaedic surgeon — and the leader of the healthcare team.

Why do I make it a point to introduce myself as “Doctor”? Because when it comes to communication between physicians and patients, words matter. And one word, in particular, has tremendous power to upset the doctor-patient dynamic: “Provider.”     

The History of ‘Provider’ in Healthcare

The term “provider” was adopted by federal (U.S.) law in the early 1970s, and in the decades since, it has become largely interchangeable with “physician” in an effort to be inclusive and emphasize the importance of the healthcare team in providing coordinated patient care.

By law, the term “provider” refers to “a doctor of medicine or osteopathy, podiatrist, dentist, chiropractor, clinical psychologist, optometrist, physician assistant, nurse practitioner, nurse-midwife or a clinical social worker who is authorized to practice by the State and performing within the scope of their practice as defined by State law, or a Christian Science practitioner.”

However, these are all distinct and unique professions — some of which require medical training and some of which do not. Each profession has its own degrees, licensing, and certifications. And each has its own area of focus: For example, although an orthopaedic surgeon and clinical psychologist are both doctors and may both treat a given patient, the psychologist cannot treat the patient’s fracture, and the orthopaedic surgeon cannot treat the patient’s depression.

A Potentially Confusing, Harmful Label

Although we collaborate and every member of the orthopaedic care team is important, calling all team members “providers” removes the distinction between the professions in the patient’s mind. If we are all “providers,” none of us are perceived as making unique contributions to the patient’s care. This can cause confusion for patients about which role each team member plays — who will perform their surgery, who will manage their pain after surgery, who will plan their therapy, who will see them at each visit, etc.

Being called a “provider” can also affect the physician’s morale, making them feel less fulfilled or engaged in their careers at a time when physicians nationwide are experiencing an unprecedented rate of burnout. It may feel disrespectful given the effort and skill required to practice medicine. It takes four years to receive an MD or DO degree; to become an orthopaedic sub-specialist, you must complete several additional years of rigorous training as a resident and (typically) fellow. Calling a physician “Doctor” acknowledges their accomplishment and can help make them feel appreciated for their hard-won expertise.

An Official Position on “Provider”

For these reasons, the American Academy of Orthopaedic Surgeons (AAOS) passed a resolution in 2022, taking "an unambiguous stance prohibiting use of the term ‘provider’ to describe any health care professional.”

The benefits of this resolution are clear:

• It establishes and reinforces a doctor-patient relationship based on trust, respect, and open communication.
• It helps patients and their families understand the healthcare team dynamic and which specific contributions each team member is expected to make to the patient's care.
• It gives patients and family members confidence that their care is being orchestrated by a professional who has the advanced training and expertise to diagnose the issue and determine the best possible treatment.

It's time to put “provider” back in its proper context: as a word used to refer to non-professional services in healthcare — like health insurance.

This Ortho-pinion was originally written for A Nation in Motion, the AAOS's award-winning public awareness campaign dedicated to sharing the stories of people whose lives were improved by orthopaedic surgery.